同期肋骨内固定手术治疗胸外伤合并多发肋骨骨折  

Fixed operation of multiple rib fraotures in chest trauma

作　　者：隋铁泉[1] 张志伟[1] 杨洋[1] 杨涛[1] 滕洪生 张秀强[1] 

机构地区：[1]天津市第五中心医院胸心外科,300450

出　　处：《中华胸心血管外科杂志》2014年第1期14-16,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：天津市滨海新区塘沽科技计划项目（2010XQ15-08）

摘　　要：目的总结重症胸外伤合并多发肋骨骨折早期应用钛板肋骨固定手术治疗的诊治经验和临床效果。方法2007年6月至2012年6月，需开胸探查的重症胸外伤患者161例，动态均衡随机化法分为两组：对照组79例常规开胸手术；肋骨内固定组82例开胸同期行肋骨内固定。比较两组术后反常呼吸、血氧饱和度、肺功能、胸腔引流、住院时间等指标。结果肋骨内固定组术后血氧饱和度、肺功能、住院时间、并发症发生率、病死率等均优于对照组。结论剖胸探查同期行肋骨内固定手术，可有效控制胸壁反常呼吸，纠正呼吸衰竭，改善肺功能，减少胸外伤患者并发症和病死率，利于患者病情恢复。Objective Summarize and analyze surgical treatment experience and clinical application value for severe chest trauma with multiple rib fractures （which has a positive rate of occurrence）, the treatment method is to surgically fix tita-nium plate to ribs at the early stage of the fractures. Methods Adopted 161 severe chest trauma cases require thoracotomy from June, 2007 to June, 2012. The patients were arranged as two groups according to the doctor＇s requirements by our full-tiem horses. 79 cases of normal thoracotomy operations were recorded as control group ; at the same period 82 cases thoracotomy operation with ribs internally fixed treatment were recorded as the group of internal plate fixing treatment group. Then compare the results of postoperative paradoxical respiration, oxygen concentration, lung function, chest drainage, length of stay and oth-ers after operations. Results The treatment results include oxygen saturation of blood, lung function, and length of stay, the complication rate and death rate. The results of ribs internally fixed group are better than the control group on average. Conclu-sion Apply internal plate fixing operation to ribs during the thoracotomy will effectively control thoracic paradoxical respiration and prevent respiratory failure, improve lung function, reduce death rate of chest trauma and the complication and be helpful for rapid recovery.

关 键 词：胸部损伤 肋骨骨折 胸外科手术 

分 类 号：R655[医药卫生—外科学]