纵形交错网式固定多段肋骨骨折

Observation on fractured ribs treated with longitudinal shape staggered mesh type fixed more root section

目的:在提高胸腹联合部创伤诊治水平的同时,探讨观察纵形交错网式固定多根多段肋骨骨折近远期疗效,提高治愈率。方法:对190例胸腹联合部创伤回顾分析。根据临床实践总结指导临床胸腹联合部创伤,一旦明确诊断,需剖胸剖腹止血并处理多脏器伤及膈肌修补。纵形交错网式內固定多根多段肋骨骨折。结果:通过16年的临床实践认为早期诊断尤为重要,及早行胸腔闭式引流术,掌握手术时机,尽早行胸腹腔内多脏器伤的处理后,通过对国內传统的保守外固定、切开克氏针,以及钢板钢丝內固定方法加以改进:在两肋骨断端钻孔以丝线贯穿并外8字固定后,并以纵形交错网式固定多根多段肋骨骨折达到矫正胸壁塌陷畸形,纠正反常呼吸,对提高治愈率有明显肯定价值。本组188例痊愈出院,2例死亡。(1例胸腹腔巨大血肿并重度脑挫裂伤,另1例胸主动脉贯通伤)。结论:纵形交错网式固定多根多段肋骨骨折能彻底矫正胸壁塌陷畸形,纠正反常呼吸,对提高治愈率有肯定价值。经4～16年随访,188例病人恢复自理生活,能正常上下班及外出务工,复查肺功能正常,胸部正侧位摄片无畸形。

Objective：To improve the level of diagnosis and treatment of joint of chest trauma,to explore the observation on the recent and forward curative effect of longitudinal shape staggered mesh type fixed more root section of fractured ribs to improve the cure rate. Methods：Retrospective analysis of 190 cases with chest trauma.According to the principle that the summary of the clinical practice guides Clinical joint department of chest trauma,once a clear diagnosis,we required to cut open the chest abdominal incision bleeding deal with multiple organ injury and repair of diaphragm and last had longitudinal staggered mesh fixation of multiple segment fracture of rib.Results： Through 16 years of clinical practice,we thought that early diagnosis was especially important.So we had chest cavity closed type drainage as soon as possible.And we grasped the opportunity of operation.After the early treatment of multiple organ injury within chest and abdominal cavity,we improved the domestic traditional conservative external fixation,incision and Kirschner wire and the steel wire internal fixation methods：A hole is drilled in the broken end of the two ribs with silk thread running through and with 8 words fixed outside;we had staggered mesh type fixed more root in a longitudinal section of fractured ribs to correct collapse of the chest wall deformity,and corrected abnormal breathing.As for improving the cure rate It was of significantly positive value.This group of 188 cases have recovered from hospital 2 cases died（One case had Huge hematoma in his thorax and abdomen and severe cerebral contusion of.The other case had fierce aorta through injury.Conclusion：It was of significantly positive value for improving the cure rate to have longitudinal shape staggered mesh type fixed more root section of fractured ribs and correct abnormal breathing.After follow - up of 4 to 16 years,188 patients had recovered on their own life.They could have normal work and become migrant workers.Their lung functions were reviewed and they were all normal.The positive side of the shoots showed no abnormal.