首页> 中文期刊> 《创伤外科杂志 》 >胸腔镜治疗胸部创伤患者的临床治疗效果研究

胸腔镜治疗胸部创伤患者的临床治疗效果研究

             

摘要

Objective To compare the effect of thoracoscope and thoracotomy in treating patients with chest trauma.Methods A total of 152 patients with thoracic trauma from Jan .2014 to Mar.2015,were randomly divided into two groups , with 76 cases in each group .Open chest group was treated with conventional thoracotomy ,and the experimental group was treated with thoracoscopic surgery .The operation time , intraoperative blood loss ,postopera-tive visual analogue scale ( VAS) ,postoperative recovery and the level of various inflammatory factors were compared between the two groups .Results The blood loss ,operation time ,postoperative VAS score in the experimental was (172.23 ±23.28)mL,(45.68 ±11.26)h and (3.51 ±1.14),respectively,which were lower than the open chest group (352.26 ±34.39)mL,(95.32 ±18.26)h,(7.18 ±1.87)d.In the experimental group,the hospitalization time was (6.13 ±2.09) d,the ambulation time was (1.69 ±0.23) d,the daily life recovery time was (9.58 ± 1.25)d,which were shorter than the open chest group (8.16 ±1.25)d,(3.25 ±1.07)d,(17.26 ±3.64)d.The drainage volume 24h after operation was (253.21 ±52.14)mL,which was less than the open chest group [280.32 ±52.31)mL,P<0.05],and the difference was statistically significant .There was no significant difference in the occurrence of complications after operation in the two groups ( P >0.05 ) .After surgery , the C reaction protein (CRP) ,TNF-alpha and IL-6 in both groups were higher than those before the surgery ,but the index in the experir-nental group were lower than those of the open chest group (P<0.05),and the difference was statistically signifi-cant.Conclusion Thoracoscope in the treatment of thoracic trauma can reduce the pain of patients ,obtain quick recovery after operation , and reduce the incidence of surgical infection , which is an effective and safe operation method.%目的:比较胸腔镜与开胸手术对胸部创伤患者的临床治疗效果。方法以2014年1月~2015年3月收治的152例血流动力学稳定的胸部创伤患者为研究对象,并随机分为两组,每组各76例。开胸组采用常规开胸手术,实验组(腔镜组)采用胸腔镜手术,比较两组手术时间、术中出血量、术后视觉模拟评分( VAS)、术后恢复情况以及术后各种炎症因子的水平。结果腔镜组患者术中出血量(172.23±23.28)mL、手术时间(45.68±11.26)h、术后VAS评分(3.51±1.14),均少于开胸组(352.26±34.39)mL、(95.32±18.26)h、(7.18±1.87);腔镜组的住院时间(6.13±2.09)d、下床活动时间(1.69±0.23)d、恢复日常生活时间(9.58±1.25)d,均少于开胸组(8.16±1.25)d、(3.25±1.07)d、(17.26±3.64)d,腔镜组术后24h引流液量(253.21±52.14)mL,少于开胸组(280.32±52.31)mL,以上差异均具有统计学意义(P <0.05)。两组术后并发症的发生差异无统计学意义( P>0.05);两组患者手术后的C反应蛋白( CRP)、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)均高于手术前,但腔镜组的各项指标要低于开胸组(P<0.05),差异具有统计学意义。结论胸腔镜手术治疗胸部创伤,能够减少患者手术的痛苦,加快患者术后恢复,减少手术感染的发生,是一种有效且较为安全的方式。

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