肋骨内固定在多发性肋骨骨折治疗中的应用56例

目的：总结肋骨内固定在胸部创伤治疗多发性肋骨骨折中的应用经验。方法：56例胸部创伤多发性肋骨骨折，在气管插管全身麻醉下分离骨折断端，应用钛镍记忆合金环抱器，在冰水中将环抱器臂部张开并根据肋骨弧度塑形，迅速将其置于已经整复的骨折端上方，用热生理盐水（40℃~50℃）湿敷，使环抱器紧缩，紧紧环抱骨折端，固定肋骨。结果：本组无死亡病例，肋骨内固定后术前有呼吸困难的明显好转，出现急性呼吸窘迫综合症（ARDS）均顺利脱离呼吸机辅助呼吸，均痊愈出院。结论：应用钛镍记忆合金环抱器进行肋骨内固定对治疗胸部创伤，手术操作简单，时间短，效果确切，出现急性呼吸窘迫综合症的均能顺利脱离呼吸机，术后呼吸功能恢复快，缩短住院时间。

56 Cases Application of internal Fixating of Multi-fractures of ribs

Objective：To summarize internal fixation of multi-fractures of ribs alter chest trauma. Methods：30 pa- tients underwent separation on both sides of the ribs stump under trachea cannula anesthesia. The holder of titanium- nickel alloys was softened in iced water.Then the arm of holder was stretched and paced with hot water（40℃-50℃）, and the holder resumed its original shape quickly and fractured rib was fixed. Results：No patients were dead.The pa- tients of dyspnea took a turn for the better after internal fixation.The patient of ARDS broke away from ventilator favourably. All patients were cured. Conclusion：It is easy to operate internal fixation of multi-fractures of ribs of the holder of titanium- nickel alloys.The operation time is short and the effect is exact. It is especially useful in multiple rib fractures,which can break away from ventilator of the patient of ARDS, quicken recovery in posoperative respira- tion and shorten the period of hospital stay.