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目的:总结胸科肋骨接骨板在老年患者开胸手术中的应用价值。方法:回顾性分析2011年1月至2012年2月48例开胸手术老年患者的临床资料,根据切口处理方式不同,随机分为标准后、外开胸切口组(A组,n=25)和改良开胸切口组(B组,n=23);比较两组术后疼痛评估、手术时间、术野显露、拔除胸管时间、心血管系统并发症、肺部并发症。结果:B组在术后3 d内切口疼痛轻微,与使用术后静脉镇痛泵的A组无明显差异,而术后7 d、60 d、90 d随访则较A组明显减轻(P<0.05);B组拔除胸管时间、肺部并发症均明显少于A组(P<0.05);两组在手术时间、术野显露、心血管系统并发症方面无明显差异(P>0.05)。结论:应用胸科肋骨接骨板改良开胸切口可明显减轻术后切口疼痛,促进老年患者术后恢复,建议临床推广应用。
Objective: To summarize the value of thoracic rib plate in thoracotomy for elderly patients. Methods: The clinical data of 48 elderly patients undergoing thoracotomy from January 2011 to February 2012 were retrospectively analyzed. According to different incision treatments, patients were randomly divided into standard thoracotomy group (group A, n = 25) And modified thoracotomy group (group B, n = 23). The postoperative pain evaluation, operation time, operative field exposure, chest tube removal time, cardiovascular complications and pulmonary complications were compared between the two groups. Results: The incision pain in group B was slight within 3 days after operation, and there was no significant difference between group A and group A at 7 d, 60 d and 90 d after operation (P < 0.05). The time of removing the chest tube and the complications of the lung in group B were significantly less than those in group A (P <0.05). There was no significant difference between the two groups in terms of operation time, operative field exposure and cardiovascular complications (P> 0.05) . Conclusion: The application of thoracic rib plate to improve thoracotomy incision can significantly reduce postoperative incision pain, and promote the recovery of elderly patients after surgery, it is recommended for clinical application.