早期髓内针内固定治疗胸部创伤并发股骨折与胸部并发症的关系

目的　研究早期髓内钉内固定治疗胸部创伤并发股骨骨折是否增高胸部并发症发生率及死亡率。方法　依据AIS - 90 ,应用ISS评分方法评估 1 0年来行早期髓内钉内固定的胸部创伤并股骨骨折患者 36例 ,并与同期 36例胸部创伤评分相同的延迟内固定的胸部创伤并股骨骨折患者 ,及 36例单纯胸部创伤患者进行对照。结果　三组患者术后成人呼吸窘迫综合征、肺栓塞、肺部炎症、多器官功能衰竭的发生率及死亡率均无显著差异 (P >0 .0 5) ,而早期内固定组患者ICU监护时间、住院天数明显低于延迟内固定组 ,差异显著 (P <0 .0 5)。结论　早期髓内针内并不增加术后胸部并发症发生率及死亡率 ,减少患者痛苦及住院周期 ,是治疗胸部创伤并股骨骨折的安全、有效的方法

CONTRASTIVE STUDY OF THORACIC COMPLICATION FOLLOWING THORACIC INJURY AND FEMORAL FRACTURE TREATED WITH EARLY INTRAMEDULLARY NAILING WITH REAMING

Objective To study the influence on thoracic complication following thoracic injury and femoral fracture treated with early intramedullary nailing with reaming. Methods According to the AIS90-ISS scoring, patients within recent 10 years were divided into 3 groups ( 36 cases in each group): group A treated with early intramedullary nailing fixation; group B treated with delayed intramedullary nailing fixation, and group C of simple thoracic injury. Incidence of thoracic complication and their mortality in the 3 groups were observed. Results There was no difference in the incidence of ARDS, MOSF, pulmonary embolism and pulmonary inflammation nor in their mortality (P>0.05), but the custodial time in ICU and the days of hospitalization in group A were less than that in group B with significant difference (P<0.05). Conclusion Early intramedullary nailing fixation does not increase the incidence of thoracic complication or mortality, and can reduce patients' pain and shorten their hospitalization time, so it is a safe and effective method for the treatment of thoracic injury and femoral fracture.