Application of thoracoscope combined with mechanical ventilation in elderly patients with chest trauma compli-cated by acute respiratory distress syndrome / 局解手术学杂志

ABSTRACT

Objective To investigate the application of thoracoscope combined with mechanical ventilation in elderly patients with chest trauma complicated by acute respiratory distress syndrome(ARDS).Methods Selected 49 elderly patients with chest trauma complicated by ARDS who were admitted into our hospital from Jan.2015 to Jun.2017 as the study objects.And divided these patients into the control group (n=25)and the observation group(n=24)upon the different treatment method.Patients of the control group underwent conventional thora-cotomy combined with mechanical ventilation,while patients of the control group underwent the microinvasive video -assisted thoracoscopic surgery(VATS)combined with mechanical ventilation.Post-operative incision size,duration of operation,intraoperative bleeding,severity of pain 5 days after surgery,drainage duration,patients with post-operative complication,and hospital stays after operation of all patients were e-valuated.Compared and analyzed the changes of pulmonary function before surgery and 1 week after surgery, as well as the VAS score and anxiety and depression of patients before and after surgery.Results The postoperative incision size,VAS score and operation time in the ob-servation group were significantly better those of the control group,and the difference was statistically significant(P<0.05).The postopera-tive complications of the observation group were significantly lower than that in the control group,and the difference was statistically signifi-cant(χ2=4.75,P<0.05).One week after treatment,the pulmonary function index of the observation group were obviously superior to the control group with statistically significant difference(P<0.05).And the improvement degree of anxiety and depression was better in the ob-servation group compared to the control group(P<0.05).Conclusion Compared to traditional thoracotomy,reasonable VATS will help to decrease the intra-operative bleeding,duration of operation,post-operative hospital stays,and number of complications after surgery.What is more,it can improve pulmonary function of elderly patients.In addition,it can relief the degree of anxiety and depression of patients after op-eration,which is better than ones accepting traditional thoracotomy.