2022 年第 11 期 第 17 卷

胸腔镜微创手术联合注射用骨瓜提取物治疗严重钝性胸部损伤合并血气胸的效果观察

Effect of thoracoscopic minimally invasive surgery combined with injection of bone melon extract on severe blunt chest injury complicated with hemopneumothorax

作者：周攀吴中权程玲玲朱杰舒圣

英文作者：Zhou Pan Wu Zhongquan Cheng Lingling Zhu Jie Shu Sheng

单位：武汉科技大学附属汉阳医院胸外科，武汉430050

英文单位：Department of Thoracic Surgery Hanyang Hospital Affiliated to Wuhan University of Science and Technology Wuhan 430050 China

关键词：严重钝性胸部损伤；血气胸；胸腔镜微创手术；注射用骨瓜提取物

英文关键词：Severebluntchestinjury;Hemopneumothorax;Thoracoscopicminimallyinvasivesurgery;Injectionofbonemelonextract

• 摘要：

• 目的 探讨胸腔镜下镍钛形状记忆合金环抱接骨板微创手术联合注射用骨瓜提取物治疗严重钝性胸部损伤合并血气胸患者的临床效果。方法 选取2018年1月至2021年12月于武汉科技大学附属汉阳医院进行治疗的严重钝性胸部损伤合并中量以上血气胸患者100例，采用随机数字表法将患者分为对照组和观察组，各50例。对照组使用胸腔镜下镍钛形状记忆合金环抱接骨板微创手术治疗，观察组在对照组基础上术后予注射用骨瓜提取物治疗。比较2组治疗前后肺功能指标、心电监护指标、疼痛程度、炎性因子水平、并发症、康复指标及疗效。结果 治疗10 d，2组呼气峰值流速、用力呼气容积、用力肺活量均高于治疗前，且观察组均高于对照组［（5.7±0.7）L/s比（3.3±0.5）L/s、（2.07±0.39）L比（1.45±0.28）L、（4.20±1.02）L比（2.67±0.94）L］，差异均有统计学意义（均P＜0.05）。治疗3 d，2组心率、呼吸频率、疼痛程度均低于治疗前，且观察组均低于对照组；2组白细胞介素6、肿瘤坏死因子α、C反应蛋白水平均高于治疗前，但观察组均低于对照组，差异均有统计学意义（均P＜0.05）。观察组术后并发症发生率低于对照组，骨痂形成时间、骨折愈合时间均短于对照组，总有效率高于对照组，差异均有统计学意义（均P＜0.05）。结论 胸腔镜下镍钛形状记忆合金环抱接骨板微创手术联合注射用骨瓜提取物治疗严重钝性胸部损伤合并血气胸，能显著减轻患者术后疼痛，减少肺部并发症，加快骨折愈合，促进术后康复。

• Objective To investigate the clinical effect of titanium shape memory aloy with bone plate in the minimally invasive treatment under thoracoscopy combined with injection of bone melon extract on severe blunt chest injury complicated with hemopneumothorax. Methods Totally 100 patients with severe blunt chest injury complicated with above average hemopneumothorax were selected from Hanyang Hospital Affiliated to Wuhan University of Science and Technology from January 2018 to December 2021. Patients were randomly divided into control group and observation group, with 50 cases in each group. The control group was treated with titanium shape memory aloy with bone plate in the minimally invasive treatment under thoracoscopy, and the observation group was treated with injection of bone melon extract based on the control group after surgery. The lung function indicators, electrocardiogram indicators, degree of pain, levels of inflammatory factors, complications, rehabilitation indicators and curative effects were compared between the two groups. Results After 10 d of treatment, the peak expiratory flow rate, forced expiratory volume and forced vital capacity in both groups were higher than those before treatment, and the levels in the observation group were higher than those in the control group［（5.7±0.7）L/s vs （3.3±0.5）L/s,（2.07±0.39）L vs （1.45±0.28）L,（4.20±1.02）L vs （2.67±0.94）L］(all P<0.05). After 3 d of treatment, the heart rate, respiratory rate and degree of pain in both groups were lower than those before treatment, and the levels in the observation group were lower than those in the control group; levels of interleukin-6, tumor necrosis factor-α and C-reactive protein in both groups were higher than those before treatment, while the levels in the observation group were lower than those in the control group (all P<0.05). The postoperative complication rate in the observation group was lower than that in the control group, callus formation time and fracture healing time were shorter than those in the control group, and the total effective rate was higher than that in the control group (all P<0.05). Conclusions Titanium shape memory aloy with bone plate in the minimally invasive treatment under thoracoscopy combined with injection of bone melon extract, it can significantly reduce postoperative pain and pulmonary complications in patients with severe blunt chest injury complicated with hemopneumothorax, accelerate fracture healing, and promote postoperative recovery.