The application of enhanced recovery idea in surgery for traumatic rib fractures

doi:10.3877/cma.j.issn.2095-8773.2019.01.04

Abstract

Abstract:

Objective

To explore the application of enhanced recovery idea in surgery for traumatic rib fractures.

Methods

64 patients with traumatic rib fractures admitted to the Department of Thoracic Surgery, Honghui Hospital Affiliated to School of Medicine, Xi'an Jiaotong University from August 2017 to January 2018 were randomly selected . Patients were divided into two groups according to different surgical management, 28 cases of conventional treatment group and 36 cases of enhanced recovery group.The clinical data were analyzed and compared between the two groups, including incision length, operation time, intraoperative blood loss, postoperative visual analogue scale(VAS) score on first postoperative day, time to pull out chest closed drainage tube, maximal voluntary ventilation(MVV) on 3rd postoperative day , recovery time of gastrointestinal function, average length of hospital stay , and cost of hospitalization.

Results

The incision length and intraoperative blood lose of the enhanced recovery group improved significantly compared with the conventional treatment group (P < 0.05), while the two groups had no significant differences in operation time (P>0.05). Compared with the conventional treatment group, the enhanced recovery group had lower postoperative VAS score on first postoperative day ; reduced time to pull out chest closed drainage tube ; had greater MVV on 3rd postoperative day; reduced the recovery time of gastrointestinal function; and as a result , also reduce the average length of hospital stay (P<0.05). However, there were no significant differences in cost of hospitalization (P>0.05).

Conclusions

The enhanced recovery idea has absolute advantages in operation for traumatic rib fractures, and should be widely applied in clinical treatment.

Key words: Rib fractures, Trauma, Enhanced recovery idea, Operation

Gang Wang, Baoli Jing, Zhe Song, Bin Qi, Shanghua Feng, Jing He, Jinsong Zhou. The application of enhanced recovery idea in surgery for traumatic rib fractures[J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2019, 06(01): 17-20.

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References 20

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评价指标	快速康复组	常规治疗组	t/χ²值	P值
性别(男/女，n/n)	23/13	21/7	0.00	0.83
年龄(岁)	51.27±8.63	46.96±12.81	1.86	0.07
术前MVV(%)	50.81±11.16	51.54±11.11	0.26	0.80
肋骨骨折数量(根)	8.36±0.36	11.75±0.44	6.22	0.00
手术切口长度(cm)	6.17±2.02	5.57±2.06	1.12	0.07
手术时间(min)	63.06±16.00	66.43±17.26	0.81	0.42
术中出血量(ml)	71.39±17.91	108.21±23.74	7.08	<0.01
术后第1天VAS评分	2.53±0.94	3.29±1.08	2.99	0.01
拔除闭式引流管时间(h)	63.78±14.29	85.93±20.92	5.03	<0.01
术后第3天MVV(%)	79.11±9.10	69.21±7.49	4.66	<0.01
胃肠道恢复时间(h)	7.94±2.90	10.75±3.28	3.62	<0.01
住院时间(日)	8.50±1.65	10.11±1.66	3.86	<0.01
住院费用(万元)	3.75±0.99	3.53±0.72	0.98	0.33

评价指标	快速康复组	常规治疗组	t/χ²值	P值
性别(男/女，n/n)	23/13	21/7	0.00	0.83
年龄(岁)	51.27±8.63	46.96±12.81	1.86	0.07
术前MVV(%)	50.81±11.16	51.54±11.11	0.26	0.80
肋骨骨折数量(根)	8.36±0.36	11.75±0.44	6.22	0.00
手术切口长度(cm)	6.17±2.02	5.57±2.06	1.12	0.07
手术时间(min)	63.06±16.00	66.43±17.26	0.81	0.42
术中出血量(ml)	71.39±17.91	108.21±23.74	7.08	<0.01
术后第1天VAS评分	2.53±0.94	3.29±1.08	2.99	0.01
拔除闭式引流管时间(h)	63.78±14.29	85.93±20.92	5.03	<0.01
术后第3天MVV(%)	79.11±9.10	69.21±7.49	4.66	<0.01
胃肠道恢复时间(h)	7.94±2.90	10.75±3.28	3.62	<0.01
住院时间(日)	8.50±1.65	10.11±1.66	3.86	<0.01
住院费用(万元)	3.75±0.99	3.53±0.72	0.98	0.33

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