胸部护板在胸部创伤早期治疗中的效果

目的评价胸部护板在以多发肋骨骨折、胸骨骨折为主的胸部创伤早期治疗中的临床效果。方法对46例肋骨骨折和（或）胸骨骨折创伤患者，随机分为传统治疗组（对照组，16例）、胸部护板治疗组（观察组，30例），对两组患者的疼痛及血气分析指标、肺部并发症、住院时间进行评价。结果观察组与对照组疼痛指数评分（VAS）[（4．45±2．23）、（8．15±2．02）分，t=2．921，P〈0．01]，血气分析Pa02[（88．16±9．12）mmHg与（77．22±6．24）mmHg，t=2．413，P〈0．05]、PaCO2[（40．91±3．40）mlnHg与（46．06±5．40）mmHg，t=2．335，P〈0．05]、肺部并发症[17％（5／30）、44％（7／16），X2=23．478，P〈0．05]、住院时间[（7．26±4．17）d与（14．26±3．53）d，t=2．430，P〈0．05]比较差异均有统计学意义。结论胸部护板在胸部创伤早期治疗中能减少患者痛苦，明显改善病情，且简单易行，临床效果显著。

Effectiveness of chest orthosis in early treatment of chest trauma

Objective To evaluate the clinical effect of the chest orthosis on patients with multiple rib or（and） sternal fracture in early period of closed chest trauma. Methods Patients with multiple fractured of ribs or（and） sternal fracture were divided into control group（ n = 16 ）treated with the traditional fixation methods （thoracic girdle added with folding towels）and experimental group（ n = 30） treated with chest orthosis between January 2009 and December 2011. Correlated parameters of these patients in the two groups, including pain, indexes of blood gas analysis, pulmonary complications and hospitalization time were evaluated. Results There were significant differences on visual analogue seale（VAS） [ （4.45 ±2. 23） vs （8. 15 ±2.02） ,t = 2. 921 ,P 〈 0.01 ], blood gas analysis including PaO2 [ 88.16 ± 9. 12） mm Hg vs （ 77. 22 ± 6.24 ） mm Hg, t = 2. 413, P 〈 0.05] andPaCO2[ （40.91±3.40）mm Hg vs （46.06±5.40）mm Hg, t =2.335,P 〈0.05] between experimental group and control group. The incidence rate of pulmonary complications in experimental group was significantly lower than that in control group [ 17% （ 5/30 ） vs 44% （ 7/16 ）, X2 = 23.478, P 〈 0. 05 ]. And hospitalization time in experimental group was significantly shorter compared with control group[ （7. 26± 4. 17 ） d vs （ 14.26 ± 3.53 ） d, t = 2. 430, P 〈 O. 05 ]. Conclusion The chest orthosis in early treatment of chest trauma can reduce the pain and improve the condition of patients, and it is a simple, effective and cheap method with significant clinical effect.