肋骨钉固定治疗连枷胸临床疗效观察.docVIP

肋骨钉固定治疗连枷胸临床疗效观察 　　【摘要】目的 观察肋骨钉固定治疗连枷胸的临床疗效。方法 选取我院自2008年4月~2010年3月收治的78例连枷胸患者随机分为观察组（肋骨钉固定组）和对照组（肋骨夹板固定组）各39例，比较两组患者的治疗效果。结果 （1）观察组与对照组术后第一天反常呼吸及引流管留置时间比较差异明显（P0.05），具有统计学意义。（2）观察组与对照组术后第一天反常呼吸及引流管留置时间比较差异明显（P0.05），具有统计学意义。（3）观察组与对照组从术后住院时间、死亡率及治愈率方面比较差异显著（P0.01），具有统计学意义。结论 应用可吸收性肋骨钉固定治疗连枷胸可以显著提高治疗效果、减少术后并发症及死亡率，值得临床推广使用。 　　【关键词】连枷胸 肋骨钉 固定 　　中图分类号：R655文献标识码：A文章编号：1005-0515（2011）2-024-02 　　Rib screw fixation for the treatment of flail chest clinical observation 　　SHI Yongkang ZHANG Dongmei FAN Zhixiong 　　（Yunnan Dali Bai Autonomous Prefecture Peoples Hospital, Dali, Yunnan 671000） 　　【Abstract】Objective To observe the rib screw fixation for the treatment of clinical efficacy of flail chest. Methods in our hospital from April 2008 ~ March 2010 78 patients with flail chest were randomly divided into two groups(rib screw fixation group) and control group (rib splint group) of the 39 patients, two groups were compared therapeutic effect. Results (1) observation group and control group after the first day of abnormal breathing and drainage tube indwelling time was significantly difference (P 0.05), with statistical significance. (2) the observation group and control group after the first day of abnormal breathing and drainage tube indwelling time was significantly difference(P 0.05), with statistical significance.(3) the observation group and control group from postoperative hospital stay, mortality and recovery rates were significant differences(P 0.01), with statistical significance. Conclusions The absorbable screw fixation ribs flail chest can significantly improve the therapeutic effect and reduce postoperative complications and mortality, is worthy of clinical use. 　　【Key words】flail chest rib nails fixed 　　 　　连枷胸是严重闭合性胸部创伤之一，单纯连枷胸的死亡率为16%，若合并肺挫伤其死亡率可高达42%[1]。由于多根多处肋骨骨折，或多根肋骨骨折合并肋骨与肋软骨交界分裂或合并胸骨骨折，受伤部位的胸壁失去肋骨支持而软化，形成浮动胸壁，直接影响患者的呼吸、循环功能，如不及时恰当处理，可引起严重的呼吸、循环功能障碍而导致死亡。对浮动胸壁进行固定支持是临床抢救连枷胸的关键措施，本文就两种不同固定方法进行讨论，报告如下： 　　1 资料与方法 　　1.1 一般资料 选取我院自2008年4月~2010年3月收治