记忆合金环抱器手术内固定治疗多根多处肋骨骨折的临床研究

目的：探究记忆合金环抱器手术内固定在治疗多根多处肋骨骨折中的疗效。方法：选择符合纳入标准的患者50例,分为对照组和手术组各25例。方法：手术组应用记忆合金环抱器手术复位内固定。对照组采用胸骨固定板胸带包扎固定,重症呼吸不稳定者行呼吸机辅助内固定。分别观察对比两组患者的疼痛缓解时间、住院天数、骨折愈合天数；术后1周和出院随访3个月的VC、FEV1/ FVC、MVV；以及术后胸廓畸形、肺不张、肺部感染、胸腔积液等并发症的发生率。结果：手术组疼痛缓解时间(8.96±2.85)天、住院天数(9.96±3.23)天、骨折愈合天数(33.84±2.59)天均少于对照组手术组疼痛缓解时间(16.40±2.32)天、住院天数(18.50±2.31)天、骨折愈合天数(56.16±2.51)天,P<0.05,有统计差异；在肺功能改善方面,术前、术后1个月及出院3个月的手术组与对照组组间比较,P<0.05,均具有统计差异,术前手术组在VC、FEV1/ FVC、MVV三方面与对照组相比较(P>0.05),两组无统计差异,术后1周和出院随访3个月的手术组在VC、FEV1/ FVC、MVV三方面与对照组相比较,P<0.05,有统计差异；在不良反应方面,各并发症经卡方检验,P>0.05,无统计差异,总不良反应发生率经卡方检验P=0.031<0.05,有统计差异。结论：记忆合金环抱器手术内固定在治疗多根多处肋骨骨折中的疗效确切,为今后临床和科研提供新的思路和证据。

Clinical study of memory alloy embracing fixator in the treatment of multiple rib fractures

Objective: To explore the effect of memory alloy embracing fixator in the treatment of multiple rib fractures. Methods: 50 patients who met the inclusion criteria were selected and divided into control group (n = 25) and operation group (n = 25). Methods: memory alloy embracing fixator was used in the operation group. The patients in the control group were treated with sternal fixation plate and bandage, and those with severe respiratory instability were treated with ventilator assisted internal fixation. The pain relief time, hospitalization days and fracture healing days of the two groups were observed and compared; Vital capacity (VC), forced expiratory volume in the first second (FEV1) / forced vital capacity (FVC) and maximum ventilation volume (MVV) were measured at 1 week after operation and 3 months after discharge; And the incidence of postoperative atelectasis, pulmonary infection, pleural effusion, thoracic deformity and other adverse reactions. Results: the pain relief time (8.96 ± 2.85) days, hospitalization days (9.96 ± 3.23) days and fracture healing days (33.84 ± 2.59) days in the operation group were significantly shorter than those in the control group (16.40 ± 2.32) days, hospitalization days (18.50 ± 2.31) days and fracture healing days (56.16 ± 2.51) days (P < 0.05). In terms of pulmonary function improvement, there were statistically significant differences between the operation group and the control group before operation, 1 month after operation and 3 months after discharge (P < 0.05). There was no significant difference in VC, FEV1 / FVC and MVV between the two groups (P > 0.05); There were significant differences in VC, FEV1 / FVC and MVV between the two groups (P < 0.05). In terms of adverse reactions, the complications by chi square test p > 0.05, no statistical significance, the total incidence of adverse reactions by chi square test p = 0.031 < 0.05, statistically significant. Conclusion: memory alloy embracing fixator is effective in the treatment of multiple rib fractures, which provides new ideas and evidence for clinical and scientific research in the future.