手术内固定在创伤性连枷胸治疗中的应用

摘要

Objective::To compare the outcomes of traumatic flail chest with multiple injuries treated by operative fixation versus conservative approach . Methods:The clinical data were retrospectively analyzed in 107 cases with traumatic flail chest with multiple injuries , and compared regarding case fatali-ty rate, mean length of hospital stay, mean time of required mechanical ventilation,the draining volume,resuming of off-bed activity, pain perception, the prevalence of chest wall deformity,the complication and other outcomes between operative group(treated by operative fixation, n=39)and non-operative group(treated by conservative approach, n=68).Results:The operative group had lower case fatality rate, shorter mean length of hospital stay and me-chanical ventilation, lower draining volume as well as earlier resuming of off-bed activity, less pain perception, lower incidence of chest wall deformity, pulmonary infection, pulmonary atelectasis and respiratory failure than the non-operative group (P <0.05).Conclusion:Surgical internal fixation for traumatic flail chest with multiple injuries may lead to fewer complications , yet to better short-and long-term effects.%目的：探讨手术内固定在治疗创伤性连枷胸为主的全身多发伤中的疗效。方法：对107例以创伤性连枷胸为主的全身多发伤患者的临床资料进行回顾性分析，比较手术组（手术内固定治疗，n＝39）和非手术组（外固定治疗，n＝68）患者的病死率、平均住院时间、平均机械通气时间、引流量、下床时间、疼痛感觉、胸壁畸形以及肺部炎症、肺不张和呼吸功能衰竭等并发症发生率及其他临床疗效。结果：手术组患者病死率、平均住院时间、平均机械通气时间、引流量均显著低于于非手术组（P＜0．05）。下床时间、疼痛感觉、胸壁畸形以及肺部炎症、肺不张和呼吸功能衰竭等并发症发生率均显著低于非手术组（ P＜0．05）。结论：手术内固定治疗连枷胸，可减少并发症，有良好的近期和远期疗效。