不同方式治疗多发性肋骨骨折临床疗效分析

Clinical Analysis of Different Treatment for Multiple Rib Fractures

目的:分析采用不同方式治疗多发性肋骨骨折的临床疗效。方法:回顾性分析本院134例多发性肋骨骨折患者临床资料,其中A组43例,采用Ti Ni环抱式接骨器将骨折处肋骨内固定;B组51例,采用可吸收髓内钉将骨折处肋骨内固定;C组40例,采用胸带加厚棉垫行外固定。观察并分析A、B组患者的手术时间、固定肋骨数、术中出血量及胸腔积液引流时间,对三组患者治疗的止痛有效率、外观满意率、肺炎发生率、住院时间进行分析比较。结果:A、B组的手术时间、固定肋骨数、术中出血量及胸腔积液引流时间比较差异无统计学意义(P>0.05)。三组之间的止痛有效率、外观满意率、肺炎发生率、住院时间比较差异有统计学意义(P<0.05),经过进一步的两两比较分析发现A、B组之间各项指标比较差异均无统计学意义(P>0.0167),A组与C组、B组与C组之间各项指标比较差异均有统计学意义(P<0.0167)。结论:Ti Ni环抱式接骨器及可吸收髓内钉相对于外固定治疗肋骨骨折均有促进骨折愈合、减少住院时间、缓解胸部疼痛的作用,临床上应结合骨折患者的自身情况选择合适的内固定方式。

Objective：To compare clinical effect for different treatment of multiple rib fractures.Method：Totally 134 patients with multiple rib fractures in our hospital were selected,they were randomly divided into 3 groups.Group A of 43 cases were managed by internal fixation of ribs with titanium-nickel alloy embracing holder for rib fracture.Group B of 51 cases were managed by absorbable intramedullary nail for rib fracture.Group C of 40 cases were managed by expectant treatments for rib fracture.The operation time,number of fixed rib,peri-operative bleeding,and drainage time with pleural effusions of group A and B were observed and analyzed.The effective rate of relieve pain,appearance satisfaction,pneumonia,and hospital stay time of 3 groups were compared.Result：By means of statistics analysis,there were no statistical differences of the operation time, number of fixed rib,peri-operative bleeding,and drainage time with pleural effusions between group A and B（P〉0.05）. There were statistical differences of the effective rate of relieve pain, appearance satisfaction, pneumonia, and hospital stay time of 3 groups（P〈0.05）.After further comparison of every index between each two groups,there were no statistical differences between group A and B（P〉0.0167）,there were statistical differences between group A and C,group B and C（P〈0.0167）.Conclusion：Internal fixation of ribs with titanium-nickel alloy embracing holder and absorbable intramedullary nail are better than expectant treatments to promoting fracture healing,reduce hospital stay and relieve chest pain,we should combined with the situation of fracture patients to select the suitable internal fixation in clinical.