多发肋骨骨折合并血胸早期使用肋骨骨折内固定术的疗效探讨

Discussion of the Curative Effect of Internal Fixation in Early Stage on the Patients of Multiple Fractured Ribs with Hemothorax

目的:探讨早期内固定手术与保守治疗多发性肋骨骨折合并血胸的对比治疗。方法:选取山西省人民医院收治的70例多发肋骨骨折合并血胸的患者为研究对象,根据治疗方法不同分为观察组与对照组,观察组35例,对照组35例,观察组采用肋骨切开复位内固定术治疗,对照组采用保守治疗,比较两组患者的治疗效果。结果:观察组住院天数、使用呼吸机时间及拔除胸管时间与对照组比较,均明显缩短,差异有统计学意义(P<0.05);住院期间观察组肺炎、肺不张发生情况明显少于对照组,差异有统计学意义(P<0.05);观察组疼痛评分入院时与对照组比较,差异无统计学意义(P>0.05);治疗后24 h、48 h、72 h观察组疼痛评分明显低于对照组,差异有统计学意义(P<0.05)。结论:早期使用肋骨切开复位内固定手术与保守方法治疗多发肋骨骨折合并血胸,两者相比可以明显减轻患者疼痛,缩短应用呼吸机时间及拔管时间,缩短住院时间,减少肺部感染发生率。

Objective：To investigate the therapeutic effect of internal fixation in early stage and conventional treat-ment of multiple rib fractures with hemothorax. Methods：70 patients of multiple rib fractures with hemothorax ,who were treated in Shanxi provincial people＆#39;s hospital,were chosen and divided into into two groups,35 cases of study group and 35 cases of control group according to their therapeutic method. Patients in study group were given internal fixation opera-tion treatment,while patients in control group were given conventional treatment. Then the treatment efficacy of these two groups were observed and compared. Results：The hospitalization time ,ventilator support time and the extubation time of closed thoracic drainage in the study group were much lower and less than those in the control group. There was statistical-ly significant difference（P ﹤ 0. 05）. The incidence of pneumonia and atelectasis in study group were significantly lower than that in the control group. There was statistically significant difference（P ﹤0. 05）. There was no statistically signifi-cant difference between two groups in pain index of admission（P ﹥ 0. 05）. However,in the study group,the pain index through 24、48 and 72 hours after treatment were lower than that in the control group,so there was statistically significant difference（P ﹤ 0. 05）. Conclusion：Compared with conventional treatment,internal fixation in early stage can relieve pain,reduce the incidence of complications and shorten the time of hospitalization,ventilator support and the extubation of closed thoracic drainage . As a result,the incidence of complications is supposed to be reduced.