镍钛合金环抱器肋骨内固定在合并连枷胸的多发伤救治中的应用价值

Value of Ti-Ni shape memory alloy embracing fixator in the first-aid treatment of multiple fractures of ribs

目的探讨多根、多处肋骨骨折急救中镍钛合金环抱器肋骨内固定手术的疗效和应用价值。方法对47例多根、多处肋骨骨折连枷胸实施急诊肋骨内固定手术的患者资料进行回顾性分析。结果内固定组治愈46例,平均下床自主活动时间为术后6d;平均住院时间16d。出院后均无胸廓畸形及术侧胸部、肩部、上肢活动障碍等后遗症。术后6个月复查胸片,骨折全部骨性愈合,同时,患者术后发生呼吸衰竭、血气胸、肺不张及肺部感染等并发症较非手术治疗组有明显减少,差异有统计学意义(P<0.05)。结论镍钛合金环抱器结合重点固定法肋骨内固定在合并连枷胸的多发伤救治中,较其他的非手术常规治疗具有更好的疗效;而对手术适应证的良好把握是确保疗效的关键。

Objective To discuss the curative effect and value of Ti - Ni shape memory alloy embracing fixator in the surgical treatment of multiple fractures of ribs. Methods 47 cases with multiple fractures of ribs and flail chest were retrospectively analyzed. Results In 47 cases ,46 cases were cured. All the patients underwent the operation of internal fixation. After internal fixation, chest wall was stable, respiratory function recovered and the patients discharged from the hospital. After six months, chest deformity was not seen, and X - ray indicated internal fixation was stable and fracture points of rib healed up. Conclusion Internal fixation of fracture is much better than other routine therapies for multiple fractures of ribs and flail chest, and to master the indication of operation is the key to good efficacy.