机械通气加胸壁外固定在连枷胸合并肺挫伤治疗中的作用

Combined Treatment of Mechanical Ventilation and External Fixation of Chest Wall for Frail Chest Complicated by Pulmonary Contusion

目的评价机械通气加胸壁外固定在治疗连枷胸合并急性肺挫伤中的作用。方法回顾性总结分析我院2005年1月至2008年12月的22例行机械通气加胸壁外固定治疗连枷胸合并肺挫伤的患者临床资料。结果行机械通气加胸壁外固定术联合治疗后动脉血氧分压(PaO2)、二氧化碳分压(PaCO2)、氧合指数(PaO2/FiO2)和脉搏血氧饱和度(SpO2)均较治疗前有明显改善(P<0.01),患者舒适度明显提高(P<0.01);治愈19例,死亡3例。结论机械通气加胸壁外固定在治疗连枷胸合并急性肺挫伤中能明显改善病情,减轻患者不适。

Objective To evaluate the therapeutic effect of combined treatment of mechanical ventilation and external fixation of chest wall for frail ehest complicated by pulmonary contusion. Methods A retrospective analysis was conducted based on the clinical data of 21 patients with frail chest complicated by pulmonary contusion between January, 2005 and December, 2008. Results Parameters of the patients＇ blood gas analysis such as Pa02, Sp02, and PaO2/FiO2 all significantly improved and PaCO2 significantly decreased compared with those before the treatment （ P 〈 0. 01 ） ; meanwhile, the patients＇ comfort level was significantly improved （ P 〈 0. 01 ）. Of 22 patients, 19 were successfully cured and 3 died. Conclusion It was found that the combined treatment of mechanical ventilation and external fixation of chest wall was able to significantly improve the conditions of the patients with frail chest complicated by pulmonary eontusion as well as lessen their discomfort.