肋骨骨折后并发血胸的危险因素探析

Risk Factors for Hemothorax After Rib Fracture

目的探讨肋骨骨折后并发血胸的危险因素。方法选取20120年3月-2022年3月我院收治的100例肋骨骨折患者为研究对象,根据患者有无并发血胸将其分为血胸组(62例)和非血胸组(38例)。分别比较2组一般资料,实验室检查,损伤、疼痛评分及多因素分析。结果血胸组骨折数量≥3根、骨折部位中胸近脊柱段、下胸近脊柱段、双侧骨折、连枷胸、合并气胸、肺部挫伤、心肌挫伤、胸腔置管占比高于非血胸组(P<0.05);血胸组白细胞、谷草转氨酶、尿素氮、纤维蛋白原、D-二聚体高于非血胸组,凝血酶时间低于非血胸组(P<0.05);血胸组创伤严重评分高于非血胸组(P<0.05);骨折数量≥3根、中胸近脊柱段骨折、下胸近脊柱段骨折、合并肺部挫伤、心肌挫伤、胸腔置管、尿素氮≥5.0 mmol/L、创伤严重评分≥3分是肋骨骨折后并发血胸的危险因素(P<0.05)。结论肋骨骨折后并发血胸的危险因素包括骨折数量≥3根、中胸近脊柱段骨折、下胸近脊柱段骨折、合并肺部挫伤、心肌挫伤、胸腔置管、尿素氮≥5.0 mmol/L、创伤严重评分≥3分。

Objective To investigate the risk factors of hemothorax after rib fracture.Methods Selected 100 patients with rib fractures treated in our hospital from March 20120 to March 2022 as the research objects,and divided them into a hemothorax group(62 cases)and a non-hemothorax group(38 cases)according to whether the patients had hemothorax or not.The general data,laboratory tests,injury and pain scores and multivariate analysis were compared between the two groups.Results The number of fractures in the hemothorax group was greater than or equal to 3,the fracture sites of the middle thoracic proximal spine segment,the lower thoracic proximal spine segment,bilateral fractures,flail chest,combined pneumothorax,pulmonary contusion,myocardial contusion,and thoracic tube placement were higher than those in the non-hemothorax group.group(P<0.05);The leukocytes,aspartate aminotransferase,urea nitrogen,fibrinogen and D-dimer in the hemothorax group were higher than those in the non-hemothorax group,and the thrombin time was lower than that in the non-hemothorax group(P<0.05);The trauma severity score in the hemothorax group was higher than that in the non-hemothorax group(P<0.05);The number of fractures≥3,the fracture of the mid-thoracic proximal spinal segment,the proximal lower thoracic spinal segment fracture,combined with pulmonary contusion,myocardial contusion,thoracic tube placement,blood urea nitrogen≥5.0 mmol/L,and trauma severity score≥3 points are after rib fractures Risk factors for complicated hemothorax(P<0.05).Conclusion The risk factors for hemothorax after rib fracture include the number of fractures≥3,fractures of the proximal midthoracic spine,fractures of the proximal lower thoracic spine,combined pulmonary contusion,myocardial contusion,thoracic cannulation,blood urea nitrogen≥5.0 mmol/L,Trauma severity score≥3 points.