Clinical effect of thoracoscopy-based reduction and internal fixation in treatment of elderly patients with rib fracture

CHENG Gang; WANG Changxing

doi:10.7619/jcmp.20233999

Journal of Clinical Medicine in Practice > 2024 > 28(5): 89-93. > DOI: 10.7619/jcmp.20233999

CHENG Gang, WANG Changxing. Clinical effect of thoracoscopy-based reduction and internal fixation in treatment of elderly patients with rib fracture[J]. Journal of Clinical Medicine in Practice, 2024, 28(5): 89-93. DOI: 10.7619/jcmp.20233999

Citation:

PDF (1570 KB)

Clinical effect of thoracoscopy-based reduction and internal fixation in treatment of elderly patients with rib fracture

CHENG Gang,
WANG Changxing^,

Department of Cardiothoracic Surgery, Suzhou City Hospital in Jiangsu Province, Suzhou, Jiangsu, 215000

More Information

Received Date: December 10, 2023
Revised Date: February 07, 2024
Available Online: March 21, 2024

Graphical Abstract

Abstract

Abstract

Objective
To investigate the effects of thoracoscopy-based reduction and internal fixation in the rehabilitation process and functional recovery of elderly patients with rib fracture.
Methods
Eighty-five elderly patients with rib fracture were selected as the study objects, and divided into control group (n=41, thoracotomy and internal fixation) and observation group (n=44, thoracoscopy-based reduction and internal fixation) according to different treatment plans. The surgical indexes (oxygensaturation recovery time, respiratory rate recovery time, mechanical ventilation time, hospital stay and bone healing time), pain scores, lung function indexes[forced expiratory volume in one second (FEV₁), forced vital capacity (FVC) and peak expiratory flow rate (PEF)], blood gas indexes { arterial partial pressure of oxygen[p_a(O₂)] and arterial partial pressure of carbon dioxide [p_a (CO₂)]}, clinical efficacy and complication rate were compared between the two groups.
Results
The blood oxygen saturation recovery time, respiratory rate recovery time, thoracic drainage tube indwelling time, hospital stay time and fracture healing time in the observation group were significantly shorter than those in the control group, and the chest tube drainage volume was significantly less than that in the control group (P < 0.05). At the 7 days after operation, visual analogue scale (VAS) score and p_a (CO₂) level in the two groups were significantly lower than before surgery, and the observation group was significantly lower than the control group (P < 0.05). At 7 days after surgery, the levels of FEV₁, FVC, PEF, FEV₁/FVC and p_a(O₂) in the two groups were significantly higher than before surgery, and the observation group was significantly higher than the control group (P < 0.05). The total effective rate of the observation group was 93.18%, which was significantly higher than 78.05% of the control group (P < 0.05). The incidence of complications in the observation group was 4.55%, which was significantly lower than 9.51% in the control group (P < 0.05).
Conclusion
Thoracoscopy-based reduction and internal fixation in treatment of elderly patients with rib fracture has significant clinical efficacy, which can effectively shorten the rehabilitation process, relieve the pain of patients, and promote the recovery of lung function, with high safety.
- thoracoscopy,
- reduction and internal fixation,
- rib fractures in the elderly,
- lung function,
- bone healing

FullText(HTML)

References (18)

References

[1]	NISHIMURA E, FINGER A, HARRIS M, et al. One-view chest radiograph for initial management of most ambulatory patients with rib pain[J]. J Am Board Fam Med, 2021, 34(1): 144-150. doi: 10.3122/jabfm.2021.01.200276
[2]	GONGOLA A, BRADSHAW J C, JIN J, et al. Retrospective study on rib fractures: smoking and alcohol matter for mortality and complications[J]. Trauma Surg Acute Care Open, 2021, 6(1): e000732. doi: 10.1136/tsaco-2021-000732
[3]	闻吉军. 老年多发性肋骨骨折患者术后发生肺部并发症的影响因素分析[J]. 中国现代药物应用, 2022, 16(11): 23-26. https://www.cnki.com.cn/Article/CJFDTOTAL-ZWYY202211005.htm
[4]	WU C M, HONG Y J, WU B Y, et al. The effects of add-on self-care therapy on epidural catheter analgesia and pain in patients after surgical stabilization of multiple rib fractures[J]. Pain Manag Nurs, 2021, 22(6): 764-768. doi: 10.1016/j.pmn.2021.01.011
[5]	CHOI J, MULANEY B, LAOHAVINIJ W, et al. Nationwide cost-effectiveness analysis of surgical stabilization of rib fractures by flail chest status and age groups[J]. J Trauma Acute Care Surg, 2021, 90(3): 451-458. doi: 10.1097/TA.0000000000003021
[6]	周攀, 程玲玲, 朱杰, 等. 胸腔镜下肋骨固定在严重钝性胸部损伤合并血气胸中的效果观察[J]. 实用临床医药杂志, 2022, 26(4): 55-59. doi: 10.7619/jcmp.20214314
[7]	NACIF A, DE ABREU G E, BESSA JUNIOR J, et al. Agreement between the visual analogue scale (VAS) and the dysfunctional voiding scoring system (DVSS) in the post-treatment evaluation of electrical nerve stimulation in children and adolescents with overactive bladder[J]. J Pediatr Urol, 2022, 18(6): 740. e1-740740. e8. doi: 10.1016/j.jpurol.2022.07.032
[8]	DORMAN J R, CLARKE P T M, SIMPSON R B, et al. Testing the clinical validity of the Bemelman Rib Fracture Management Guideline[J]. Interact Cardiovasc Thorac Surg, 2020, 30(4): 597-599. doi: 10.1093/icvts/ivz317
[9]	牛晓光, 仝烨峰. 瑞芬太尼、丙泊酚复合全凭静脉麻醉对老年肋骨骨折切开复位内固定手术患者术后认知功能的影响[J]. 中国老年学杂志, 2022, 42(10): 2394-2397. doi: 10.3969/j.issn.1005-9202.2022.10.024
[10]	林鑫, 刘庆, 吴按明, 等. 多发肋骨骨折内固定手术时机选择对患者恢复的影响[J]. 实用临床医药杂志, 2021, 25(12): 46-49, 53. doi: 10.7619/jcmp.20210676
[11]	HE W W, YANG Y, SALONGA R, et al. Surgical stabilization of multiple rib fractures in an Asian population: a systematic review and meta-analysis[J]. J Thorac Dis, 2023, 15(9): 4961-4975. doi: 10.21037/jtd-23-1117
[12]	MIYAMOTO K, SUZUKI K, NAKAMURA M, et al. Hypovolemic shock induced by a large chest wall hematoma caused by a single rib fracture in an elderly patient[J]. Trauma Case Rep, 2021, 32: 100459. doi: 10.1016/j.tcr.2021.100459
[13]	顾书鸣. CT三维定位下小切口手术内固定治疗多发性肋骨骨折的临床治疗分析[J]. 中国医疗器械信息, 2023, 29(1): 97-99. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGQX202301021.htm
[14]	彭积贵, 金忠文, 颜海强, 等. 超声引导下与CT引导下肋骨骨折切开复位内固定术治疗肋骨骨折的效果比较[J]. 临床外科杂志, 2023, 31(3): 283-286. https://www.cnki.com.cn/Article/CJFDTOTAL-LCWK202303021.htm
[15]	冉隆强, 李勇, 贾萌. 胸腔镜辅助内固定术对多发肋骨骨折合并胸部创伤患者肺功能及预后的影响[J]. 中国医刊, 2023, 58(5): 517-520. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYI202305014.htm
[16]	KUMATA S, MATSUOKA K, NAGAI S, et al. Contralateral tension pneumothorax during video-assisted thoracic surgery for lung cancer in a patient with obesity and rib fractures: a case report and review of the literature[J]. J Med Case Rep, 2020, 14(1): 221.
[17]	潘帅. 胸腔镜辅助小切口手术与传统开胸手术治疗多发性肋骨骨折合并肺撕裂伤的效果比较[J]. 中国医疗器械信息, 2023, 29(18): 82-84. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGQX202318026.htm
[18]	李震宇, 张朋朋, 常亮, 等. 胸腔镜辅助下MIPO治疗创伤性多发肋骨骨折的临床疗效[J]. 川北医学院学报, 2023, 38(9): 1173-1177. https://www.cnki.com.cn/Article/CJFDTOTAL-NOTH202309005.htm

[1]	YANG Shuangyue, JIN Xing, MENG Zhaoxiang, KE Minghui, ZHANG Minjie, CHEN Chen. Efficacy of low-frequency repetitive transcranial magnetic stimulation assisted virtual reality interactive robot training on function of upper limbs in patients with stroke[J]. Journal of Clinical Medicine in Practice, 2025, 29(1): 28-32. DOI: 10.7619/jcmp.20243115
[2]	WU Yusi, JIANG Mingqing, LUO Hua, RUAN Jianghai. Research on spontaneous upper limb activity and graph theory of electroencephalogram in patients with acute ischemic stroke[J]. Journal of Clinical Medicine in Practice, 2024, 28(19): 73-78. DOI: 10.7619/jcmp.20242749
[3]	ZHAO Huiduo, WU Bing, CHE Zhiying. Construction and validation of risk predictive visualized model of upper limb lymphedema after breast cancer surgery[J]. Journal of Clinical Medicine in Practice, 2023, 27(24): 30-36. DOI: 10.7619/jcmp.20232484
[4]	ZHAO Chunhong, FENG Xuguang, WANG Xiaoxi, YIN Changheng. Effect of upper limb rehabilitation training combined with microwave hyperthermia for breast cancer patients undergoing peripherally inserted central catheter[J]. Journal of Clinical Medicine in Practice, 2021, 25(8): 39-42. DOI: 10.7619/jcmp.20210016
[5]	SONG Lin. Effect of group psychological intervention on psychological disturbance and upper extremity exercise in patients with breast cancer undergoing radical mastectomy[J]. Journal of Clinical Medicine in Practice, 2020, 24(11): 121-124. DOI: 10.7619/jcmp.202011033
[6]	HU Jie. Study on functional recovery and rehabilitation nursing in patients with breast cancer after radical operation[J]. Journal of Clinical Medicine in Practice, 2019, 23(24): 111-113, 117. DOI: 10.7619/jcmp.201924035
[7]	WANG Hailin. Effect of stage nursing intervention on function recovery of affected upper limbs in postoperative patients with breast cancer[J]. Journal of Clinical Medicine in Practice, 2018, (6): 90-92. DOI: 10.7619/jcmp.201806026
[8]	WANG Weifeng, CHEN Shi, SUN Qiong, WANG Shiqun. Effect of doctor-nurse integration health education on prevention of upper limb edema after breast cancer surgery[J]. Journal of Clinical Medicine in Practice, 2017, (12): 73-76. DOI: 10.7619/jcmp.201712022
[9]	ZHAO Shuai, HOU Nina. Effect of evidence-based nursing on upper limb function in breast cancer patients with postoperative radiotherapy[J]. Journal of Clinical Medicine in Practice, 2015, (18): 45-47,51. DOI: 10.7619/jcmp.201518015
[10]	ZHENG Li, JIANG Yinfen, CAI Lichun, LIU Hong, CHEN Bo. Research on postoperative early functional exercise in patients with mastoscope-assisted breast cancer surgery[J]. Journal of Clinical Medicine in Practice, 2013, (18): 4-6. DOI: 10.7619/jcmp.201318002

Cited By

Cited by

Periodical cited type(4)

1.	王杰，王霞，李静，李燕燕，花淑婷，孙亚坤. 联合检测血清PLA2R、IgG4对特发性膜性肾病诊断的临床价值分析. 医药论坛杂志. 2024(23): 2532-2536 .
2.	王晓，张铁征，王春宁，李敏. CysC、SCr、BUN在肾病患者外周血中的检测意义. 标记免疫分析与临床. 2022(07): 1170-1173 .
3.	罗熙，远方. 从“瘀”论治膜性肾病. 中医药临床杂志. 2022(12): 2238-2241 .
4.	温玉，刘嘉伟，邱友春，李莉华，杨雪. 血清PLA2R、IgG4检测对特发性膜性肾病的诊断中的临床价值分析. 临床和实验医学杂志. 2021(16): 1712-1716 .

Other cited types(1)

Get Citation

PDF

XML

Article views PDF downloads Cited by(5)

Turn off MathJax

Article Contents

Abstract

References

Clinical effect of thoracoscopy-based reduction and internal fixation in treatment of elderly patients with rib fracture