两种不同类型的肋骨接骨板在肋骨骨折固定手术中的应用研究  

Application of two different types of rib plates in rib fracture fixation

作　　者：倪达 王明松 杨志胤[1] 程佑爽 朱智军 庄步峰 滕继平 Ni Da;Wang Mingsong;Yang Zhiyin;Cheng Youshuang;Zhu Zhijun;Zhuang Bufeng;Teng Jiping(Department of Thoracic Surgery,Shanghai Ninth People’s Hospital,Shanghai JiaoTong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院胸外科,上海200011

出　　处：《创伤外科杂志》2021年第9期646-649,共4页Journal of Traumatic Surgery

摘　　要：目的探讨两种不同类型的肋骨接骨板治疗多发性肋骨骨折的临床疗效。方法回顾性分析2019年3月—2020年9月上海交通大学医学院附属第九人民医院胸外科收治的92例切开复位内固定术的多发性肋骨骨折患者资料,按照不同的内固定手术方式分为观察组和对照组,每组46例。观察组采用形状记忆环抱接骨板治疗,男性28例,女性18例;年龄21~65岁,平均42.1岁;撞伤23例,跌伤21例,其他2例;骨折数量3~8根,平均4.2根。对照组采用肋骨锁定接骨板治疗,男性30例,女性16例;年龄20~66岁,平均45.4岁;撞伤20例,跌伤23例,其他3例;骨折数量3~6根,平均3.5根。观察并记录两组患者的手术时间、术中出血量、胸管引流量、拔除引流管时间、住院时间等围术期指标,比较两组胸痛缓解时间以及术后并发症(包括伤口感染、肺部感染、肺不张、骨折延迟愈合等)的情况。结果经手术治疗后,观察组较对照组手术时间更短[(58.11±13.43)min vs.(75.31±10.56)min,P<0.05]。两组患者术中出血量[(50.45±9.78)mL vs.(51.36±8.90)mL]、拔除引流管时间[(5.15±1.32)d vs.(5.24±1.08)d]、胸腔引流量[(330.24±150.78)mL vs.(348.53±148.29)mL]及住院时间[(7.45±2.01)d vs.(8.02±1.76)d]比较差异无统计学意义(P>0.05);两组在治疗24h和48h后VAS均有所降低,且观察组明显低于对照组[(7.85±0.55)分vs.(8.53±0.62)分,(7.01±0.27)分vs.(7.89±0.18)分,P<0.05];观察组患者术后并发症发生率更低(8.7%vs.21.7%,P<0.05)。结论采用形状记忆环抱接骨板进行肋骨骨折固定较肋骨锁定接骨板可以有效缩短手术时间,患者术后疼痛程度较轻,并发症发生率低,值得临床广泛应用。Objective To investigate the clinical efficacy of two different types of rib plates in the treatment of multiple rib fractures.Methods A total of 92 patients with multiple rib fractures who underwent open reduction and internal fixation in Department of Thoracic Surgery,Shanghai Ninth People’s Hospital,Shanghai JiaoTong University School of Medicine from Mar.2019 to Sep.2020 were retrospectively analyzed.According to different internal fixation methods,they were divided into observation group and control group,with 46 cases in each group.In the observation group,there were 28 males and 18 females,aged from 21 to 65 years,with an average of 42.1 years.The causes of injury were collision injury in 23 cases,falling injury in 21 cases and others in 2 cases.The number of fractures ranged from 3 to 8,with an average of 4.2.In the control group,there were 30 males and 16 females,aged from 20 to 66 years,with an average of 45.4 years.The causes of injury were collision injury in 20 cases,falling injury in 23 cases and others in 3 cases.The number of fractures ranged from 3 to 6,with an average of 3.5.The observation group was treated with shape memory embracing plate,while the control group was treated with rib locking plate.The operation time,intraoperative blood loss,chest tube drainage volume,drainage tube removal time,hospital stay and other perioperative indicators of the two groups were observed and recorded.The chest pain relief time and postoperative complications of the two groups were compared.Results After operation,compared with the control group,the operation time of the observation group was shorter[(58.11±13.43)minutes vs.(75.31±10.56)minutes],P<0.05.The intraoperative blood loss of the two groups was[(50.45±9.78)mL vs.(51.36±8.90)mL]and the time of drainage tube removal time[(5.15±1.32)days vs.(5.24±1.08)days],thoracic drainage volume[(330.24±150.78)mL vs.(348.53±148.29)mL]and length of hospital stay[(7.45±2.01)days vs.(8.02±1.76)days]had no statistical differences between the two groups(P>0.0

关 键 词：多发性肋骨骨折 形状记忆环抱接骨板 肋骨锁定接骨板 内固定 

分 类 号：R683.1[医药卫生—骨科学]