不同手术时间对创伤性多发肋骨骨折内固定术后预后的影响  

Effect of different operative time on the prognosis after internal fixation of multiple traumatic rib fractures

作　　者：任清泉[1] 郭建峰[1] 杨扬[1] 王启[1] 曹强[1] REN Qing-quan;GUO Jian-feng;YANG Yang;Wang Qi;CAO Qiang(Department of Thoracic Surgery,Affiliated Hospital of Yan'an University,Yan'an,Shaanxi 716000,China)

机构地区：[1]延安大学附属医院胸外科,陕西延安716000

出　　处：《创伤外科杂志》2020年第6期451-453,共3页Journal of Traumatic Surgery

摘　　要：目的探究不同手术时间对创伤性多发肋骨骨折内固定术后预后的影响。方法回顾性分析2017年2月—2018年11月延安大学附属医院治疗创伤性多发肋骨骨折患者61例,男性37例,女性24例;年龄30~52岁,平均42.3岁。按照创伤至接受手术时间分为早期组(29例)与常规组(32例),早期组为伤后至手术时间<72h,常规组>72h。观察两组患者临床疗效,比较术后两组患者呼吸机辅助通气时间、疼痛缓解率及并发症,并采用健康状况调查问卷SF-36观察两组患者术后30d的生活质量。结果早期组呼吸机辅助通气时间、肺部感染率及肺不张发生率均显著短(低)于常规组(9.0±3.5)h vs.(13.7±5.3)h、6.90%vs.43.75%、0 vs.28.13%,疼痛改善率显著优于常规组(93.10%vs.65.62%,P<0.05);早期组在生理职能、社会功能、情感职能、精神健康各方面上均优于常规组患者(50.23±4.31)分vs.(44.56±3.09)分、(80.47±6.19)分vs.(72.39±5.21)分、(58.35±5.41)分vs.(54.00±4.98)分、(76.29±7.06)分vs.(71.32±6.45)分,差异有统计学意义(P<0.05)。结论创伤性多发肋骨骨折应尽快接受内固定术手术可显著提高其临床疗效,且对患者预后有良好改善。Objective To explore the effect of different operation time on the prognosis after traumatic multiple rib fracture internal fixation.Methods From Feb.2017 to Nov.2018,61 patients with traumatic multiple rib fractures admitted to Yan'an University Hospital were selected as the research subjects.There were 37 males and 24 females,with an average age of 42.3 years(range,30-52 years).Random number table method was used to divide them into early group(29 cases)and conventional group(32 cases).Patients in the early group underwent surgical treatment within 72 hours after injury,and patients in the conventional group underwent surgical treatment 72 hours after injury.The clinical efficacy,ventilator-assisted ventilation time,pain relief rate and complications after operation were observed and compared,and the prognostic quality of life of the two groups of patients was analyzed.Results The ventilator-assisted ventilation time,lung infection rate and atelectasis incidence in the early group were significantly shorter(lower)than those in the conventional group[(9.0±3.5)h vs.(13.7±5.3)h,6.90%vs.43.75%,0 vs.28.13%],the pain improvement rate was significantly better than the conventional group(93.10%vs.65.62%,P<0.05);the early group was superior to all aspects of physiological function,social function,emotional function,mental health compared with those of the routine group[(50.23±4.31)points vs.(44.56±3.09)points,(80.47±6.19)points vs.(72.39±5.21)points,(58.35±5.41)points vs.(54.00±4.98)points,(76.29±7.06)points vs.(71.32±6.45)points],and the difference was statistically significant(P<0.05).Conclusion After undergoing traumatic multiple rib fractures,if the internal fixation surgery can be performed as soon as possible,its clinical efficacy can be significantly improved,and the patient's postoperative prognosis can be improved.

关 键 词：肋骨骨折 内固定 手术时间 预后 

分 类 号：R683.1[医药卫生—骨科学]