期刊文献+

多发性肋骨骨折微创手术治疗体会 预览

Clinical experience of minimally invasive surgery for patients with multiple fractures of ribs
在线阅读 下载PDF
分享 导出
摘要 目的探讨多发性肋骨骨折微创治疗的手术方法。方法回顾性分析2015年3月至2018年9月在石家庄市第三医院心胸外科行微创手术治疗260例多发肋骨骨折患者的临床资料。观察患者的术中和术后指标。结果全组无死亡病例,手术时间40~180min,平均手术时间103min,手术出血量20~150ml,平均手术出血量83ml。术后12例患者因呼吸功能不全,送ICU过渡,1~5d顺利拔出气管插管、脱离呼吸机,转回普通病房。多数患者术后胸痛明显缓解,短期可停用镇痛药物,生活质量明显改善。术后复查显示内固定物塑形良好,胸廓成型良好,与对侧胸廓基本对称。切口脂肪液化、感染患者11例,均经短期换药治愈。出院后每月随访,连续3个月,无明显胸部不适,骨折断端愈合良好。结论以胸廓的解剖特点为基础,根据不同部位及肋骨骨折情况选择、设计切口,解剖性游离、保护周围神经、血管,并结合3D打印技术、腔镜技术等,可以个体化、微创化的方式完成内固定手术,完美恢复胸廓形态,取得满意疗效。 Objective To explore minimally invasive surgery treatments for patients with multiple fractures of ribs.Methods A retrospective analysis of the clinical data of 260 patients with multiple fractures of ribs who were admitted to the Department of Cardiothoracic Surgery,the Third Hospital of Shijiazhuang,from March 2015 to September 2018 was performed.The intraoperative and postoperative indicators were observed.Results Among all cases,no death occurred.The mean operative time was 103 min(40-180 min)and the mean operative blood loss was 83 ml(20-150 ml).12 cases were transferred to ICU due to respiratory insufficiency,and after about 1-5 days’care,endotracheal intubations could be pulled out and ventilators could be removed,the patients thus were transferred back to regular room.Chest pain was relieved remarkably in most patients,and some could stop using analgesics in a short period.Postoperative reexamination showed that all internal fixators were in good shape and thoracic contours were well formed,basically symmetrical with contralateral thoracic contours.Incisional fat liquefaction occurred in 11 cases,and all were cured by short-term dressing change.After 3 months’follow-up,no obvious chest discomfort occurred and rib fractures were cured.Monthly follow-up after discharge,3 months in a row,no obvious chest discomfort,fracture healing good.Conclusions On the basis of anatomic characteristics of thoracic cavity,minimally invasive surgery for rib fractures should be designed and performed differently according to the different injured part of body,the condition of fractured ribs,with different incision and anatomical dissociation to protect the surrounding nerves and blood vessels.Also,3D printing techniques and endoscopic techniques can also be used together with minimally invasive techniques in the internal fixation procedure to perfectly restore thoracic morphology.
作者 周雪涛 谢泽新 陈孟晖 梁政 杨杨 张国亮 张东升 Zhou Xuetao;Xie Zexin;Chen Menghui;Liang Zheng;Yang Yang;Zhang Guoliang;Zhang Dongsheng(Department of Cardiothoracic Surgery,The Third Hospital of Shijiazhuang,Shijiazhuang 050000,China)
出处 《中华胸部外科电子杂志》 2019年第1期6-11,共6页 Chinese Journal Of Thoracic Surgery(Electronic Edition)
关键词 多发性肋骨骨折 微创技术 切开复位内固定术 Multiple fractures of ribs Minimally invasive technique Open reduction and internal fixation
作者简介 通讯作者:张东升,Email:ZDS9999@163.com.
  • 相关文献

参考文献4

二级参考文献39

  • 1Beg MH, Reyazuddin, Ansari MM. Conservative management of flail chest[J]. J Indian Med Assoc, 1990- 88(7) : 186-187. 被引量:1
  • 2Al -Koudmani I, Darwish B, A1 -Kateb K, et al. Chest trauma experience over eleven - year period at al - mouassat university teaching hospital - Damascus: a retrospective review of 888 cases [J]. J Cardiothorac Surg, 2012, 7:35. 被引量:1
  • 3Battle CE, Hutehings H, Evans PA. Risk factors that predict mor- tality in patients with blunt chest wall trauma: a systematic review and meta - analysis[ J]. Injury, 2012, 43 ( 1 ) :8 - 17. 被引量:1
  • 4Fabrieant L, Ham B, Mullins R, et al. Prolonged pain and disa- bility are common after rib fractures[ J]. Am J Surg, 2013, 205 (5) :511 -515. 被引量:1
  • 5Demirhan R, Onan B, O2 K, et al. Comprehensive analysis of4205 patients with chest trauma: a 10 - year experience [ J ]. Inter- act Cardiovasc Thorac Surg, 2009, 9 (3) :450 - 453. 被引量:1
  • 6Carbognani P, Cattelani L, Bellini G, et al. A technical proposal for the complex flail chest[ J ]. Ann Thorac Surg, 2000, 70( 1 ) : 342 - 343. 被引量:1
  • 7Bottlang M, Long WB, Phelan D, et al. Surgical stabilization of flail chest injuries with MatrixRIB implants: a prospective obser- vational study[J]. Injury, 2013, 44(2):232 -238. 被引量:1
  • 8Slobogean GP, MaePherson CA, Sun T, et al. Surgical fixation vs nonoperative management of flail chest: a meta -analysis [ J ]. J Am Call Surg, 2013, 216(2) :302 -311. 被引量:1
  • 9Bansal V, Conroy C, Chang D, et al. Rib and sternum fractures in the elderly and extreme elderly following motor vehicle crashes[J]. Accid Anal Prev, 2011,43(3) :661 -665. 被引量:1
  • 10Lafferty PM, Anavian J, Will RE, et al. Operative treatment of ehest wall injuries: indications, technique, and outcomes[J]. J Bone Joint Surg Am, 2011, 93(1) :97 -110. 被引量:1

共引文献13

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部 意见反馈