| 摘要: |
| 目的 研究多发肋骨骨折行内固定手术治疗时机对术后并发症的影响。方法 纳入我院2014年3月至2016年7月接受内固定手术治疗的多发肋骨骨折患者31例，根据受伤至实施手术时间将患者分为早期手术组（≤72 h，n=17）和常规手术组（>72 h，n=14），比较两组患者年龄、性别、体质量指数（BMI）、肋骨骨折数、合并症以及术后并发症发生率、疼痛改善率的差异。结果 早期手术组与常规手术组患者的年龄、性别、BMI、肋骨骨折数、合并症发生率差异均无统计学意义（P均>0.05），受伤至手术时间的差异有统计学意义[（2.2±1.5）d vs（7.4±2.8）d，P<0.01]。早期手术组术后呼吸机辅助通气时间平均为（8.9±3.7）h，短于常规手术组的（13.6±5.2）h，差异有统计学意义（P=0.006）。早期手术组术后肺部感染率、肺不张发生率均低于常规手术组[5.9%（1/17）vs 42.9%（6/14）、0.0%（0/17）vs 28.6%（4/14），P=0.028、0.032]。早期手术组术后疼痛改善率为94.1%（16/17），与常规手术组的78.6%（11/14）比较差异无统计学意义（P>0.05）。结论 多发肋骨骨折患者早期（≤72 h）行内固定手术在减少肺部感染和肺不张发生率等方面有明显优势。 |
| 关键词: 肋骨骨折 内固定 最佳时机 并发症 |
| DOI：10.16781/j.0258-879x.2018.05.0564 |
| 投稿时间：2017-12-10修订日期：2018-03-28 |
| 基金项目:嘉兴市科技计划项目（2017BY18045）. |
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| Effect of optimal timing of internal fixation on postoperative complications in multiple rib fracture patients |
| LAN Gang*,WANG Xi-yong,GUO Da-wei,XIAO Huai-qing,XU Zhu-hui,ZHANG Zhi-hao |
(Department of Cardiothoracic Surgery, Hospital of Armed Police Forces Zhejiang Regional Headquarters, Jiaxing 314000, Zhejiang, China
*Corresponding author) |
| Abstract: |
| Objective To explore the effect of optimal timing of internal fixation on postoperative complications of multiple rib fractures. Methods A total of 31 cases of multiple rib fractures receiving internal fixation in our hospital from Mar. 2014 to Jul. 2016 were included in this study. According to the time from injury to internal fixation, the patients were divided into early operation group (≤ 72 h, n=17) and routine operation group (>72 h, n=14). The clinical data of the patients were compared between the two groups, including age, gender, body mass index (BMI), number of fractured ribs, incidence of comorbidity, incidence of postoperative complications and pain improvement rate. Results There were no significant differences in age, gender, BMI, number of fractured ribs, or incidence of comorbidity between the two groups (all P>0.05). The time from injury to internal fixation was significantly less in the early operation group than that in the routine operation group ([2.2±1.5] d vs[7.4±2.8] d, P<0.01). The ventilator-assisted ventilation time was significantly shorter in the early operation group than that in the routine operation group ([8.9±3.7] h vs[13.6±5.2] h, P=0.006). The incidence of pulmonary infection and postoperative atelectasis was significantly lower in the early operation group than that in the routine operation group (5.9%[1/17] vs 42.9%[6/14], P=0.028; 0.0% (0/17) vs 28.6%[4/14], P=0.032). The improvement of postoperative pain was 94.1%[16/17] and 78.6%[11/14] in the early and routine operation groups, respectively, and the difference was not significant (P>0.05). Conclusion Early internal fixation surgery (≤ 72 h) may contribute to reducing incidence of postoperative pulmonary infection and atelectasis of the patients with multiple rib fracture. |
| Key words: rib fractures internal fixation optimal timing complications |
