肋骨环抱器内固定治疗多发性肋骨骨折80例

Clinical Effect of 80 Cases of Multiple Rib Fractures Treated With Internal Fixation With Rib Embracing Fixator

目的研究肋骨环抱器在多发性肋骨骨折中的治疗价值。方法回顾性分析2014年1月—2016年3月我科用肋骨环抱器治疗连枷胸的临床资料,80例患者术前行胸片、胸部CT及三维重建明确肋骨骨折部位及胸腔脏器损伤情况。在气管插管全麻下切开并显露肋骨断端,应用环抱式肋骨接骨器行内固定,在安放肋骨环抱器的同时尽可能不损伤肋间血管及神经。如胸膜有损伤可放置胸腔闭式引流。结果 80例患者平均住院时间(15.2±5.5)d,术后发生肺不张1例,经气管镜吸痰二次后治愈;肺部感染1例,经抗感染治疗后痊愈;所有患者均治愈出院,无围手术期死亡。结论肋骨环抱器手术内固定是治疗多根肋骨骨折疗效显著,术后并发症较少,适合于临床应用。

Objective To study the value of rib cage in the treatment of multiple rib fractures. Methods A retrospective analysis of clinical data from January 2014 to March 2016 in our department with embracing fixator for treatment of flail chest, 80 cases were confirmed by chest X-ray, chest CT and three-dimensional reconstruction to confirm the position of rib fracture and the injury of thoracic organs. Incision and exposing the broken end of the rib under general anesthesia, the application of internal fixation with embracing rib. As far as possible, no damage to the intercostal vessels and nerves should be placed at the same time. If pleural injury can be placed closed thoracic drainage. Results In 80 patients, the average hospitalization time （15.2 ±5.5） d, postoperative atelectasis occurred in 1 case, endobronchial sputum two times after cure. Pulmonary infection in 1 cases, after anti-infection treatment. All patients were cured and no perioperative death. Conclusion Embracing fixator in the treatment of multiple rib fractures with obvious effect, can effectively relieve pain,shorten hospitalization time, reduce the rate of complications, effectively restore the anatomic integrity and thoracic rib fractures, reconstruction of the pleural cavity negative pressure.