腔镜配合爪型肋骨接骨钛板小切口内固定治疗连枷胸42例临床分析

The treatment of 42 flail chest patients by thoracoscope and internal fixation with claw type rib bones titanium plate through small incision

目的：探讨应用腔镜配合爪型肋骨接骨钛板内固定治疗连枷胸的手术指征及治疗效果。方法：42例连枷胸患者均在全麻下切开复位,采用腔镜配合爪型肋骨接骨钛板重点固定法对多发性肋骨骨折行内固定治疗。结果：患者术后胸痛均显著减轻,胸壁稳定,胸廓畸形矫正满意,呼吸功能恢复,血气胸等胸内合并伤迅速纠治,且无明显并发症发生。术后3-48个月复查胸部X线片,显示胸廓饱满,内固定牢固,骨折断端骨性愈合。结论：应用腔镜配合爪型肋骨接骨钛板重点内固定法治疗连枷胸操作简便,疗效可靠,组织相容性好,并可同时探查、处理胸内合并伤,安全快捷,值得临床推广。

Objective： To investigate the surgical indications and therapeutic effect about the treatment of flail chest by the application of thoracoscope and internal fixation with claw type rib bones titanium plate. Methods： All of the 42 patients with flail chest received open reduction under general anesthesia,and received focused internal fixation with the help of thoracoscope and claw type rib bone titanium plate for the treatment of multiple fracture of ribs. Results： Chest pain of these patients was significantly reduced after the therapy,chest wall stayed stable,thoracic deformity was corrected,respiratory function recovered,hemopneumothorax and other intrathoracic combined injury got remedied quickly,without obvious complications. 3-48 months after the surgery,review of the chest X ray film showed full thorax,firm internal fixation,and osseous healing of fracture end. Conclusions： The treatment method of flail chest by the application of thoracoscope and focused internal fixation with claw type rib bones titanium plate is easy to operate,brings reliable curative effect and good histocompatibility,and at the same time can probe and deal with intrathoracic injury,which is safe,fast and worth clinical promotion.