可吸收髓内钉和环抱式接骨器治疗多发性肋骨骨折的比较  

Comparing the treatment of multiple rib fractures between the absorbable intramedullary nail and encircling compressive connector

作　　者：王立[1] 康迪[1] 伊斯拉木江.吐尔逊 孙琴琴[1] 杜萍[1] 

机构地区：[1]新疆医科大学第六附属医院胸外科,乌鲁木齐830002 [2]新疆医科大学第二附属医院心胸外科

出　　处：《临床急诊杂志》2014年第7期399-401,共3页Journal of Clinical Emergency

基　　金：新疆医科大学2012年科研创新基金(No:XJC2012145)

摘　　要：目的：探讨使用可吸收髓内钉或环抱式接骨器内固定治疗多发性肋骨骨折的疗效。方法：选取2007-06-2013-06我院收治的多发性肋骨骨折胸部创伤评分（AIS-ISS评分）9~20（16±2）分的患者302例,随机分为可吸收髓内钉组147例,男79例、女68例,年龄25~61岁,平均（36±4）岁;环抱式接骨器组155例,男84例、女71例,年龄24~63岁,平均（35±6）岁,分别用可吸收髓内钉和环抱式接骨器行肋骨内固定手术。观察术后患者胸廓外观满意度、肺部炎症发生率、止痛有效率,以及闭式引流带管时间和住院时间,并对治疗效果进行比较。结果：2组内固定患者均恢复良好,手术肋骨对位、对线良好,无严重手术并发症。胸廓外观满意,胸部疼痛程度、带胸管时间、住院时间2组无明显差异（P〉0.05）。结论：对严重骨质疏松的患者宜采用环抱式接骨器治疗,对不宜二次手术的患者可采用可吸收髓内钉治疗。两种肋骨内固定手术,对有选择性的多发肋骨骨折患者,都取得了较好的疗效。Objective：To investigate the effect of internal fixation in the treatment of multiple fractured ribs between the absorbable intramedullary nail and the encircling compressive connector. Method： 302 cases of patients with multiple rib fractures treated in the department of Thoracic Surgery the Sixth Hospital Affiliated to Xinjiang Medical University were selected in the study. They were randomly divided into absorbable intramedullary nail group （147 cases,male 79,female 68,age 25 to 61 years old, （36±4） years old ）and encircling compressive connector group （155 cases,male 84,female 71,age 24-63 （35±6） years old）. They were separately treated with Line frame internal fixation surgery using the absorbable intramedullary nail and the encircling compressive connector. Then, the thoracic appearance of satisfaction, the incidence of lung inflammation, the analgesic efficiency, and closed drainage tube time and hospitalization time were observed and compared. Result： Two groups of internal fixation patients recovered well. The rib alignment and the line were good with no serious complications. The satisfaction of thoracic appearance, the degree of chest pain,the hospitalization time and the time with a chest tube had no sig- nificant difference between the two groups （P〈 0.05）. Conclusion： Patients with severe osteoporosis should be treated by encircling compressive connector. For patients who were not suitable for secondary surgery, the absorbable intramedullary nail should be considered. Two kinds of frame internal fixation surgery have achieved good results for patients with selective multiple fractured ribs.

关 键 词：多发性肋骨骨折 可吸收髓内钉 环抱式接骨器 

分 类 号：R683.1[医药卫生—骨科学]