重点肋骨内固定联合机械通气治疗连枷胸伴创伤性湿肺21例

The key ribs internal fixation combined with mechanical ventilation treatment of flail chest with 21 cases of traumatic wet lung

目的探讨大面积连枷胸的损伤特征及治疗。方法 21例大面积连枷胸伴创伤性湿肺的患者接受急诊手术行重点肋骨内固定联合机械通气综合治疗,观察和比较21例患者治疗前后临床症状及动脉血气的变化情况。结果 21例患者在治疗后24 h、48 h、72 h动态观察发现PH、PaO2、PaCO2均明显改善(P<0.01),HR、R及BP也明显改善(P<0.05)。结论重点肋骨内固定联合机械通气治疗大面积连枷胸伴创伤性湿肺可明显改善连枷胸患者的呼吸循环状况,是促进大面积连枷胸患者康复的重要措施。

Objective To study the damage characteristics and the treatment of large area flail chest. Methods 21 cases of pa- tients with traumatic wet lung with large area of flail chest were carried on the emergency surgery of the key ribs internal fixation with me- chanical ventilation therapy, 21 patients who were observed and compared before and after treatment of clinical symptoms and changes of the arterial blood gas. Results 21 patients in the treatment of 24 h, 48 h, 72 h after dynamic observation found that PH, PaO2 , and PaCO2 were significantly improved （ P 〈 0.01 ）, HR, R, BP also improved significantly （ P 〈 0. 05 ）. Conclusion Key ribs internal fix- ation combined with mechanical ventilation treatment of flail chest with large area of traumatic wet lung can obviously improve breathing and circulation in patients with flail chest, is the key measures to recover in patients with the large - area flail chest.