镍钛环抱式接骨器内固定修复多发性肋骨骨折:与克氏针应用安全性比较

摘要

背景:传统治疗多发性肋骨骨折的方法有胸廓外加压包扎、肋骨钉固定等,术后具有较高的疼痛率和并发症率,治疗效果不理想.目的:分析镍钛环抱式接骨器内固定修复多发性肋骨骨折的临床疗效,分析其安全性.方法:纳入 90 例多发性肋骨骨折患者,以治疗方式为依据分为治疗组(n=45)和对照组(n=45),治疗组采用TiNi 环抱式接骨器进行内固定修复,对照组采用克氏针进行内固定修复.对比两组手术时间、呼吸机使用时间、住院时间、镇痛药物使用时间及并发症发生情况,以及修复前后的目测类比评分.结果与结论:两组修复后12,24,48 h的目测类比评分均低于修复前(P < 0.05),并且治疗组修复后12,24, 48 h的目测类比评分低于对照组(P < 0.05).治疗组手术时间、呼吸机使用时间、住院时间、镇痛药物使用时间、并发症发生率均少于对照组(P < 0.05).表明临床采用镍钛环抱式接骨器内固定治疗多发性肋骨骨折疗效显著,具有手术操作简单、损伤低、稳定性高、并发症率低、与组织良好相容等优点.%BACKGROUND:Traditional therapies for multiple rib fractures include extra-thoracic pressure dressing and rib fixation, but have no ideal outcomes because of a higher pain and complication incidence. OBJECTIVE:To discuss the clinical efficacy of internal fixation of TiNi encircling compressive connector on multiple rib fractures and to analyzes its security. METHODS: Ninety patients with multiple rib fractures were selected to be studied, and they were divided into treatment group (45 patients were subject to internal fixation of TiNi encircling compressive connector) and control group (45 patients were subject to internal fixation with Kirschner wire. Surgical time, mechanical ventilation time, length of stay, duration of analgesic drug, and complication incidence were compared between two groups. Visual analog scale scores were measured before and after internal fixation. RESULTS AND CONCLUSION: The visual analog scale scores were significantly decreased in the both two groups at 12, 24, 48 hours after internal fixation (P < 0.05), moreover, the treatment group had lower scores on the visual analog scale than the control group at 12, 24, 48 hours after internal fixation (P < 0.05). Compared with the control group, the surgical time, mechanical ventilation time, length of stay, duration of analgesic drug, and complication incidence were al lower in the treatment group (P < 0.05). These findings indicate that the internal fixation of TiNi encircling compressive connector is effective in the treatment of multiple rib fractures, which is characterized as simple operation, smal injury, high stability, low complication incidence and good histocompatibility.