微创嵌入式Judet固定架内固定与呼吸机持续正压通气治疗连枷胸的临床效果

Clinical effects of minimally invasive embedded Judet fixator internal fixation and ventilator continuous positive pressure ventilation therapy in the treatment of flail chest

目的分析微创嵌入式Judet固定架内固定与呼吸机持续正压通气治疗连枷胸的临床效果。方法回顾性分析2016年4月至2018年4月三亚市人民医院收治的78例连枷胸患者的临床资料,根据治疗方法不同将其分为对照组(31例,呼吸机持续正压通气治疗)和观察组(47例,微创嵌入式Judet固定架内固定治疗)。比较两组患者呼吸机使用时间、住院天数、视觉模拟评分法(visual analogue scale,VAS)评分下降情况、肺功能和血气分析指标以及胸廓畸形、肺部感染、死亡发生率。结果观察组患者呼吸机使用时间、住院天数均显著短于对照组(均P<0.05),VAS评分下降显著大于对照组(P<0.05),胸廓畸形、肺部感染、死亡的发生率均显著低于对照组(均P<0.05)。两组患者第1秒用力呼气容积、最大呼气流量比较差异均无统计学意义(均P>0.05),但观察组患者肺总量、用力肺活量、动脉血氧分压和动脉血氧饱和度均显著大于对照组(均P<0.05)。结论微创嵌入式Judet固定架内固定可缩短连枷胸患者住院天数和呼吸机使用时间,减轻疼痛,改善肺功能,降低胸廓畸形、肺部感染和死亡的发生率。

Objective To study the clinical effects of minimally invasive embedded Judet fixation internal fixation and ventilator continuous positive pressure ventilation therapy in the treatment of flail chest.Method The clinical data of 78 patients with flail chest treated in Sanya People's Hospital from April 2016 to April 2018 were retrospectively analyzed,they were divided into control group(31 cases,ventilator continuous positive pressure ventilation therapy)and observation group(47 cases,minimally invasive embedded Judet fixator internal fixation)according to the treatment methods.The ventilator use time,hospital day,the decrease of visual analogue scale(VAS)score,pulmonary function and blood gas analysis index,the incidences of chest deformity,pulmonary infection and death were compared between the two groups.Result The ventilator use time and hospital day in observation group were significantly shorter than those in control group(all P<0.05),the decrease of VAS score was significantly higher than that in control group(P<0.05),the incidences of chest deformity,pulmonary infection and death were significantly lower than those in control group(all P<0.05).There were no significant differences in forced expiratory volume in one second and maximal expiratory flow between the two groups(all P>0.05),but the total lung volume,forced vital capacity,arterial oxygen saturation and arterial partial pressure of oxygen in observation group were significantly higher than those in control group(all P<0.05).Conclusion Minimally invasive embedded Judet fixator internal fixation can shorten the hospital day and ventilator use time,relieve pain,improve pulmonary function,reduce the incidence of chest deformity,pulmonary infection and death of patients with flail chest.