不同内固定术治疗创伤性多发肋骨骨折疗效观察

Therapeutic effect of internal fixation techniques on traumatic multiple rib fractures

目的探究不同内固定术治疗创伤性多发肋骨骨折疗效。方法以泰康同济(武汉)医院2021年1月至2023年5月医治的100例创伤性多发肋骨骨折患者为研究对象,依据不同手术方法分为研究组(n=53)、对照组(n=47),前者行环抱式接骨器内固定术,后者行克氏针肋骨内固定术。比较两组手术指标、手术前后血气指标、呼吸功能[最高呼气流速(PEF)、第1秒用力呼气容积(FEV1)、用力肺活量(FVC)]、疼痛数字评价量表(NRS)评分、并发症。结果与对照组相比,研究组下床时间、镇痛药使用时间、手术时间、住院时间、骨折愈合时间均较短(P<0.05);术后1周,与对照组相比,研究组氧饱和度(SaO_(2))、动脉氧分压[p(O_(2))]指标较高,动脉二氧化碳分压[p(CO_(2))]指标较低(P<0.05);术后1周,与对照组相比,研究组PEF、FEV1、FVC指标较高(P<0.05);与对照组相比,研究组术后NRS评分较低(P<0.05);两组并发症发生率(1.89%VS 6.38%)相比,差异无统计学意义(P>0.05)。结论环抱式接骨器内固定术能改善肋骨骨折患者血气指标,减少对呼吸功能的损伤,减轻术后疼痛程度,缩短住院时间,加快康复进程。

Objective To explore the efficacy of internal fixation techniques on traumatic multiple rib fractures.Methods A total of 100 patients with traumatic multiple rib fractures treated in the Taikang Tongji(Wuhan)Hospital during January 2021 to May 2023 were recruited and assigned into the study group(n=53)and control group(n=47)according to different surgical methods.Internal fixation using an embracing device was performed in the study group,and internal fixation using the Kirschner needle was conducted in the control group.The surgical indicators,blood gas before and after surgery,respiratory function(peak expiratory flow[PEF],forced expiratory volume in 1 s[FEV1],forced vital capacity[FVC]),the numerical rating scale(NRS)score and complications were compared between the two groups.Results Compared with those of the control group,the time of off-bed activities,duration of using analgesics,operation time,length of stay and the duration of fracture healing were significantly shorter in the study group(P<0.05).At 1 week after operation,patients in the study group had significantly higher oxygen saturation(SaO_(2))and arterial partial pressure of oxygen[p(O_(2))],but lower arterial partial pressure of carbon dioxide[p(CO_(2))],P<0.05.At 1 week after operation,PEF,FEV1 and FVC were significantly higher in the study group than those of the control group(P<0.05).The NRS score of the study group was significantly lower than that of the control group(P<0.05).There was no significant difference in the incidence of complications between the two groups(1.89%VS 6.38%,P>0.05).Conclusion The internal fixation using an embracing device effectively improves blood gas,reduces respiratory function injury and postoperative pain,shortens length of stay and accelerates the process of rehabilitation in patients with rib fractures.