保留骨膜的肋骨内固定术对减轻多发性肋骨骨折术后肋间神经痛的效果

Periosteal Reserved Rib Fixation for the Relief of the Postoperative Intercostal Neuralgia in Multiple Rib Fractures

目的探讨保留肋骨骨膜肋骨内固定术对降低多发性肋骨骨折术后肋间神经痛效果。方法本组106例多发性肋骨骨折患者根据随机数字表法随机分为对照组和观察组,各53例。观察组采用保留肋骨骨膜的肋骨内固定术治疗,对照组则不保留肋骨骨膜。对比观察两组手术时间、出血量、术后7 d、1个月、3个月VAS评分、术后24 h动脉血氧分压(PaO_2)、动脉血氧饱和度(SaO_2)以及动脉血二氧化碳分压(PaCO_2)等指标。结果观察组手术时间、住院时间显著短于对照组,术中出血量显著少于对照组(P<0.05);观察组术后7d、1个月、3个月VAS评分均显著低于治疗前及同期对照组,差异有统计学意义(P<0.05);观察组术后24 h PaO_2、SaO_2显著高于治疗前及同期对照组,PaCO_2显著低于治疗前及同期对照组,且差异均有统计学意义(P<0.05);观察组肺不张、肺部感染并发症发生率均显著低于对照组,差异有统计学意义(P<0.05)。结论多发性肋骨骨折患者应用保留肋骨骨膜的肋骨内固定术治疗效果显著,能够显著降低患者术后肋间神经痛。

Objective To investigate the periosteal reserved rib fixation for the relief of the postoperative intercostal neuralgia in multiple rib fractures. Methods 106 patients with multiple rib fractures were randomly divided into control group and observation group according to a random number table,53 cases for each. The control group received the conventional treatment,while the observation group received the periosteal reserved rib fixation. Results The operative time and hospital stay of the observation group was significantly shorter than the control group,and the blood loss was significantly less than the control group（ P〈0. 05）. After 7d,1 month and3 months,the VAS scores of the observation group were significantly lower than that of the pre-operation and the control group. Pa O2 and Sa O2 of the observation group 24 h after operation was significantly higher than that of the pre-operation and the control group. And Pa CO2 was significantly lower that of the pre-operation and the control group（ P〈0. 05）. The complication rate of observation group,such as atelectasis,pulmonary infection,and etc,was significantly lower than the control group,and has a statistically significant difference（ P〈0. 05）. Conclusion It can significantly relieve the postoperative intercostal neuralgia and reduce the postoperative complications of the periosteal reserved rib fixation for patients with multiple rib fractures.