早期内固定治疗创伤性连枷胸的临床疗效对比研究  

Comparative study on the clinical effect of early internal fixation on traumatic flail chest

作　　者：张文通 黄波 马瑞东[2] Zhang Wentong;Huang Bo;Ma Ruidong(Department of Cardiothoracic Surgery,Medical Center Hospital of Qionglai City,Qionglai,Sichuan 611530,China;Department of Cardiothoracic Surgery,The First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,China)

机构地区：[1]邛崃市医疗中心医院心胸外科,四川邛崃611530 [2]成都医学院第一附属医院胸心外科,成都610500

出　　处：《创伤外科杂志》2021年第12期913-915,共3页Journal of Traumatic Surgery

摘　　要：目的探讨早期内固定治疗创伤性连枷胸(traumatic flail chest,TFC)的临床疗效。方法回顾性分析2018年1月—2020年12月邛崃市医疗中心医院心胸外科行内固定治疗的83例TFC患者,男性52例,女性31例;年龄18~65岁,平均49.0岁;体质量指数(BMI)20.29~24.93kg/m^(2),平均23.43kg/m^(2);致伤原因道路交通伤58例,高处坠落伤16例,其他9例。依据手术时间分为早期组(n=41)与对照组(n=42),早期组伤后24h内行内固定治疗,对照组于伤后24h后行内固定治疗。观察两组术中失血量、手术时间、呼吸机使用时间、留置引流管时间以及住院时间,术前及术后7d动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)指标及术后并发症。结果两组术中失血量、手术时间比较差异均无统计学意义(P>0.05)。早期组呼吸机使用时间、留置引流管时间及住院时间均短于对照组(P<0.05)。术后7d,早期组PaO2大于对照组(74.96±8.07)mmHg vs.(70.55±7.41)mmHg,PaCO2小于对照组(32.08±3.42)mmHg vs.(35.35±3.70)mmHg,P<0.05。早期组术后并发症发生率(17.07%,7/41)低于对照组(38.10%,16/42),P<0.05。结论早期内固定治疗TFC能缩短患者住院时间,减少术后并发症,促进患者康复。Objective To investigate the clinical effect of early internal fixation on multiple rib fracture.Methods A retrospective analysis was performed on the medical data of 83 patients with TFC who received internal fixation treatment in our hospital from Jan.2018 to Dec.2020.There were 52 males and 31 females;the age ranged from 18 to 65 years,with an average of 49.0 years;BMI ranged from 20.29 to 24.93 kg/m^(2),with an average of 23.43kg/m^(2).Causes of injury were:58 cases of road traffic injury,16 cases of falling injury and 9 cases of other injuries.They were divided into early group(n=41)and late group(n=42)using the table of operation time,the early group was given internal fixation treatment within 24 hours after injury,and the late group was given internal fixation treatment 24 hours after injury.The perioperative period indexes such as intraoperative blood loss,operative time,ventilator service time,indwelling time of drainage tube,and hospital stays time were observed in the two groups.Preoperatively and at postoperative 7d,pulmonary function indicators such as arterial partial pressure of oxygen(PaO2),arterial partial pressure of dioxide(PaCO2)and postoperative complications were compared.Results There was no difference in the intraoperative blood loss,operative time between the two groups(P>0.05).The ventilator service time,indwelling time of drainage tube,and hospital stays in the early group were less than those in the late group[(74.96±8.07)mmHg vs.(70.55±7.41)mmHg],PaCO2 in the early group was lower than that in the late group[(32.08±3.42)mmHg vs.(35.35±3.70)mmHg],P<0.05.The incidence of postoperative complications in the early group(17.07%,7/41)was lower than that in the late group(38.10%,16/42).Conclusion Early treatment of TFC with internal fixation can shorten the length of hospital stay,reduce postoperative complications and promote patients'recovery.

关 键 词：胸部创伤 连枷胸 内固定 肋骨环抱器 

分 类 号：R683.1[医药卫生—骨科学]