多发肋骨骨折微创治疗的研究进展  

Research progress in minimally invasive surgery for multiple rib fractures

作　　者：余小平[1] 易云峰[1] 陈松林[1] 陈检明[1] 张艳美[2] Yu Xiaoping;Yi Yunfeng;Chen Songlin;Chen Jianming;Zhang Yanmei(Department of Cardiothomcic Surgery,909th Hospital of PLA Joint Logistics Support Force(Xiamen University Affiliated Southeast Hospital),Zhangzhou 363000,China;Department of Pharmacology,Medical College of Shantou University,Shantou 515063,China)

机构地区：[1]解放军联勤保障部队第九〇九医院(厦门大学附属东南医院)心胸外科,漳州363000 [2]汕头大学医学院药理教研室,515063

出　　处：《中华创伤杂志》2020年第10期950-955,共6页Chinese Journal of Trauma

基　　金：全军后勤科研项目(CWH17J030,CNJ14C007,BLB20J009);国家自然科学基金(81773729)。

摘　　要：肋骨骨折是最常见的胸部创伤,约占所有创伤患者的10%。无明显移位骨折经非手术治疗可以取得良好的疗效,而对于多发肋骨骨折,特别是连枷胸,可引起患者剧烈疼痛、呼吸循环异常,伴随严重肺挫裂伤、血气胸和钝性心脏损伤,通常需要手术治疗。肋骨骨折切开复位内固定常涉及多个肋骨,传统的肋骨骨折手术需要大的切口才能达到满意的暴露,导致胸壁肌肉、血管和神经损伤,术后切口感染率明显增加,上肢、肩部、背部功能障碍及长时间胸部麻痛感,严重影响患者日常生活质量,因此逐渐被外科医师弃用。而学者们为多发肋骨骨折治疗探索了多种微创手术方法,笔者就多发肋骨骨折治疗的微创技术研究进展作一综述,为临床治疗提供帮助。Rib fracture is the most common chest trauma,accounting for almost 10%of all trauma patients.Non-surgical treatment of the fractures without significant displacement can achieve good results.Surgical treatment is often needed for multiple rib fractures,especially flail chest,which can induce severe pain,respiratory and circulatory abnormalities,accompanied by severe lung contusion and laceration,hemopneumothorax and blunt heart injury.Open reduction and internal fixation of rib fracture often involves multiple ribs.Traditional rib fracture surgery requires a large incision to achieve satisfactory exposure effect,which causes damages to the chest wall muscle,blood vessels and nerve damages,significantly increasing postoperative incision infection and dysfunctions in the upper limb,shoulder,back and long-term chest numbness and pain and seriously affecting the quality of patients'daily life.Therefore,it is gradually abandoned by surgeons.Experts have explored various minimally invasive surgical methods for the treatment of multiple rib fractures.The authors review the research progress of minimally invasive technology in the treatment of multiple rib fractures,in order to provide better help for clinical treatment.

关 键 词：肋骨骨折 骨折固定术 内 外科手术 微创性 

分 类 号：R687.3[医药卫生—骨科学]