Objective  To explore the effect of thoracoscopic rib fixation in the treatment of patients with severe blunt chest injury complicated with hemopneumothorax.

  Methods  A total of 200 patients with severe blunt chest injury complicated with more than moderate volume of hemopneumothorax were selected and divided into control group (n=100) and research group (n=100) according to patients′ opinions. The control group was treated with rib fixation and closed thoracic drainage for hemopneumothorax at the same time, while the research group was treated with thoracoscopic exploration and rib fixation at the same time. The pulmonary function, levels of inflammatory factors, heart rate, respiratory rate, blood oxygen saturation and degree of pain before and after treatment, therapeutic effect and incidence of postoperative complications were compared between the two groups.

  Results  Before treatment, there were no significant differences in heart rate, plumonary function indexes, respiratory rate, blood oxygen saturation, degree of pain and levels of interleukin-6(IL-6), tumor necrosis factor-α(TNF-α) and C reactive protein (CRP) between the two groups (P>0.05). After treatment, the blood oxygen saturation, IL-6, TNF-α and CRP in both groups increased significantly, while the heart rate, respiratoy rate and degree of pain decreased significantly (P>0.05). After treatment, levels of pulmonary function indexes and blood oxygen saturation in the research group were significantly higher than those in the control group, while the heart rate, respiratory rate, degree of pain, incidence of postoperative complications and levels of IL-6, TNF-α and CRP were significantly lower than those in the control group (P < 0.05). The total effective rate of the research group was 98.00%, which was significantly higher than 72.00% of the control group (P < 0.05).

  Conclusion  Thoracoscopic rib fixation has the advantages of thorough exploration, less trauma and rapid recovery in the treatment of patients with severe blunt chest injury complicated with above medium volume of hemopneumothorax, which can replace some traditional operations.