Abstract:

【Abstract】Objective To investigate the curative effects on multiple rib fractures under video-assisted thoracoscopy (VATS). Methods From March 2008 to February 2012,56 patients with multiple rib fracture under VATS using Tin shape memory alloy embracing fixator for internal fixation were analyzed retrospectively. Results The average operative time was 53 min (35-110 min). The mean blood loss was 40 mL(10-85 mL). The postoperative average hospitalization time was in 19.6 d (12 to 23 d). Fourty seven patients were followed up for 3 to 6 months, an average of 4.8 months. The first intention of incision was got in all cases. In this group,complicated ARDS was in 13 cases. Excepting 6 cases died from severe multiple organ injuries, the other cases were reeoverred well. Fourty one cases were followed-up for 3-6 months (Average 4.8 months). No severe sequelae of cardiopulmonay complications were found during follow-up period. No remnant obvious deformity of chest wall occurred and the respiratory function was well. Conclusion Internal fixation of multiple rib fracture under VATS is accurate positioning and effective minimally invasive treatment.

Key words: Video-assisted thoracoscopy, Multiple rib fractures, TiNi shape memory alloy embr-acing fixator

摘要：

【摘要】 目的 分析电视胸腔镜辅助下多根多处肋骨骨折内固定疗效,探讨内固定的手术指征及治疗方法。方法 2008年3月至2012年2月我科收治多根多处肋骨骨折56例在电视胸腔镜辅助下采用TiNi肋骨环抱式接骨板进行肋骨内固定进行回顾性分析。结果 手术时间平均53 min,术中术野出血平均40 mL,术后平均住院19.6 d (12~23 d),共6例死亡患者包括4例因ARDS伴多脏器损伤,2例颅脑外伤合并腹部及骨盆损伤。41例病人随访3~6个月,平均4.8个月未出现明显胸腔畸形等并发症。所有患者的手术切口均获得一期愈合。本组并发ARDS13,除6例死于严重的多发性器官损伤外,其余患者均恢复良好。41例患者获得随访,随访时间为3~6个月(平均4.8个月)随访期间均未见发现心肺后遗严重并发症。无遗留明显的胸壁畸型,呼吸功能良好。结论 电视胸腔镜辅助下多根多处肋骨骨折定位准确,骨折内固定治疗效果良好。

关键词: 电视胸腔镜, 多根多处肋骨骨折, TiNi肋骨环抱式接骨板