环抱式记忆合金肋骨接骨板内固定治疗连枷胸伴呼吸衰竭的疗效  

Effect of claw-type pure titanium rib bone plate internal fixation on flail chest with respiratory failure

作　　者：赵常青 Zhao Changqing(Department of Cardiothoracic Surgery,Xinzheng Public People's Hospital,Xinzheng 451100,China)

机构地区：[1]河南省新郑市公立人民医院心胸外科,451100

出　　处：《临床医学》2021年第4期17-20,共4页Clinical Medicine

摘　　要：目的探讨环抱式记忆合金肋骨接骨板内固定治疗连枷胸伴呼吸衰竭患者的效果。方法选取2016年1月至2019年12月新郑市公立人民医院接受治疗的124例连枷胸伴呼吸衰竭患者,采用随机数字表法分为观察组与对照组,每组62例。对照组接受胸廓外固定治疗,观察组接受环抱式记忆合金肋骨接骨板内固定治疗。分别记录两组患者临床指标并比较;分别于固定前、固定后3 d检测两组血清胱抑素C(CysC)及血气[氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))]并比较;分别于固定前、固定后2个月,检测两组肺功能[第一秒用力呼气容积(FEV1)、用力肺活量(FVC)、最大呼气流速(PEF)]并比较;记录固定后并发症并比较。结果观察组ICU治疗、机械通气及住院时间均短于对照组(P<0.05)。固定后3 d,两组血清CysC水平及PaCO_(2)均较固定前降低,PaO_(2)较固定前升高,且观察组血清CysC、PaCO_(2)低于对照组,PaO_(2)高于对照组(P<0.05)。固定后2个月,两组FEV1、FVC及PEF均较固定前升高,且观察组高于对照组(P<0.05)。两组固定后均未发生并发症。结论连枷胸伴呼吸衰竭患者经环抱式记忆合金肋骨接骨板内固定治疗效果显著,肺功能更好更快恢复,血气指标改善明显,更利于缩短ICU治疗时间缩短,加速康复。Objective To investigate the effect of claw-type pure titanium rib bone plate internal fixation on patients with flail chest and respiratory failure.Methods A total of 124 flail chest patients with respiratory failure treated in Xinzheng Public People's Hospital from January 2016 to December 2019 were selected and divided into observation group and control group by random number table,with 62 cases in each group.The control group received external thoracic fixation,and the observation group received claw-type pure titanium rib bone plate internal fixation.The clinical indicators of the two groups were recorded and compared;before fixation and 3 days after fixation,the serum cystatin C(CysC)and blood gas[partial pressure of oxygen(PaO_(2))and carbon dioxide(PaCO_(2))]were measured and compared between the two groups;before fixation and 2 months after fixation,the lung function of the two groups’patients[forced expiratory volume in the first second(FEV1),forced vital capacity(FVC),maximum expiratory flow rate(PEF)]were compared;the complications of the two groups after fixation were recorded and compared.Results The ICU treatment time,mechanical ventilation time and hospitalization time of the observation group were shorter than those of the control group(P<0.05).At 3 days after fixation,the serum CysC and PaCO_(2) levels of the two groups were lower than those before fixation,and PaO_(2) levels were higher than those before fixation;the serum CysC and PaCO_(2) levels of the observation group were lower than those of the control group,and PaO_(2) level was higher than that of the control group(P<0.05).At 2 months after fixation,the FEV1,FVC and PEF levels of the two groups were higher than those before fixation,and those of the observation group were higher than those of the control group(P<0.05).There were no complications occurred in the two groups after fixation.Conclusions The effect of claw-type pure titanium rib bone plate internal fixation on patients with flail chest and respiratory failure is significant

关 键 词：连枷胸 呼吸衰竭 内固定 环抱式记忆合金肋骨接骨板 血气 肺功能 

分 类 号：R687.3[医药卫生—骨科学]