机械通气联合肋骨切开复位内固定治疗多发性肋骨骨折合并ARDS患者疗效分析

目的探讨机械通气联合选择性肋骨切开复位内固定术治疗多发性肋骨骨折合并ARDS的临床疗效。方法回顾性荟萃分析2009年10月至2012年5月多发性肋骨骨折合并急性呼吸窘迫综合征（ARDS）患者32例的临床资料，其中22例采用机械通气联合选择性肋骨切开复位内固定术治疗（手术组），10例仅采用单纯机械通气治疗（非手术组）。比较两组机械通气时间、PaO2，PaCO2，SPO2、pH值等氧合指标改善情况、入住ICU时间、气管切开率、呼吸机相关性肺炎发生率、镇痛镇静剂使用时间等指标。结果与单纯机械通气组比较，手术组机械通气时间、PaO2，PaCO2，SPO2、pH值等氧合指标改善情况、人住ICU时间、气管切开率、呼吸机相关性肺炎发生率、镇痛镇静剂使用时间等指标均明显优于非手术组。结论机械通气联合选择性肋骨切开复位内固定术治疗多发性肋骨骨折合并ARDS的方法，疗效明显优于单纯机械通气治疗方法。

Objective To investigate the mechanical ventilation combined with selective ribs open reduction and internal fixation for the treatment of fracture of multiple ribs combined with the clinical curative effect of ARDS. Methods retrospective meta-analysis of ICU in our hospital since 2009, October to 2012 05were multiple rib fractures associated with ARDS patients with clinical data of 32 cases, including 22 cases with mechanical ventilation combined with selective ribs open reduction and internal fixation for the treatment of （ operation group ） , 10 cases using only simple mechanical ventilation in the treatment of （ non operation group ） .Comparison was made between the groups on the mechanical ventilation time, PaO2, PaCO2, SPO2, pH and oxygenation index to improve the situation, time in the ICU, tracheotomy rate, incidence of ventilator - associated pneumonia, analgesic sedation time index. Results compared with simple mechanical ventilation, mechanical ventilation time operation group, PaO2, PaCO2, SPO2, pH values of oxygenation index to improve the situation, in the ICU time, tracheotomy rate, incidence of ventilator - associated pneumonia, analgesic and sedative use time index were significantly better than the non operation group. Conclusion Mechanical ventilation combined with selective ribs open reduction and internal fixation for the treatment of fracture of multiple ribs combined with ARDS method, curative effect is obviously superior to the simple mechanical ventilation treatment.