环抱式接骨器内固定术治疗肋骨骨折的效果及对肺功能的影响

Effect of Internal Fixation with Embracing Bone Connector in the Treatment of Rib Fractures and Influence on Lung Function

目的:探讨环抱式接骨器内固定术治疗肋骨骨折的效果及对肺功能的影响。方法:选取2019年1月—2021年1月民航总医院收治的108例肋骨骨折患者为分析对象,对其临床资料进行回顾性分析,按照其接受治疗方法的异同将其分组,将接受克氏针内固定术治疗的患者划分为对照组(n=54),将接受环抱式接骨器内固定术治疗的患者划分为观察组(n=54)。对比两组手术与恢复指标、疼痛评分、氧化应激指标、血气分析参数及肺功能指标。结果:观察组手术与恢复指标均优于对照组,差异均有统计学意义(P<0.05)。观察组术后3 h、6 h、12 h、1 d及3 d的简式麦吉尔疼痛问卷(MPQ)评分均低于对照组,差异均有统计学意义(P<0.05)。术前,两组丙二醛(MDA)、晚期氧化蛋白产物(AOPP)水平相较差异均无统计学意义(P>0.05);术后,两组指标均低于术前,且观察组均低于对照组,差异均有统计学意义(P<0.05)。术前,两组动脉二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))及血氧饱和度(SaO_(2))相较差异均无统计学意义(P>0.05);术后,两组的PaCO_(2)均低于术前,且观察组低于对照组,PaO_(2)及SaO_(2)均高于术前,且观察组均高于对照组,差异均有统计学意义(P<0.05)。术后12 h,两组用力肺活量实测值占预计值百分比(FVC%pred)、第1秒用力呼气容积实测值占预计值百分比(FEV1%pred)及肺总量实测值占预计值百分比(TLC%pred)相较差异均无统计学意义(P>0.05);术后3 d,两组的各项指标均高于术前,且观察组均高于对照组,差异均有统计学意义(P<0.05)。结论:环抱式接骨器内固定术治疗肋骨骨折,可改善手术及恢复相关指标,降低术后疼痛程度,减弱术后氧化应激反应,促进肺功能恢复,效果良好。

Objective:To investigate the effect of internal fixation with embracing bone connector in the treatment of rib fractures and the influence on lung function.Method:A total of 108 patients with rib fractures admitted to Civil Aviation General Hospital from January 2019 to January 2021 were selected as the analysis objects,the clinical data were retrospectively analyzed.They were grouped according to the similarities and differences of the treatment method,the patients who received Kirschner wire internal fixation were divided into the control group(n=54).The patients who received internal fixation with embracing bone connector were divided into the observation group(n=54).The surgical and recovery indicators,pain scores,oxidative stress indicators,blood gas analysis parameters and lung function indicators of the two groups were compared.Result:The surgical and recovery indicators of the observation group were better than those of the control group,the differences were statistically significant(P<0.05).The short form McGill pain questionnaire(MPQ)scores of the observation group were lower than those of the control group at 3 h,6 h,12 h,1 d and 3 d after operation,the differences were statistically significant(P<0.05).Before operation,there were no significant differences of malondialdehyde(MDA)and advanced oxidative protein product(AOPP)levels between the two groups(P>0.05);after operation,the indexes of the two groups were lower than those before operation,and the indexes of the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).Before operation,there were no significant differences in the arterial partial pressure of carbon dioxide(PaCO_(2)),arterial partial pressure of oxygen(PaO_(2))and blood oxygen saturation(SaO_(2))between the two groups(P>0.05);after operation,PaCO_(2) in both groups were lower than those before the operation,and that in the observation group was lower than that in the control group,PaO_(2) and SaO_(2) in both groups were higher than those before the operation,those in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).At 12 h after operation,there were no significant differences in forced vital capacity as percentage of predicted value(FVC%pred),forced expiratory volume in first second as percentage of predicted value(FEV1%pred)and total lung capacity as percentage of predicted value(TLC%pred)between the two groups(P>0.05);three days after operation,the indicators of both groups were higher than those before surgery,and those of the observation group were higher than those of the control group,the differences were statistically significant(P<0.05).Conclusion:The treatment of rib fractures by internal fixation with embracing bone connector can improve the surgery and recovery related indicators,reduce the degree of postoperative pain,attenuate the postoperative oxidative stress reaction and promote the recovery of lung function,with good results.