重点肋骨内固定联合机械通气治疗连枷胸伴创伤性湿肺临床疗效

目的:分析重点肋骨内固定联合机械通气治疗连枷胸伴创伤性湿肺的临床效果。方法:选取2014年1月至2015年10月江苏省新沂市人民医院胸心外科收治的连枷胸伴创伤性湿肺患者50例作为研究对象,其中男性35例,女性15例;年龄20~68岁,平均(43.40±2.40)岁。所有患者行重点肋骨内固定术并联合机械通气治疗,术后对比患者治疗前后动脉血气指标变化情况,并详细评估患者治疗前后疼痛和呼吸改善情况。结果:术后患者心率(P)、呼吸频率(RR)、收缩压(SBP)、舒张压(DBP)等体征指标及二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))、酸碱度(PH)等动脉血气指标均优于术前(P<0.05);术后所有患者经CT三维成像复查无二次撕裂或移动松脱并发症发生,内固定均牢固。术后疼痛评分及呼吸困难均明显改善。结论:重点肋骨内固定术联合机械通气治疗可改善患者的呼吸循环状况,加速促进患者的康复,值得临床推广使用。

Clinical efficacy of key rib internal fixation combined with ventilator breathing for flail chest with lung contusion

ObjectiveTo analyze the clinical effect of flail chest with traumatic wet lung treated with key rib internal fixation combined with mechanical ventilation. MethodsFifty patients with flail chest and traumatic wet lung admitted to the Department of cardiothoracic surgery of Xinyi people’s Hospital of Jiangsu Province from January 2014 to October 2015 were selected as the research objects, including 35 males and 15 females; The age ranged from 20 to 68 years, with an average of (43.40±2.40) years. All patients were treated with key rib internal fixation combined with mechanical ventilation. The changes of arterial blood gas indexes before and after treatment were compared, and the improvement of pain and respiration before and after treatment were evaluated in detail. ResultsPostoperative patients’ heart rate, respiratory rate, SBP, DBP and PaCO₂, PaO₂, pH indicators were better than before surgery, the difference was statistically significant (P<0.05); The re-examination of the 3-D CT image showed no complications of secondary laceration and mobile loosening, and all were fixed internally. ConclutionFor flail chest with traumatic wet lung patients, combined key rib internal fixation and mechanical ventilation treatment can improve the breathing cycle and promote the rehabilitation. It is worthy of clinical promotion.