听诊三角入路行多发肋骨骨折内固定与保守治疗的比较研究  

Comparison between internal fixation by auscultation triangle approach and conservative therapy in treatment of multiple rib fractures

作　　者：鲁彪 李小兵 王长喜 LU Biao;LI Xiaobing;WANG Changxi(Department of Cardiothoracic Surgery,Shaoxing Central Hospital,Shaoxing 312030,China.)

机构地区：[1]绍兴市中心医院心胸外科,浙江绍兴312030

出　　处：《全科医学临床与教育》2020年第4期318-320,共3页Clinical Education of General Practice

摘　　要：目的探讨多发肋骨骨折行手术内固定治疗与保守治疗的临床疗效。方法以135例多发肋骨骨折患者为研究对象,随机分成手术组和保守治疗组。手术组采用经听诊三角入路进行肋骨骨折的内固定治疗。保守治疗组行胸带外固定治疗。比较两组的术后疼痛持续时间、住院时间、肺部并发症、肺通气功能及工作中断时间之间的差别。结果手术组的疼痛时间、住院时间、工作中断时间明显短于保守治疗组,差异有统计学意义(t分别=-2.96、-6.11、-9.44,P均<0.05),且手术组的并发症发生率明显低于保守治疗组,差异有统计学意义(χ~2=53.51,P<0.05)。入院时两组患者每分钟最大通气量(MVV)及一秒用力呼气容积所占百分比(FEV1%)相比较,差异无统计学意义(t分别=0.48、1.04,P均>0.05)。但术后第7天复查发现手术组MVV明显高于保守治疗组(t=5.67,P<0.05),但两组FEV1%比较,差异仍无统计学意义(t=0.29,P>0.05)。结论经听诊三角入路手术内固定治疗多发肋骨骨折比保守治疗的治疗效果更好。Objective To investigate the clinical effects of internal fixation by auscultation triangle approach and conservative treatment in patients with multiple rib fractures. Methods Totally 135 patients with multiple rib fractures were randomly divided into operation group and conservative treatment group.The operation group was treated by internal fixation of rib fracture through auscultation triangle approach.The conservative treatment group received external fixation of chest band.The differences in postoperative pain duration,hospitalization time,pulmonary complications,pulmonary ventilation function and the time of resuming work were compared between the two groups. Results The postoperative pain duration,hospitalization time,and the time of resuming work in the operation group were significantly shorter than those in the conservative treatment group(t=-2.96-6.11,-9.44,P<0.05),and the incidence of complications in the operation group was significantly lower than that in the conservative treatment group(χ~2= 53.51,P<0.05).At the time of admission,there was no statistically significant difference between the two groups in MVV and FEV1%(t =0.48,1.04,P>0.05).However,the results of reexamination on the 7 th day after the operation showed that MVV in the operation group was significantly higher than that in the conservative treatment group(t=5.67,P<0.05),but the difference in FEV1% between the two groups was still not statistically significant(t=0.29,P>0.05). Conclusion Internal fixation by auscultation triangle approach in treatment of multiple rib fractures is more effective than conservative treatment.

关 键 词：肋骨骨折 听诊三角 镍钛合金环保器 

分 类 号：R687.3[医药卫生—骨科学]