胸腔镜辅助下钛镍记忆合金钢板内固定治疗肋骨多发性骨折患者的疗效与安全性

Efficacy and safety of thoracoscopic assisted titanium-nickel memory alloy plate internal fixation in patients with multiple rib fractures

摘要:

目的 探讨胸腔镜辅助下钛镍记忆合金钢板内固定在肋骨多发性骨折患者中的疗效与安全性。方法 选取该院2018年1月－2019年12月87例肋骨多发性骨折患者作为研究对象，随机分为对照组（n = 43）和观察组（n = 44）；对照组行胸部护板外固定，观察组行胸腔镜辅助下钛镍记忆合金钢板内固定；比较两组术后恢复情况、肺功能指标、治疗效果和并发症发生情况。结果 观察组ICU停留时间、机械通气时间、住院时间、下床活动时间和胸腔引流时间明显短于对照组［（3.74±0.63）和（5.58±1.21）d、（2.68±1.65）和（9.78±2.36）d、（19.46±3.27）和（26.85±2.73）d、（10.18±2.22）和（16.23±2.42）d、（4.72±1.91）和（7.23±2.12）d］，视觉模拟评分（VAS）明显低于对照组［（3.62±1.21）和（5.89±1.34）分］，两组比较，差异均有统计学意义（P < 0.05）。观察组第1秒用力呼气容积（FEV₁）、最大自主通气量（MVV）和用力肺活量（FVC）均明显优于对照组［（101.37±18.46）%和（88.82±16.15）%，（89.21±14.36）和（68.37±18.46）L/min，（94.26±18.25）%和（82.15±12.67）%］（P < 0.05）。观察组有效率（95.45%）明显高于对照组（69.77%）（P < 0.05）。观察组肺部感染、肺不张和胸部畸形发生率均明显低于对照组（13.64%和37.21%、18.18%和39.53%、0.00%和32.56%）（P < 0.05）。结论 胸腔镜辅助下钛镍记忆合金钢板内固定能明显改善患者恢复情况和肺功能，提高治疗有效率，降低并发症发生率。

Abstract:

Objective To investigate the efficacy and safety of thoracoscopy assisted titanium-nickel memory alloy plate internal fixation in patients with multiple rib fractures.Methods 87 patients with multiple rib fractures from January 2018 to December 2019 were randomly divided into control group (n = 43) and observation group (n = 44); The control group was given chest plate external fixation, the observation group was given thoracoscopy-assisted titanium-nickel memory alloy steel plate internal fixation treatment; The recovery situation, lung function indexes, treatment effect and complications of the two groups were compared.Results The ICU stay time, mechanical ventilation time, hospitalization time, time to get out of bed and chest drainage time of the observation group were significantly shorter than those of the control group [(3.74 ± 0.63) d vs (5.58 ± 1.21) d, (2.68 ± 1.65) d vs (9.78 ± 2.36) d, (19.46 ± 3.27) d vs (26.85 ± 2.73) d, (10.18 ± 2.22) d vs (16.23 ± 2.42) d, (4.72 ± 1.91) d vs (7.23 ± 2.12) d], the visual analogue score (VAS) of the observation group was significantly lower than that of the control group (3.62 ± 1.21) vs (5.89 ± 1.34)] (P < 0.05). The FEV₁, MVV and forced vital capacity (FVC) of the observation group were significantly better than those of the control group [(101.37 ± 18.46)% vs (88.82 ± 16.15)%, (89.21 ± 14.36) vs (68.37 ± 18.46) L/min, (94.26 ± 18.25)% vs (82.15 ± 12.67%)] (P < 0.05). The effective rate of the observation group (95.45%) was significantly higher than that of the control group (69.77%) (P < 0.05). The incidence of pulmonary infection, atelectasis and chest deformity of the observation group were significantly lower than those of the control group (13.64% vs 37.21%, 18.18% vs 39.53%, 0.00% vs 32.56%) (P < 0.05).Conclusion Thoracoscopy assisted internal fixation of titanium-nickel memory alloy steel plate can significantly improve patients' recovery and lung function, improve treatment efficiency, and reduce complications.