Clinical Effect of Thoracoscopic Internal Fixation in Treatment Multiple Rib Fractures and Analysis of Analysis the Ameliorative Effect of Pulmonary Ventilation Disorde
LUO Hua, PENG Jianming, YUAN Yuexi
Changsha Central Hospital Affiliated to Nanhua University, Hunan Changsha 413000, China
Abstract：Objective: To analyze the thoracoscopic internal fixation in treatment multiple rib fractures and analysis of analysis the ameliorative effect of pulmonary ventilation disorder.Methods: 112 patients with multiple rib fractures who were treated in our hospital from October 2017 to January 2019, theoe patients were divided into control group (n=54) and treatment group (n=58) according to simple random method. The control group was treated with traditional open reduction and internal fixation, while the treatment group was treated with thoracoscopic internal fixation. The operation conditions, clinical efficacy, visual analogue scale (VAS), blood gas analysis, changes in pulmonary ventilation function before and after the operation and complications between the two groups were compared. Results: The incision length, operation time, intraoperative blood loss, postoperative thoracic drainage volume, postoperative ventilator usage time and hospitalization time of the treatment group were lesser than those in the control group (P<0.05). On the 1st and 3rd day after operation, VAS and arterial blood carbon dioxide partial pressure(PaCO2) in both groups decreased. The treatment group was lower than the control group, while arterial oxygen partial pressure(PaO2) in both groups increased. The treatment group was higher than the control group. 14 days and 6 months after operation, the forced expiratory volume (FEV1), maximum ventilation volume (MVV) and forced vital capacity (FVC) in the first second of the two groups all increased. the treatment group was higher than the control group. VAS, blood gas analysis and pulmonary ventilation function indexes of the two groups had interaction between time and groups. there were statistically significant differences between the two groups in the above indicators 1d and 3d postoperatively (P<0.05), there were statistically significant differences within two groups in the above indicators 1d and 3d postoperatively(P<0.05). The incidence of complications in the treatment group was lower than that in the control group (P<0.05).Conclusion: Thoracoscopic internal fixation is safe and effective in the treatment of multiple rib fractures, which can effectively reduce pulmonary ventilation dysfunction with less postoperative complications.
[1] Marasco SF, Martin K, Niggemeyer L, et al. Impact of rib fixation on quality of life after major trauma with multiple rib fractures[J]. Injury, 2019,50(1):119~124. [2] Maduka AKI, Lin GJ, Lim WW, et al. A comprehensive analysis of traumatic rib fractures in an acute general hospital in singapore[J].Emerg Trauma Shock, 2019,12(2):145~149. [3] Kelley KM, Burgess J, Weireter L, et al. Early use of a chest trauma protocol in elderly patients with rib fractures improves pulmonary outcomes[J]. Am Surg,2019,85(3):288~291. [4] 李世健,邢万红.切开复位内固定治疗外伤性多发肋骨骨折临床疗效及手术时机评价[J].中华创伤杂志,2016,32(6):533~535. [5] 汪方清,徐美青,胡卫建,等.胸腔镜下辅行手术与传统手术治疗多发性肋骨骨折的不同疗效对比[J].中国内镜杂志,2018,24(4):48~51. [6] 国建飞,张金玲,邢琳琳,等.胸腔镜辅助内固定术治疗多发肋骨骨折的效果观察[J].解放军医药杂志,2018,30(2):54~57. [7] 陆熠,盛波,丁一,等.胸腔镜辅助内固定术与传统手术治疗肋骨骨折的效果观察[J].中国综合临床,2015,31(8):753~755. [8] Carver TW, Kugler NW, Juul J, et al. Ketamine infusion for pain control in adult patients with multiple rib fractures: Results of a randomized control trial[J].Trauma Acute Care Surg, 2019,86(2):181~188. [9] Fagevik Olsen M, Slobo M, Klarin L, et al. Physical function and pain after surgical or conservative management of multiple rib fractures - a follow-up study[J]. Scand Trauma Resusc Emerg Med, 2016,24(1):128.
2020, Vol. 26 
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