记忆合金环抱器固定肋骨骨折的适应证及手术技巧  

Indications and surgical techniques of fixation of rib fractures with memory alloy osteosynthesis plates

作　　者：徐恩五[1] 乔贵宾[1] 彭秀凡[1] 蒋仁超[1] 张卓华[1] 曾伟生[1] 

机构地区：[1]广州军区广州总医院胸外科,510010

出　　处：《中华创伤杂志》2012年第6期533-536,共4页Chinese Journal of Trauma

基　　金：2011年广东省科技计划资助项目（2010A030400011-02）

摘　　要：目的评价记忆合金环抱器固定肋骨骨折的临床效果，探讨该术式的手术适应证及手术技巧。方法回顾性总结2010年10月-2011年4月应用记忆合金环抱器治疗的肋骨骨折患者30例的临床资料。统计记忆合金环抱式固定器的使用数量、固定部位、手术时间，对比患者术前、术后的疼痛评分，分析手术疗效及并发症情况。结果30例患者手术时间（111．9±48．0）min，使用固定器（4．3±2．1）个，固定肋骨（3．5±1．3）根。术前疼痛评分（6．93±0．88）分，术后疼痛评分（4．04±0．62）分（P〈0．05）。下床活动时间（4．6±1．9）d，住院时间（27．2±10．8）d。术后出现切口、胸壁血肿3例，肺部感染6例，无顽固性胸痛、异物排斥反应或切口感染。结论记忆合金环抱器固定肋骨骨折可明显减轻患者疼痛、改善肺功能、减少呼吸机应用时间及肺部感染等并发症的发生。Objective To evaluate the clinical effects of memory alloy embracing fixators in fixa- tion of the rib fractures and investigate the related surgical indications and surgical techniques. Meth- ods Retrospectively review was conducted on the clinical data of 30 patients with rib fractures treated with memory alloy embracing fixators from October 2010 to April 2011 at General Hospital of Guangzhou Military Command. The number of memory alloy embracing fixators used in operation, the number of fixed positions, and operation time were recorded. The pain scores before and after operation were comparative- ly studied. Operation efficacy and complications were analyzed. Results Of the 30 patients, the total operation time, number of fixators, and number of fixed ribs were （ 111.9 ±48.0） minutes, 4.3± 2.1 and 3.5 ±1.3, respectively. Meanwhile, the difference between pre-operative and post-operative pain scores was significant [ （6.93 ± 0.88） points vs （4.04 ±0.62） points, P 〈 0.05 ]. The ambulation pe- riod was （4.6 ±1.9） days and length of hospital stay was （27.2± 10.8） days. Incisional and thoracic wall hematoma was detected in three patients and pulmonary infection in six post-operatively but none presented intractable chest pain, foreign body rejection or wound infection. Conclusion Memory alloy embracing fixators for rib fractures is reliable, easy, and effective in alleviating pain, improving lung function, reducing the frequency of ventilator use and preventing complications like lung infection.

关 键 词：肋骨骨折 连枷胸 内固定器 胸腔镜 

分 类 号：R687.3[医药卫生—骨科学]