保留骨膜应用于环抱型肋骨接骨板治疗创伤性连枷胸的临床研究

Clinical Study of Preserving Periosteum in Rib Embracing Osteosynthesis Plates for the Treatment of Traumatic Flail Chest

目的 探讨环抱型肋骨接骨板治疗创伤性连枷胸时保留骨膜的临床疗效.方法 选取北京市大兴区人民医院和河北医科大学第一医院2013年5月～ 2015年6月收治的89例创伤性连枷胸患者为研究对象,根据数字法将患者随机分为环抱型肋骨接骨板治疗保留骨膜组（观察组45例）和环抱型肋骨接骨板组（对照组44例）,比较分析两组患者的术后恢复情况、术后住院时间、术后并发症、术后肺功能差异.结果 两组患者均骨性愈合.观察组患者术后疼痛评分、住院时间、机械通气时间、镇痛药物使用时间均低于对照组,差异具有统计学意义（P＜0.05）;肺功能检测结果则显示观察组患者改善情况明显优于对照组,差异具有统计学意义（P＜0.05）.同时观察组患者并发症发生率也显著低于对照组（P＜0.05）.结论 用环抱型肋骨接骨板治疗创伤性连枷胸患者时保留骨膜具有较好的临床效果,能有效减少并发症的发生,促进患者肺功能的恢复.

Objective To investigate the clinical efficacy of preserving periosteum in rib embracing osteosynthesis plates for the treatment of traumatic flail chest.Methods Totally 89 cases of traumatic flail chest patients were selected as the research object from May 2013 to June 2015 in People＇s Hospital of Beijing Daxing District and The First Hospital of Medical University.According to the random number method,the patients were classified as rib embracing plate treatment retention periosteum group （observation group,45 cases） and rib embracing plate treatment group （control group,44 cases）.The differences of recover after surgery,postoperative hospitalization time,postoperative complications and postoperative pulmonary function between two groups were analyed.Results All patients were healed.The postoperative pain score,postoperative hospitalization time,duration of mechanical ventilation and pain medication using times in observation group were lower than in control group,the difference was statistically significant （P ＜ 0.05）.The improvement of pulmonary function was better in observation group than in control group,and the difference was significant （P ＜ 0.05）,and the postoperative complications in observation group were significantly lower than in control group （P ＜ 0.05）.Conclusion Retention periosteum when the traumatic flail chest patients were treated by rib embracing osteosynthesis plates has better clinical effect,and could effectively reduce the complications and promote the recovery of lung function.