目的探讨重症连枷胸早期应用钛合金接骨板内固定联合电视胸腔镜手术治疗的临床经验及诊治效果。方法 2010年7月—2014年6月需行肋骨内固定的重症连枷胸外伤患者160例,随机分为两组:对照组79例应用行常规胸腔闭式引流加肋骨骨折内固定术;观察组81例行电视胸腔镜开胸探查肋骨骨折内固定术。比较两组术后肺功能、血氧饱和度、胸腔引流量、肺复张程度、住院时间等指标。结果本组160例患者中死亡3例,均为对照组患者;观察组平均胸腔引流时间2.5 d,对照组为5.5 d,两组差异有统计学意义(P<0.05)。观察组术后血氧饱和度、肺功能、并发症发生率、住院时间、疼痛评分、病死率等均优于对照组,差异有统计学意义(P<0.05)。结论电视胸腔镜开胸探查同期行肋骨骨折内固定手术,可有效改善肺功能、纠正呼吸衰竭、控制胸壁反常呼吸、降低疼痛评分、减少连枷胸患者并发症和病死率,有利于患者病情恢复,改善生活质量。 Objective To investigate the clinical experience and diagnosis and treatment of severe flail chest radiotherapy with titanium alloy plate fixation and video-assisted thoracoscopic surgery. Methods From July 2010 to June 2014, 160 patients with severe flail chest injury requiring internal fixation with ribs were randomly divided into two groups: control group, 79 cases underwent conventional thoracic closed drainage and rib fracture internal fixation; the observation group Eighty-one patients underwent video-assisted thoracoscopic thoracotomy for rib fracture internal fixation. The postoperative pulmonary function, oxygen saturation, chest drainage, degree of lung recruitment and hospital stay were compared between the two groups. Results Three of the 160 patients died in the control group. The average duration of chest drainage in the observation group was 2.5 days and that in the control group was 5.5 days. There was significant difference between the two groups (P <0.05). Oxygen saturation, pulmonary function, incidence of complications, length of hospital stay, pain scores and mortality in the observation group were all better than those in the control group (P <0.05). Conclusions Video-assisted thoracoscopic thoracoscopic exploration of internal fixation with rib fractures during the same period can effectively improve pulmonary function, correct respiratory failure, control abnormal chest wall respiration, reduce pain score, reduce the complications and mortality of patients with flail chest, and is conducive to the recovery of patients, Improve the quality of life