不剥离骨膜法肋骨钉内固定治疗多发肋骨骨折的随机对照研究  

A randomized controlled study of internal fixation treatment for multiple rib fracture with rib-connecting-pins without periosteal stripping

作　　者：吕振业[1] 冯競 邹宗望[1] 戈洁梦[1] 冯锐[1] 周慧洁[1] 余捷[1] 孙成超[2] 

机构地区：[1]温州医科大学温州市第三临床学院 [2]温州医科大学附属第一医院

出　　处：《浙江创伤外科》2014年第1期1-4,共4页Zhejiang Journal of Traumatic Surgery

基　　金：浙江省温州市科技计划基金项目(编号Y20100151)

摘　　要：目的探讨不剥离骨膜法肋骨钉内固定术治疗多发肋骨骨折的效果。方法将44例肋骨骨折患者随机分成不剥离骨膜组和剥离骨膜组,每组各22例,不剥离骨膜组应用不剥离骨膜法行肋骨钉内固定术治疗,剥离骨膜组应用传统方法(剥离骨膜)行肋骨钉内固定术治疗。比较两组手术时间、镇痛药物使用时间、术后胸腔引流液量及肋骨愈合情况。结果不剥离骨膜组及剥离骨膜组均顺利完成手术,手术时间不剥离骨膜组为(75.86±13.40)分,剥离骨膜组为(88.91±16.12)分(P<0.01);使用镇痛药物时间分别为(7.86±1.42)天,(9.09±1.19)天(P<0.01);手术后胸腔引流量分别为(619.55±94.59)ml,(678.18±101.07)ml(P<0.05),差异均有统计学意义。不剥离骨膜组肋骨断端对位对线良好,骨痂形成较早,骨折线消失较早。结论不剥离骨膜法肋骨钉内固定术相对于剥离骨膜法行肋骨钉内固定术治疗多发性肋骨骨折,具有手术方法简便、创伤相对小、术后疼痛轻、固定满意、恢复快等优点,值得临床推广。Objective To investigate the effect of internal fixation clinical effect of multiple rib fracture with rib-connecting-pins without periosteal stripping. Methods 44 patients with multiple rib fracture were randomly divided into two groups, 22 in each group. In non periosteal stripping group （NPSG） patients were treated by internal fixation with absorbable rib-connecting-pins without periosteal stripping. In periosteal stripping group （PSG） patients were treated by internal fixation with absorbable rib-connecting-pins with periosteal stripping. The operative time, the time of using pain relievers, the fluid drainaged from thoracic cavity and the healing situation of ribs after operation between the two groups were compared. Results The operative time in NPSG and PSG was 75.86±13.40min and 88.91±16.12 min （P〈0.01） respectively. The time of using pain relievers af- ter operation in NPSC and PSG were 7.86±1.42 d and 9.09±1.19 d （P〈0.01） respectively. The thoracic fluid drainage in NPSG and PSG was 619.55±94.59 ml and 678.18±101.07 ml （P〈0.05） respectively. The differences had statistical significance. NPSG showed better fracture alignment, earlier callus formation and faster disappearing of fracture line compared with PSG. Conclusion Compared with periosteal stripping, the internal fixation with rib-connecting-pins without periosteal stripping have an advantage of easier to operate, lesser trauma, lighter pain, better fixing and faster recov- ery. It is worth popularizing application in clinic.

关 键 词：肋骨骨折 可吸收肋骨钉 内固定 手术 

分 类 号：R687.3[医药卫生—骨科学]