预成型肋骨锁定钛板内固定与胸部护板外固定对创伤性多发肋骨骨折的应用效果对比

Comparison of effects of preformed rib locking titanium plate internal fixation and chest guard plate external fixation on traumatic multiple rib fractures

目的探讨预成型肋骨锁定钛板内固定与胸部护板外固定对创伤性多发肋骨骨折的应用效果对比。方法选取2020年7月—2023年1月收治的创伤性多发肋骨骨折患者76例,分为对照组和观察组,各组均为38例。对照组采取胸部护板外固定治疗,观察组采取预成型肋骨锁定钛板内固定治疗。对比两组患者临床疗效;对比两组患者首次下床时间、术后7 d疼痛视觉模拟评分法(VAS)评分、机械通气时间、住院时间、骨折愈合时间;分别在术后7 d及术后3个月应用肺功能检测仪检测两组患者第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)及第1秒用力呼气量占用力肺活量比值(FEV_(1)/FVC)等相关肺功能指标变化,对比两组间差异;最后对比两组术后并发症发生率。结果观察组优良率明显高于对照组(P<0.05);观察组患者首次下床时间、术后7 d VAS评分、机械通气时间、住院时间以及骨折愈合时间明显低于对照组(P<0.05);术后7 d两组患者FEV_(1)、FVC和FEV_(1)/FVC对比无明显差异(P>0.05),术后3个月两组患者FEV_(1)、FVC和FEV_(1)/FVC均升高,且观察组高于对照组(P<0.05);观察组术后并发症发生率明显低于对照组(P<0.05)。结论对创伤性多发肋骨骨折患者采取预成型肋骨锁定钛板内固定治疗的效果优于胸部护板外固定治疗,且能够促进患者康复,提升远期肺功能,降低术后并发症发生率。

Objective To compare the effects of preformed rib locking titanium plate internal fixation and chest guard plate external fixation on traumatic multiple rib fractures.Methods A total of 76 patients with traumatic multiple rib fractures from July 2020 to January 2023 were selected as study subjects and divided into two groups,38 cases in each group.The control group was treated with external fixation with chest guard plate,and the observation group was treated with internal fixation with preformed rib locking titanium plate.The clinical efficacy,the first out-of-bed time,visual analogue scale(VAS)score at 7 d postoperatively,mechanical ventilation time,hospitalization time,and fracture healing time were compared between the two groups.The forced expiratory volume in the first second(FEV_(1)),forced vital capacity(FVC),and ratio of forced expiratory volume in the first second to forced vital capacity(FEV_(1)/FVC)were detected with a pulmonary function measuring device at 7 d and 3 months after operation,respectively.Theincidence of postoperative complications was also compared.Results Compared to the control group,the excellentand good rate of the observation group was significantly higher(P<0.05);the first out-of-bed time,VAS score at 7 dpostoperatively,mechanical ventilation time,hospitalization time,and fracture healing time in the observation groupwere significantly shorter(P<0.05).There was no significant difference in FEV_(1),FVC,and FEV_(1)/FVC between thetwo groups 7 d after operation(P>0.05).FEV_(1),FVC,and FEV_(1)/FVC in the two groups increased 3 months afteroperation,and the observation group showed higher levels than the control group(P<0.05).The incidence ofpostoperative complications in the observation group was significantly lower than that in the control group(P<0.05).Conclusion For patients with traumatic multiple rib fractures,the effect of internal fixation with preformed rib lockingtitanium plate is better than that of external fixation with chest guard plate,which can promote the early recovery ofpatients,improve long-term lung function,and reduce the incidence of postoperative complications.