Clinical effect of emergency surgical treatment and comprehensive nursing in multiple rib fractures complicated with traumatic diaphragmatic hernia

doi:10.3877/cma.j.issn.1674-392X.2019.05.021

Abstract

Abstract:

Objective

To explore the clinical effect of emergency surgical treatment and comprehensive nursing in the multiple rib fractures complicated with traumatic diaphragmatic hernia.

Methods

From February 2014 to January 2018, 45 patients with multiple rib fractures complicated with traumatic diaphragmatic hernia in Second Affiliated Hospital of Army Medical University were randomly divided into the control group (n=22) and the observation group (n=23). The control group was treated with thoracoscopic surgery and usual nursing, while the observation group was treated with thoracoscopic surgery and comprehensive nursing. The surgery index, short-term curative effect and postoperative situation of the two groups were compared.

Results

The satisfaction rate of the observation group was 95.65%, which was higher than that of the control group (68.18%, P<0.05). The time of mechanical ventilation, hospital stay, and ICU stay in the observation group were lower than those in the control group (t=2.193, 2.153, 2.768, P=0.034, 0.037, 0.008). The score of visual analogue scale (VAS) and the recovery time of upper limb function in the observation group were lower than those in the control group (t=2.147、2.839, P=0.038、0.007). The incidence of complications was 8.70% in the observation group and 36.36% in the control group, while the incidence of complications in the observation group was lower than that in the control group (χ²=4.980, P=0.026).

Conclusion

On the basis of thoracoscopic surgery, comprehensive nursing has a good effect in the treatment of multiple rib fractures complicated with traumatic diaphragmatic hernia, which can promote postoperative recovery, improve the short-term curative effect, and has fewer complications, so as to obtain the approval of the patients.

Key words: Traumatic diaphragmatic hernia, Comprehensive care, Multiple rib fractures, Thoracoscopic surgery

Zhongyan Luo, Feng Wang, Ran Li. Clinical effect of emergency surgical treatment and comprehensive nursing in multiple rib fractures complicated with traumatic diaphragmatic hernia[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2019, 13(05): 469-472.

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References 20

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组别	例数	非常满意 [例(%)]	满意 [例(%)]	不满意 [例(%)]	满意度 (%)
观察组	23	15(65.22)	7(30.43)	1(4.35)	95.65^a
对照组	22	8(36.36)	7(31.82)	7(31.82)	68.18

组别	例数	非常满意 [例(%)]	满意 [例(%)]	不满意 [例(%)]	满意度 (%)
观察组	23	15(65.22)	7(30.43)	1(4.35)	95.65^a
对照组	22	8(36.36)	7(31.82)	7(31.82)	68.18

组别	例数	机械通气时间(h)	住院时间(d)	入住ICU时间(d)
观察组	23	4.75±0.58	8.15±0.91	2.94±0.72
对照组	22	5.18±0.73	8.79±1.08	3.68±1.05
t值	?	2.193	2.153	2.768
P值	?	0.034	0.037	0.008

组别	例数	机械通气时间(h)	住院时间(d)	入住ICU时间(d)
观察组	23	4.75±0.58	8.15±0.91	2.94±0.72
对照组	22	5.18±0.73	8.79±1.08	3.68±1.05
t值	?	2.193	2.153	2.768
P值	?	0.034	0.037	0.008

组别	例数	视觉模拟评分(分)	术后上肢功能恢复时间(d)
观察组	23	4.04±0.61	3.66±0.35
对照组	22	4.48±0.76	4.12±0.69
t值	?	2.147	2.839
P值	?	0.038	0.007

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