微创内固定治疗多根多处肋骨骨折临床效果和安全性评价

Clinical Efficacy and Safety of Minimally Invasive Internal Fixation in Treatment of Multiple Rib Fractures

目的探讨微创内固定治疗多根多处肋骨骨折临床效果和安全性。方法对2015年1月—2017年2月收治的多根多处肋骨骨折80例的临床资料进行回顾性分析。根据治疗方式分为内固定组和保守组,每组40例。比较2组术后疼痛视觉模拟评分(VAS)、胸腔引流管放置时间、机械通气时间、住院时间、镇痛药使用剂量、ICU监护时间、并发症发生情况及术后1个月肺功能改善情况。结果内固定组VAS评分低于保守组,镇痛药使用剂量少于保守组,胸腔引流管放置时间、机械通气时间、住院时间、ICU监护时间均短于保守组(P<0.05,P<0.01)。内固定组并发症总发生率低于保守组(P<0.05,P<0.01)。术后1个月内固定组肺功能改善情况优于保守组(P<0.01)。结论微创内固定治疗多根多处肋骨骨折临床效果较好,且可降低并发症发生率,改善肺功能。

Objective To investigate clinical efficacy and safety of minimally invasive internal fixation in treat-ment of multiple rib fractures. Methods Clinical data of 80 patients with multiple rib fractures admitted during January 2015 and February 2017 was retrospectively analyzed, and the patients were divided into internal fixation group and con-servative therapy group （ n=40 for each group） according to different treatment methods. Postoperative pain visual ana-logue scales （ VAS） score, placement duration of intrathoracic drain tube, mechanical ventilation time, hospitalization time, dosage of analgesics, ICU monitoring time, incidence rate of complications and improvement condition of pulmonary function 1 months after operation were compared in two groups. Results Compared with those in conservative therapy group, in internal fixation group, values of VAS score, dosage of analgesics, placement duration of intrathoracic drain tube, mechanical ventilation time, hospitalization time and ICU monitoring time were significantly lower than those in control group （P〈0. 05, P〈0. 01）. The total incidence rate of complications in internal fixation group was significantly lower than that in conservative therapy group （P〈0. 05, P〈0. 01）. The improvement condition of pulmonary function 1 months after operation in internal fixation group was better than that in conservative therapy group （P〈0. 01）. Conclu-sion The minimally invasive internal fixation in treatment of multiple rib fractures can achieve good efficacy, reduce in-cidence rate of complications and improve pulmonary function.