胸腔镜与开胸手术治疗肋骨骨纤维结构不良的临床对照研究

发布时间：2018-03-28 20:48

本文选题：肋骨　切入点：骨纤维结构不良　出处：《重庆医学》2017年35期

【摘要】：目的比较胸腔镜手术与开胸手术治疗肋骨骨纤维结构不良的疗效,以明确胸腔镜手术的可行性、安全性和有效性。方法回顾性分析该院2000年1月至2015年10月收治的42例肋骨骨纤维结构不良患者的病例资料。根据不同的手术方式分为两组:胸腔镜组16例行胸腔镜肋骨切除术,开胸组26例行开胸肋骨切除术。比较分析两组患者的手术切口总长度、手术时间、术中出血量、术后疼痛时间和程度、术后活动情况、术后胸腔引流时间、术后住院时间、术后并发症及切口满意度。结果胸腔镜组患者的手术切口总长度[(6.2±1.6)vs.(12±2.2)cm,P0.05]、术后住院时间[(5.4±1.6)vs.(9.3±2.7)d,P0.05]均明显小于开胸组;胸腔镜组术后第1、2天疼痛视觉模拟评分(VAS)最小值、术后第1~3天及术后第7天VAS最大值均低于开胸组(P0.05);胸腔镜组术后第1、2天自主下床活动患者百分比及术后切口满意度均高于开胸组(P0.05);但两组在手术时间、术中出血量、胸腔引流时间和术后并发症总发生率比较,差异均无统计学意义(P0.05)。结论胸腔镜肋骨骨纤维结构不良切除术安全可行,且与开胸手术相比,具有微创、术后疼痛轻和术后恢复快的优点。
[Abstract]:Objective to compare the thoracoscopic surgery and thoracotomy in the treatment of fibrous dysplasia of bone rib effect, to define the feasibility of video-assisted thoracoscopic surgery, safety and efficacy. Methods a retrospective analysis of 42 patients with poor structure of fiber rib bone in our hospital from January 2000 to October 2015 were the disease cases. According to the different operation mode is divided into two group: Thoracoscopic group 16 underwent thoracoscopic rib resection, thoracotomy group 26 patients undergoing thoracic rib resection. Comparative analysis of the total length of the incision, two groups of patients with operation time, intraoperative blood loss, postoperative pain time and degree of activity, the postoperative chest drainage time after surgery, postoperative hospitalization time after complications and incision satisfaction after operation. Results the total length of incision of thoracoscopic Group [(6.2 + 1.6) vs. (12 + 2.2) cm, P0.05], postoperative hospitalization time [(5.4 + 1.6) vs. (9.3 + 2.7) d, P0.05] were significantly less than the thoracotomy group; pleural Mirror group 1,2 days after operation visual analogue scale (VAS) minimum, 1~3 days after operation and seventh days after the maximum value of VAS was lower than the thoracotomy group (P0.05); the VATS group 1,2 days after operation of independent ambulation in patients with postoperative incision and the percentage of satisfaction were higher than the thoracotomy group (P0.05 two); but the group in the operation time, intraoperative blood loss, chest drainage time and postoperative complication rate comparison, there were no significant differences (P0.05). Conclusion thoracoscopic rib bone fibrous dysplasia resection is safe and feasible, and compared with the thoracic surgery with minimally invasive, less postoperative pain and postoperative after the rapid recovery.

【作者单位】：贵州医科大学附属人民医院胸外科;
【基金】：贵州省卫生厅科学技术基金资助项目(gzwkj2013-1-149)
【分类号】：R655

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