纯钛爪型肋骨内固定板在多发肋骨骨折的应用

目的探讨纯钛爪型肋骨内固定板在多发肋骨骨折中的应用。方法选取2010年1月～2012年4月收治的接受纯钛爪型肋骨内固定板治疗的多发性肋骨骨折患者63例为手术组。选择既往接受保守治疗的多发肋骨骨折患者425例为对照组。比较两组患者治疗后VAS疼痛评分、机械通气时间、胸腔引流管放置时间、重症监护室（ICU）监护时间、住院时间及镇痛剂使用情况，肺功能及并发症的发生情况。结果治疗后手术组VAS评分、机械通气时间、胸腔引流管放置时间、ICU监护时间、住院时间及止痛药的使用剂量均明显少于对照组，差异均有统计学意义（均P〈0．05），手术组肺活量、第1秒用力呼气容积占用力肺活量的百分率（FEV1／FVC）、最大通气量均明显优于对照组，差异均有统计学意义（均P〈0．05）；手术组术后肺不张、肺部感染、胸廓畸形、骨折移位及迟发性气胸等并发症的总发生率为11．1％（7／63），对照组为47．5％（202／425），手术组并发症总发生率低于对照组，差异有统计学意义（P〈0．05）。结论纯钛爪型肋骨内固定板治疗多发肋骨骨折的安全有效，相比传统的保守治疗缩短了患者的恢复时间，且并发症较少，故值得推广。

Application of titanium claw-like rib bone plate in the treatment of multiple rib fractures

Objective To investigate the application of titanium claw-like rib bone plate in the treatment of multiple rib fracture. Methods 63 patients with multiple rib fractures who received the application of titanium claw-like rib bone plate from January 2010 to April 2012 were selected as the operation group while 425 patients with multiple rib fractures who received conservative treatment were selected as the control group. The VAS score, time of mechanical ventilation, indwelling time of drainage time, ICU monitoring time, hospitalization time, analgesic usage, lung function and complication occurrence of the two groups after the treatment were compared. Results The VAS score, time of me- chanical ventilation, indwelling time of drainage time, ICU monitoring time, hospitalization time, analgesic usage of the operation in operation group after the treatment were less than those in control group, the differences were all statisti- cally significant （all P 〈 0.05）; the vital capacity, FEWFVC, maximal voluntary ventilation in operation group after the treatment were better than those in control group, the differences were all statistically significant （all P 〈 0.05）. The to- tal rate of complication occurrence such as pulmonary atelectasis, pulmonary infection, thoracocyllosis, displacement fracture, late-occurred pneumothorax in operation group 11.1% （7/63）] was lower than that in control group 47.5% （202/425）], the difference was statistically significant （P 〈 0.05）. Conclusion Titanium claw-like rib bone plate has a significant effect in the treatment of multiple rib fractures, which costs the patients less recovery time than the tradi- tional treatment. And it has little complications after the surgery, so it is worthy of promoting.