肋骨板螺钉固定与肋骨环抱器固定治疗肋骨骨折的临床疗效研究  

Clinical Efficacy of Rib Plate Screw Fixation and Rib Embracing Device Fixation in the Treatment of Rib Fractures

作　　者：薛行娟 林平华 俞晓辉 杨常平 XUE Xingjuan;LIN Pinghua;YU Xiaohui;YANG Changping(Department of Thoracic Surgery,Fuqing Hospital Affiliated to Fujian Medical University,Fuzhou 350300,China)

机构地区：[1]福建医科大学附属福清市医院胸外科,福州350300

出　　处：《中国医药指南》2024年第35期34-36,共3页Guide of China Medicine

摘　　要：目的对比肋骨板螺钉固定与肋骨环抱器固定治疗肋骨骨折的临床疗效,探索最佳术式。方法选取2022年3月至2024年3月福建医科大学附属福清市医院实施肋骨骨折切开复位内固定手术的61例患者,其中29例使用肋骨板螺钉固定(观察组);32例使用肋骨环抱器固定(对照组),比较两组有效操作时间(术中)、失血量(术中)、引流量(术后、胸腔)、引流管拔除时间(术后、胸腔)、术后疼痛情况(VAS评分)、住院时间等围手术期指标。结果两组患者术前一般资料无差异(P>0.05)。两组有效操作时间(术中)、失血量(术中)、术后第3天VAS疼痛评分、固定肋骨数量、住院时间对比无差异(均P>0.05)。观察组与对照组相比,引流量(术后、胸腔)更少(P<0.05),术后第1天的VAS疼痛评分更低(P<0.05),引流管拔除时间(术后、胸腔)更少(P<0.05)。在术后并发症方面,对照组术后术区皮肤感觉减退事件发生比观察组多(P<0.05),术后慢性疼痛发生概率高于对照组,但差异无统计学意义(P>0.05)。结论相较于肋骨环抱器内固定,在不比较费用的情况下,肋骨板螺钉内固定可减轻患者术后疼痛,减少胸腔闭式引流的时间和胸腔引流量,可减少术后术区皮肤感觉异常事件的发生。Objective To compare the clinical efficacy of rib plate screw fixation and rib wrap fixation in the treatment of rib fractures,and explore the optimal surgical approach.Methods A total of 61 patients who underwent open reduction and internal fixation surgery for rib fractures at Fujian Medical University Affiliated Fuqing Hospital from March 2022 to March 2024.Among them,29 cases were fixed with rib plate screws(observation group),32 cases were fixed with rib wrap(control group),and perioperative indicators such as effective operation time(intraoperative),blood loss(intraoperative),drainage volume(postoperative,thoracic),drainage tube removal time(postoperative,thoracic),postoperative pain(VAS scores),and hospital stay were compared between the two groups.Results There was no statistically significant difference in the general information of the two groups of patients before surgery(P>0.05).There was no statistically significant difference in the effective operation time(intraoperative),blood loss(intraoperative),VAS pain score on the third postoperative day,number of ribs fixed,and hospital stay between the two groups(all P>0.05);compared with the control group,the observation group had less drainage volume(postoperative,thoracic)(P<0.05);lower VAS pain score on the first postoperative day(P<0.05);and less time for chest tube removal(postoperative,thoracic)(P<0.05).In terms of postoperative complications,the control group had more incidents of reduced skin sensation in the surgical area compared to the observation group(P<0.05),and the probability of chronic postoperative pain was significantly higher than the control group,but the difference was not statistically significant(P>0.05).Conclusions Compared with rib cage fixation,rib plate screw fixation can alleviate postoperative pain,reduce the time and volume of closed thoracic drainage,and reduce the occurrence of postoperative skin sensory abnormalities in the surgical area,without comparing costs.

关 键 词：肋骨骨折 切开复位内固定 肋骨板螺钉 肋骨环抱器 

分 类 号：R683.1[医药卫生—骨科学]