爪形接骨板内固定术治疗多发肋骨骨折98例效果观察  

Clinical Effect of Internal Fixation with Claw Type of Blade Plate in Treatment of 98 Patients with Multiple Rib Fractures

作　　者：国建飞[1] 张涛[2] 邢琳琳[3] 张洪雷[1] 檀振波[1] 

机构地区：[1]邢台市人民医院胸外科,河北邢台054001 [2]邢台市人民医院神经外科,河北邢台054001 [3]邢台市人民医院呼吸内科,河北邢台054001

出　　处：《解放军医药杂志》2016年第8期44-47,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

摘　　要：目的探讨爪形接骨板内固定术治疗多发肋骨骨折的适应证、手术时机及切口选择。方法对邢台市人民医院收治的98例多根多处肋骨骨折行肋骨骨折切开复位爪形接骨板内固定手术,观察效果。结果本组无死亡病例;8例术后需呼吸机辅助呼吸,2例切口感染,均治愈;随访未见明显并发症。结论有明显反常呼吸运动、胸廓塌陷、合并需手术处理的胸腹伤、骨折端错位分离、疼痛剧烈者为本术式的适应证;除急诊手术外,骨折后3~7 d手术为最佳时机,如果存在较严重的生理功能紊乱,7 d后手术较为安全;切口选择以减少损伤和利于暴露为原则。Objective To investigate operative indication,operation time and surgical incision of internal fixation with claw type of blade plate in treatment of patients with multiple rib fractures. Methods A total of 98 patients with multiple rib fractures were treated with internal fixation by claw type of rib plates,and clinical effect was observed.Results No patient died. 8 patients needed assistor respiration with ventilator after operation. Incision infection was found in 2 patients,and the patients were cured. No obvious complication was found during the follow-up. Conclusion The operative indications include obviously paradoxical respiration movement,chest wall deformity,thoraco-abdominal injury needed operation treatment,malposition and dislocated and disassociation in fracture ends and severe pain combined with fracture ribs. The best operation time is 3-7 d after fractures except for emergency operation. If patients have severely physiological dysfunction,safer operation time should be 7 d after fractures. Selecting principles of for surgical incision are decreasing injury and adequate surgical exposure.

关 键 词：肋骨骨折 骨折内固定术 损伤控制 外科手术 

分 类 号：R683.1[医药卫生—骨科学]