重症胸外伤治疗中肋骨骨折切开复位内固定术与保守治疗的临床效果对比

Comparison of clinical effects of open reduction and internal fixation and conservative treatment of rib fractures in the treatment of severe thoracic trauma

目的对比重症胸外伤治疗中肋骨骨折切开复位内固定术与保守治疗的临床效果。方法70例重症胸外伤患者,随机分为观察组与对照组,各35例。对照组采取保守治疗,观察组采取肋骨骨折切开复位内固定术治疗。比较两组使用镇痛药物次数及术后住院时间,治疗前后生活质量评分及疼痛评分,治疗优良率,并发症发生情况。结果观察组使用镇痛药物次数(0.56±0.21)次少于对照组的(2.51±1.34)次,术后住院时间(9.27±1.45)d短于对照组的(13.21±2.35)d,差异有统计学意义(P<0.05)。治疗后,观察组生活质量评分(90.45±4.21)分高于对照组的(76.68±4.01)分,疼痛评分(1.05±0.24)分低于对照组的(3.35±0.15)分,差异有统计学意义(P<0.05)。观察组治疗优良率94.29%高于对照组的74.29%,差异有统计学意义(P<0.05)。观察组并发症发生率2.86%低于对照组的20.00%,差异有统计学意义(P<0.05)。结论重症胸外伤采用肋骨骨折切开复位内固定术的疗效确切,可有效减轻患者疼痛,减少镇痛药物的使用,并有效减少并发症,缩短住院时间,改善患者的生活质量,值得推广和应用。

Objective To compare the clinical effect of open reduction and internal fixation and conservative treatment of rib fractures in the treatment of severe thoracic trauma.Methods A total of 70 patients with severe thoracic trauma were randomly divided into observation group and control group,with 35 cases in each group.The control group was treated with conservative treatment,and the observation group was treated with open reduction and internal fixation of rib fractures.The frequency of using analgesics,hospitalization time after operation,quality of life score and pain score before and after treatment,excellent-good rate,and occurrence of complications were compared between the two groups.Results The frequency of using analgesics(0.56±0.21)times of the observtion group was less than(2.51±1.34)times of the control group,and hospitalization time(9.27±1.45)d after operation was shorter than(13.21±2.35)d of the control group.All the difference was statistically significant(P<0.05).After treatment,the quality of life score(90.45±4.21)points of the observation group was higher than(76.68±4.01)points of the control group,and pain score(1.05±0.24)points was lower than(3.35±0.15)points of the control group.All the difference was statistically significant(P<0.05).The excellent-good rate 94.29%of the observation group was higher than 74.29%of the control group,and the difference was statistically significant(P<0.05).The incidence of complications 2.86%of the observation group was lower than 20.00%of the control group,and the difference was statistically significant(P<0.05).Conclusion Open reduction and internal fixation is effective in severe thoracic trauma,which can effectively relieve the pain of patients,reduce the frequency of analgesics using,effectively reduce complications,shorten hospitalization time and improve the quality of life of patients.It is worth popularizing and applying.