保留肋骨骨膜内固定术治疗多发肋骨骨折后肺部并发症临床研究.docVIP

保留肋骨骨膜内固定术治疗多发肋骨骨折后肺部并发症的临床研究 　　河北省涿州市医院胸外科，河北涿州 072750 　　[摘要] 目的 探讨保留肋骨骨膜肋骨切开复位内固定术治疗多发肋骨骨折在降低术后肺不张及肺部感染发生率方面的临床效果。 方法 选择涿州市医院2006年7月～2013年6月收治的多发肋骨骨折患者94例，其中54例行保留肋骨骨膜肋骨切开复位内固定术（A组），40例行保守治疗（B组），观察两组患者肺不张、肺部感染的发生率。 结果 A组患者治疗后肺不张[12.96%（7/54）]及肺部感染发生率[5.56%（3/54）]均低于B组[40.00%（16/40）、30.00%（12/40）]，差异有统计学意义（P 0.05）。 结论 保留肋骨骨膜肋骨切开复位内固定术治疗多发肋骨骨折在预防肺部并发症方面优于保守治疗，临床应用价值较高，值得推广应用。 　　[关键词] 多发肋骨骨折；保留肋骨骨膜；内固定术；肺不张；肺部感染 　　[中图分类号] R683.1 [文献标识码] A [文章编号] 1673-7210（2014）03（c）-0095-03 　　Effect on reducing the pulmonary complications after the operation with fracture internal fixation reserving rib periosteum for treating the multiple ribs fractured 　　ZHOU Jinqiang WANG Hui ZHANG Jinyan LI Na ZHANG Huifang LIU Yanlian 　　Department of Thoracic Surgery， Zhuozhou City Hospital， Hebei Province， Zhuozhou 072750， China 　　[Abstract] Objective To study the effect on reducing the pulmonary complications by the operation of fracture internal fixation reserving rib periosteum for treating the multiple ribs fractured. Methods 94 patients with multiple rib fractured in Zhuozhou City Hospital from July 2006 to June 2013 were included in our study. They were divided into two groups： 54 patients were selected as internal fixation group （group A）， they were operated with the fracture internal fixation reserving rib periosteum； 40 patients were chosen as conservative treatment group （group B）， they were underwent conservative treatment. The incidence of atelectasis， pulmonary infection were observed and compared between the two groups. Results The incidence of atelectasis， pulmonary infection in group A [12.96% （7/54）， 5.56% （3/54）] were all lower than those in group B [40.00% （16/40）， 30.00% （12/40）]， the differences were statistically significant （P 0.05）. Conclusion The effect of fracture internal fixation reserving rib periosteum for treating the multiple fractured ribs on reducing the pulmonary complications is superior to conservative treatment. This operation should be used wide