早期或晚期手术治疗多发肋骨骨折的效果及并发症观察

目的探讨早期或晚期手术治疗多发肋骨骨折的效果及对并发症的影响。方法我院骨科收治的102例多发肋骨骨折患者,根据手术时机的不同分为早期手术组53例和晚期手术组49例,早期手术组为受伤72 h内接受手术治疗,晚期手术组为受伤72 h后接受手术治疗;比较两组手术时间、术中出血量、术后引流量、下床活动时间及住院时间;两组手术前后肺功能及血气分析指标,术后3个月肋骨骨折愈合情况,康复期间出现的并发症总发生率。结果两组手术时间比较,差异无统计学意义(P>0.05),早期手术组术中出血量及术后引流量低于晚期手术组,下床活动时间及住院时间短于晚期手术组(P<0.05)。早期手术组术后用力肺活量(FVC)、一秒用力呼气容积(FEV1)/FVC(FEV1%)、每分钟最大通气量(MVV)及血氧饱和度(SaO2)、血氧分压(PaO2)水平高于晚期手术组,血二氧化碳分压(PaCO2)水平低于晚期手术组(P<0.05)。早期手术组骨折愈合率高于晚期手术组,并发症总发生率低于晚期手术组(P<0.05)。结论早期手术治疗多发肋骨骨折能够显著提高骨折愈合率,减少术中出血量、术后引流量、下床活动及住院时间,有利于肺功能和血气水平的恢复,并发症较少。

Curative effect of early or late surgery for multiple rib fractures and observation of complications

Objective To explore the curative effect of early or late surgery in the treatment of multiple rib fractures and its influences on complications.Methods A retrospective analysis was performed on 102 patients with multiple rib fractures who were admitted to department of orthopedic surgery of our hospital.They were divided into early surgery group(n=53)and late surgery group(n=49)according to different surgery timing.The early surgery group was given surgical treatment within 72 h after injury while the late surgery group was given surgical treatment after 72 h of injury.The operation time,intraoperative blood loss,postoperative drainage volume,leaving bed time and hospitalization time were compared between the two groups.The lung function and blood gas indexes before and after operation were compared between the two groups.After 3 months of surgery,rib fracture healing and total incidence of complications during rehabilitation were also compared between the two groups.Results There was no significant difference in operation time between the two groups(P>0.05).The intraoperative blood loss and postoperative drainage volume were lower and leaving bed time and hospitalization time were shorter in the early surgery group than those in the late surgery group(P<0.05).The forced vital capacity(FVC),percentage of forced expiratory volume in one second(FEV1)/FVC(FEV1%)and maximum ventilation ventilation(MVV)per minute as well as oxygen saturation(SaO2),blood oxygen pressure(PaO2)were higher while blood carbon dioxide partial pressure(PaCO2)was lower in the early surgery group than those in the late surgery group(P<0.05).The fracture healing rate of the early surgery group was higher than that of late surgery group(P<0.05).The total incidence of complications in the early surgery group was lower than that in the late surgery group(P<0.05).Conclusion Early surgical treatment for multiple rib fractures can significantly improve the fracture healing rate,reduce the intraoperative blood loss,postoperative drainage volume,leaving bed time and hospitalization time.These are conducive to recovery of lung function and blood gas level with fewer complications.