超声引导穿刺引流联合电视胸腔镜下内固定治疗肋骨骨折合并血气胸的疗效OA
Clinical efficacy of ultrasound-guided puncture drainage combined with video-assisted thoracoscopic internal fixation for rib fractures with hemopneumothorax
目的 观察超声引导穿刺引流联合电视胸腔镜下内固定治疗肋骨骨折合并血气胸的疗效.方法 将2023年1月至2024年12月我院收治的92例肋骨骨折合并血气胸患者随机分为对照组和联合组,每组46例.对照组患者行电视胸腔镜下内固定,联合组患者行超声引导穿刺引流联合电视胸腔镜下内固定.比较2组患者疗效、围术期指标、肺功能、炎症因子、并发症情况.结果 联合组患者治疗总有效率高于对照组(P<0.05),自主下床活动时间、住院时间、胸部疼痛缓解时间短于对照组(P<0.05).2组患者术后1个月最大呼气峰流速(PEF)、用力肺活量(FVC)显著高于术前,且联合组患者术后1个月PEF、FVC显著高于对照组(P<0.05);2组患者术后1个月残气量(RV)显著低于术前,且联合组患者术后1个月RV显著低于对照组(P<0.05).2组患者术后1个月干扰素-γ(IFN-γ)、白细胞介素-1β(IL-1β)水平显著低于术前,且联合组患者术后1个月IFN-γ、IL-1β水平显著低于对照组(P<0.05).2组患者术后并发症发生率比较,差异无统计学意义(P>0.05).结论 超声引导下穿刺引流联合电视胸腔镜下内固定治疗肋骨骨折合并血气胸的临床疗效确切,可显著改善围术期指标、肺功能,降低炎症因子水平且安全性较高.
Objective To observe the clinical efficacy of ultrasound-guided puncture drainage combined with video-assisted thoraco-scopic internal fixation in the treatment of rib fractures with hemopneumothorax.Methods A total of 92 patients with rib fractures complicated by hemopneumothorax admitted to our hospital from January 2023 to December 2024 were randomly divided into the control group and the combined group,with 46 cases in each group.Patients in the control group were treated with video-assisted thoracoscopic internal fixation,while those in the combined group were treated with ultrasound-guided puncture drainage combined with video-assisted thoracoscopic internal fixation.The two groups were compared in terms of clinical efficacy,perioperative indicators,pulmonary function,inflammatory factors,and complications.Results The combined group demonstrated a significantly higher total effective rate(P<0.05),along with shorter time to ambulation,shorter hospital stay,and faster chest pain relief compared with the control group(P<0.05).Both groups showed significantly higher peak expiratory flow(PEF)and forced vital capacity(FVC)1 month after surgery than those before surgery,and the combined group had significantly higher PEF and FVC 1 month after surgery than the control group(P<0.05).The residual volume(RV)1 month after surgery in both groups was significantly lower than that before surgery,and the combined group had significantly lower RV 1 month after surgery than the control group(P<0.05).Both groups showed significant decreases in interferon-γ(IFN-γ)and interleukin-1β(IL-1β)levels 1 month after surgery compared with preoperative levels,and the combined group had significantly lower levels of IFN-γ and IL-1β 1 month after surgery than the control group(P<0.05).No statistically significant difference was found in the incidence of postoperative complications between the two groups(P>0.05).Conclusion Ultrasound-guided puncture drainage combined with video-assisted thoraco-scopic internal fixation is effective in treating rib fractures with hemopneumothorax,which can significantly improve perioperative parameters,pulmonary function,and reduce inflammatory cytokine levels,with a high safety.
黄波;王天岚;张文通
邛崃市医疗中心医院心胸外科,四川 邛崃 611530邛崃市医疗中心医院心胸外科,四川 邛崃 611530邛崃市医疗中心医院心胸外科,四川 邛崃 611530
医药卫生
超声引导穿刺引流电视胸腔镜下内固定肋骨骨折血气胸临床疗效
ultrasound guidancepuncture drainagevideo-assisted thoracoscopic internal fixationrib fracturehemopneumothoraxclinical efficacy
《局解手术学杂志》 2026 (9)
792-796,5
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