创伤性肋骨骨折手术治疗中国专家共识(2021版)  

Chinese consensus on surgical treatment of traumatic rib fractures(2021)

作　　者：孔令文 黄光斌 易云峰[2] 都定元 姜保国[3] 高劲谋 张连阳 蒋建新 白祥军 王天兵[3] 赵兴吉 党星波[6] 李占飞[5] 徐峰[7] 刘中民[8] 王如文 肖颖彬 吴庆琛[10] 吴春[11] 程黎明[12] 余斌[13] 崔树森[14] 吴京兰 杜工亮[6] 邓进 胡平[1] 杨俊[1] 杨小锋[17] 曾俊[18] 王海东 戴继刚 符勇 侯立军 梁贵友 林一丹[23] 谭群友 沈岩[17] 胡培阳[24] 陶宁[25] 王成 王达利 吴旭[13] 钟永富 喻安永 朱东波[29] 肖仁举 邵标[31] Kong Lingwen;Huang Guangbin;Yi Yunfeng;Du Dingyuan;Jiang Baoguo;Gao Jinmou;Zhang Lianyang;Jiang Jianxin;Bai Xiangjun;Wang Tianbing;Zhao Xingji;Dang Xingbo;Li Zhanfei;Xu Feng;Liu Zhongmin;Wang Kuwen;Xiao Yingbin;Wu Qingchen;Wu Chun;Cheng Liming;Yu Bin;Cui Shusen;Wu Jinglan;Du Gongliang;Deng Jin;Hu Ping;Yang Jun;Yang Xiaofeng;Zeng Jun;Wang Haidong;Dai Jigang;Fu Yong;Hou Lijun;Liang Guiyou;Lin Yidan;Tan Qunyou;Shen Yan;Hu Peiyang;Tao Ning;Wang Cheng;Wang Dali;Wu Xu;Zhong Yongfu;Yu Anyong;Zhu Dongbo;Xiao Renju;Shao Biao(Chongqing University Central Hospital/Chongqing Emergency Medical Center,Chongqing 400014,China;2909th Hospital of Joint Logistic Support of PLA/Southeast Hospital of Xiamen University,Zhangzhou 363000,China;Peking University People's Hospital/National Center for Trauma Medicine,Beijing 100044,China;Daping Hospital,Army Medical Universityy Chongqing 400042,China;Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wulum 430030,China;People’s Hospital of Shaanxi Province,Xi'an 710068,China;First Affiliated Hospital of Soochow University,Suzhou 215006,China;Oriental Hospital of Tongji University,Shanghai 200120,China;Xinqiao Hospital,Army Medical University,Chongqing 400037,China;First Affiliated Hospital of Chongqing Medical University,Chongqing 400042,China;Children's Hospital of Chongqing Medical University,Chongqing 400015,China;Tongji Hospital,Tongji University School of Medicine,Shanghai 200065,China;Southern Hospital of Southern Medical University,Guangzhou 510515,China;China-Japan Union Hospital of Jilin University,Changchun 130033,China;Union Shenzhen Hospital,Huazhong University of Science and Technology,Shenzhen 518052,China;Affiliated Hospital of Guizhou Medical University,Guiyang 550004,China;First Affiliated Hospital,School of Medicine,Zhejiang Vniversity,Hangzhou 310014,China;Sichuan Provincial People's Hospital,Chengdu 610072,China;Southwest Hospital,Army Medical University,Chongqing 400038,China;Second Hospital,University of South China,Hengyang 421099,

机构地区：[1]重庆大学附属中心医院/重庆市急救医疗中心,400014 [2]解放军联勤保障部队第九○九医院/厦门大学附属东南医院,漳州363000 [3]北京大学人民医院/国家创伤医学中心,100044 [4]陆军军医大学大坪医院,重庆400042 [5]华中科技大学同济医学院附属同济医院,武汉430030 [6]陕西省人民医院,西安710068 [7]苏州大学附属第一医院,215006 [8]同济大学附属东方医院,上海200120 [9]陆军军医大学新桥医院,重庆400037 [10]重庆医科大学附属第一医院,400042 [11]重庆医科大学附属儿童医院,400015 [12]同济大学附属同济医院,上海200065 [13]南方医科大学附属南方医院,广州510515 [14]吉林大学附属中日联谊医院,长春130033 [15]华中科技大学协和深圳医院,518052 [16]贵州医科大学附属医院,贵阳550004 [17]浙江大学医学院附属第一医院,杭州310014 [18]四川省人民医院,成都610072 [19]陆军军医大学西南医院,重庆400038 [20]南华大学附属第二医院,衡阳421099 [21]海军军医大学长征医院,上海200003 [22]贵州医科大学,贵阳550004 [23]四川大学华西医院,成都610044 [24]浙江省天台县人民医院,台州317299 [25]四川省遂宁市中心医院,629099 [26]海南医学院第一附属医院,海口570102 [27]遵义医科大学附属医院,563003 [28]重庆大学附属三峡医院,万州400030 [29]南通大学附属医院,226006 [30]贵州省兴义市人民医院,562499 [31]昆明市第一人民医院,650034 [32]陆军军医大学陆军特色医学中心 [33]陆军军医大学创伤、烧伤与复合伤国家重点实验室 [34]陆军军医大学陆军特色医学中心战创伤中心、战伤救治前沿技术研究室

出　　处：《中华创伤杂志》2021年第10期865-875,F0003,共12页Chinese Journal of Trauma

基　　金：国家创伤区域医疗中心(委市共建)重大研究项目(jjzx2021-gjcsqyylzx01)。

摘　　要：肋骨骨折是胸部创伤中最常见的损伤,既往以非手术治疗为主.但高达50%的患者,尤其是合并连枷胸者.会出现慢性疼痛或胸壁畸形.超过30%的人会遗留长期残疾.而且往往无法重返全职工作。虽然肋骨骨折手术治疗取得良好救治结局.但普遍存在治疗不规范疗效差异大等问题。国内外专家共识着重于整体治疗决策和方案的指导.国外相关临床实践指南缺少近几年肋骨骨折手术治疗进展。为此,由中华医学会创伤学分会、中国医师协会创伤外科医师分会组织全国多学科专家共同参与,遵循循证医学原则,本着科学性与实用性.制订了《创伤性肋骨骨折手术治疗中国专家共识》(2021版).对创伤性肋骨骨折的术前影像学评估、手术指征、手术时机、手术方式.手术固定部位选择、内固定方式和材料选择及肋骨骨折常见合并损伤的处理等7个方面提出建议,为创伤性肋骨骨折的手术治疗提供指导和参考。Traumatic rib fractures are the most common injury in thoracie trauma.Previously,the patients with traumatie rib fractures were mostly treated non-surgically.of which 50%,especially those combined with flail chest presented chronie pain or chest wall deformities and over 30%had long-term disabilities.being unable to relain a full-time job.In the past 1wo decades,thanks to the development of internal fixation material technology,the surgical treatment of rib fractures has achieved good outcomes.However.there are still some problems in clinical treatment.including inconsistency in surgical treatment and quality control in medical services.The current consensuses on the managerment of regional traumatic rib fractures published at home and abroad mainly focus on the guidance of the overall treatment decisions and plans.and relevant climical guidelines abroad lacks progress in surgical treatment of rib fractures in recent years.Therefore,the Chinese Sociely of Traumatology afiliated to Chinese Medical Association and Chinese College of Trauma Surgeons afiliated to Chinese Medical Doctor Association,in conjunection with national multidisciplinary experts,formulate the Chinese Consensus for Surgical Treatment of Traumatic Rib Fractures(2021)following the prineiple of evidence-based medicine,scientifie nature and practicality.This expert consensus puts forward some clear,applicable,and graded recommendations from aspects of preoperative imaging evaluation,surgical indications.timing of surgery,surgical methods,rib fracture sites for surgical fixation,internal fixation methods and material selections,treatment of combined injuries in rib fractures,in order to prov ide references for surgical treatment of traumatic rib fractures.

关 键 词：肋骨骨折 创伤与损伤 外科手术 专家共识 

分 类 号：R687.3[医药卫生—骨科学]