重症连枷胸手术与非手术治疗的临床对比研究

目的对比研究手术内固定与非手术治疗重症创伤性连枷胸为主的全身多发伤的疗效。方法将2004年1月一2013年5月收治的116例合并胸骨骨折的重症创伤性连枷胸为主的复合伤患者分为不同的手术组与非手术治疗组对比研究，临床资料进行回顾性分析。结果手术组胸壁畸形、迟发性血气胸、肺部炎症、肺不张及呼吸功能衰竭等并发症较非手术治疗组有明显减少，差异有统计学意义（P〈0．05）。治疗后4个月肺功能手术组限制性通气障碍较非手术治疗组有明显减少，差异有统计学意义（P〈0．05）。结论对合并胸骨骨折的重症创伤性连枷胸病例行胸部手术内固定可减少连枷胸引起的并发症，内固定有一定的近期和远期效果。

Clinical study of treatment of severe traumatic flail chest by non-surgical method versus internal fixation

Objective To investigate the curative effect of the treatment of severe traumatic flail chest patients with multiple injury by non - surgical method versus internal fixation. Methods A total of 116 flail chest patients with sternum fracture and multiple injury in our unit from Jan. 2004 to May 2013 were divided into three differ- ent surgical treatment groups （ n = 24, n = 26, n = 28 ） and non - surgical group （ n = 38 ） , and the clinical data were retrospectively analyzed. Results The ratio of complications （ such as chest wall deformity, delayed hemopneumo- thorax,pulmonary infection,pulmonary atelectasis, respiratory failure） in surgical group was significantly different compared with the non - surgical group （ P 〈 0.05 ）. The results of the pulmonary functions tested four months after management indicated that in the surgical group the patients had a l.ess restrictive pattern than patients in the non- surgical group （ P 〈 0.05 }. Conclusion Chest internal fixation can reduce complications in flail chest patients with sternum fracture and multiple injury, and the operative fixation has some short and long-term benefits for flail chest.