创伤性连枷胸伴肺挫伤的外科治疗  

Surgical treatment of traumatic flail chest with pulmonary contusion

作　　者：刘晋梁[1] 葛永玲[2] 李克耀[1] 郭志刚[1] 

机构地区：[1]解放军第一医院心胸外科,甘肃兰州730000 [2]解放军第一医院质量管理科,甘肃兰州730000

出　　处：《西北国防医学杂志》2015年第1期12-14,共3页Medical Journal of National Defending Forces in Northwest China

摘　　要：目的：比较连枷胸的治疗方式和疗效,提高救治成功率。方法：回顾性分析1998-01~2010-10我院收治的56例连枷胸病例,分为牵引治疗组14例、包扎治疗组12例、手术内固定组30例,比较三组的治疗效果。结果：手术内固定组机械通气时间、ICU时间、留置胸管时间缩短,肺挫伤评分、需呼吸机支持率、胸部并发症的发生率及病死率降低（P〈0.01）,PaO2、SaO2显著升高（P〈0.01）。结论：手术内固定优于牵引治疗和包扎治疗,而包扎治疗效果最差。Objective：To compare the different treatment methods and clinical curative effect for severe chest trauma with flail chest in order to improve the survival rate.Methods：The 56 patients with severe chest trauma and flail chest admitted in the First Hospital of PLA from January 1998 to December 2010 were retrospectively analyzed.All cases were divided into rib traction group with 14 cases,pressure dressing group with 12 cases,and surgical fixation group with 30 cases.The therapeutic effect was comparedamong 3groups.Results：The mechanical ventilation time,ICU stay,retaining intrathoracicdrain time,ventilator support rate,incidence of thoracic complication,mortality and pulmonary contusion grade,were obviously shorter in surgical fixation group than that of other groups（P0.01）,whereas PaO2 and SaO2 were significantly increased（P0.01）.Conclusion：Surgical internal fixation is a more effective method than the pressure dressing and traction,and pressure dressing is the least effective.

关 键 词：创伤性连枷胸 肺挫伤 手术内固定 牵引术 包扎 

分 类 号：R655[医药卫生—外科学]