解剖型和爪形接骨板固定肋骨骨折的疗效比较  

Comparison of the therapeutic effect between anatomical plates and claw-type bone plates in fixation of multiple rib fractures

作　　者：徐凤阳 王楠[1] 任佳[1] 孟宇[1] 陈聚伍[1] Xu Fengyang;Wang Nan;Ren Jia;Meng Yu;Chen Juwu(Department of Emergency Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院急诊医学部急诊外科,450052

出　　处：《中华急诊医学杂志》2019年第2期232-235,共4页Chinese Journal of Emergency Medicine

摘　　要：目的比较爪形接骨板与解剖型接骨板内固定治疗创伤性多发肋骨骨折的效果。方法回顾性分析2016年1月至2017年11月郑州大学第一附属医院急诊医学部急诊外科收治的70例创伤性肋骨骨折内固定手术患者的临床资料。根据内固定不同分为两组:爪形接骨板组(33例)和解剖型接骨板组(37例)。记录固定每处骨折所需平均手术时间、术中出血量、术后引流量、接骨板松动脱落、胸部疼痛、胸腔大出血等指标。应用SPSS17.0统计软件,计量资料比较采用t检验和秩和检验,计数资料比较采用χ^2检验;分析两种内固定的利弊。结果从骨折端完全暴露开始记录手术时间、比较固定每处骨折所需的平均手术时间,爪型接骨板组较解剖型接骨板组短[(11.04±1.81)分/处vs(12.30±0.47)分/处](P<0.01)。爪型接骨板组术中出血量[(120.76±7.19)mL vs(110.00±7.45)mL]及伤口引流量[(114.06±7.24)mL vs(107.98±7.23)mL]较解剖型接骨板组多(P<0.01)。解剖型接骨板组术后出现1例螺钉脱落(患骨质疏松)、爪型接骨板组术后2例出现接骨板松动脱落(患者无骨质疏松等合并症)(P>0.05)。爪型接骨板组术后出现2例胸部疼痛、2例胸腔大出血,均行二次手术。结论两种内固定各有利弊,爪型接骨板较廉价、塑形方便、手术时间较短,对粉碎性骨折特别适用;解剖型接骨板昂贵、但其术中出血量、术后引流量、胸腔大出血、胸部疼痛等并发症发生率低,明显减少二次手术,安全性较高。Objective To compare the therapeutic effect of claw-type bone plates and anatomical plates in fixation of traumatic multiple rib fractures.MethodsClinical data of 70 patients with traumatic multiple rib fractures between January 2016 and November 2017 was analyzed retrospectively.Based on the treatments,patients were assigned to two groups:the claw-type bone plates fixation group(n=33)and anatomical plates fixation group(n=37).The variables including operation time,intraoperative blooding,postoperative thoracic hemorrhage rate,wound drainage,plate loosening and breakage,postoperative chest pain were compared.Data were analyzed using SPSS17.0 statistical software.Student’s t test and rank sum test were used to compare the measurement data,andχ^2test was used to compare the counting data.ResultsThe operation time after the full exposure of fractures were recorded.Operation time for each fracture[(11.04±1.81)min vs(12.30±0.47)min],intraoperative bleeding[(120.76±7.19)mL vs(110.00±7.45)mL]and wound drainage[(114.06±7.24)mL vs(107.98±7.23)mL]in the claw-type rib bone plates fixation group were statistically significant different compared with the anatomical plates fixation group(P<0.05).There were 1case of screw abscission in the anatomical plates fixation group(suffering from osteoporosis)and 2 cases in the claw-type bone plates fixation group(without osteoporosis and other complications).Two cases suffered from chest pain and 2 cases suffered from massive hemorrhage in the chest in the claw-type bone plates fixation group,with secondary operation removing internal fixations.ConclusionsThe two kinds of internal fixation have their own advantages and disadvantages.The claw-type bone plates fixation is cheaper,easier to shape and has shorter operation time,which is especially suitable for comminuted fracture.Although the anatomical plates fixation is more expensive than claw-type bone plates fixation,the anatomical plates fixation on multiple fractured ribs has less postoperative blood loss,lower postoperative

关 键 词：肋骨骨折 爪形接骨板 解剖型接骨板 内固定 

分 类 号：R687.3[医药卫生—骨科学]