保留肋骨骨膜肋骨内固定术治疗多发肋骨骨折临床研究

Clinical research of rib internal fixation with rib periosteum retention in the treatment of multiple rib fracture

目的 分析保留肋骨骨膜肋骨内固定术对减轻术后肋间神经痛的效果.方法 选择河北省涿州市医院2006年7月～2013年3月保留肋骨骨膜内固定术治疗的多发肋骨骨折患者46例为A组,选择同期行剥离肋骨骨膜内固定术治疗的多发肋骨骨折患者36例为B组.采用视觉模拟评分（VAS）分别在术后1、2周,2个月及半年对两组患者肋间神经痛的出现情况及程度进行综合评价.结果 两组患者均痊愈出院,均无明显胸廓畸形,骨折基本骨性愈合.术后A组1、2周,2个月及半年肋间神经疼痛程度VAS评分[（3.52±1.24）、（3.04±0.93）、（2.83±0.78）、（2.57±0.66）分]均优于B组[（4.50±1.58）、（3.89±1.18）、（3.44±0.86）、（3.06±0.73）分],差异均有统计学意义（t=2.20、2.27、2.42、2.26,均P＜ 0.05）.结论 保留肋骨骨膜肋骨内固定术治疗多发肋骨骨折较行剥离肋骨骨膜内固定术对减轻术后肋间神经痛有一定效果.

Objective To analyze the effect of fracture internal fixation reserving rib periosteum in alleviating intercostals neuralgia after the surgery.Methods 46 cases with multiple rib fracture treated by fracture internal fixation reserving rib periosteum from July 2006 to March 2013 in Zhuozhou City＇s Hospital were selected as group A,36 cases with multiple rib fracture treated by fracture internal fixation stripping rib periosteum in the same term were chosen as group B.The emergence and degree of intercostals neuralgia was comprehensively evaluated 1,2 weeks,2 months and half a year after the operation by VAS score.Results Both groups were cured and discharged,no obvious thoracic deformity was found,the fracture was basic osseous healing.The VAS score of intercostals nerve pain 1,2 weeks,2 months and half a year after the operation in group A [（3.52±1.24）,（3.04±0.93）,（2.83±0.78）,（2.57±0.66） scores] were better than those in group B [（4.50±1.58）,（3.89± 1.18）,（3.44±0.86）,（3.06±0.73） scores],the differences were statistically significant （t =2.20,2.27,2.42,2.26,all P ＜ 0.05）.Conclusion The effect of fracture internal fixation reserving rib periosteum is better than the fracture internal fixation stripping rib periosteum in alleviating intercostals neuralgia.