胸骨肋骨内固定术在严重胸外伤中的临床意义

目的：探讨胸骨肋骨内固定术在严重胸外伤中的临床疗效及意义。方法回顾性研究2009年6月～2013年8月我院收治的76例创伤性连枷胸患者的临床资料，分为胸骨肋骨内固定术治疗组38例，保守治疗组38例。结果两组患者共治愈72例，死亡4例（每组各2例），差异无统计学意义（P＞0.05）。但是手术组治疗后血气分析结果较保守组改善显著，机械通气时间、ICU停留时间、住院时间较保守治疗组明显缩短（P＜0.05），胸廓畸形及发生呼吸道并发症（呼吸衰竭、肺部感染、血气胸、肺不张）较保守治疗组明显减少，差异有统计学意义（P＜0.05）。结论胸骨肋骨内固定术在减少ICU停留和住院天数方面有明显疗效，并可以减轻机械通气时间、呼吸道感染等并发症，是治疗连枷胸的理想方法。

Clinical significance of sternal ribs internal fixation on severe thoracic trauma

Objective To evaluate the clinical efficacy and significance of sternal ribs internal fixation in treatment of severe chest trauma. Methods The clinical data of 76 patients with flail chest in our hospital from June 2009 to August 2013 were studied retrospectively. In the study,the patients were divided into two groups（each 38 cases）： one treated with sternal ribs internal fixation;another one treated with conservatively method. Results 72 cases of all the two groups were cured, while 4 cases were dead（2 cases in each group）. It was no significant differences（P〉0.05）. But for the surgery group, the blood gas analysis,duration of mechanical ventilation,ICU stay and hospital stay all lasted shorter than the conservative treatment group（P 〈 0.05）.Meanwhile,the probability for thoracic deformity and respiratory tract complications（respiratory failure, pulmonary infection, pneumothorax, atelectasis etc） also decreased significantly compared with conservative treatment group, the difference was significant（P〈0.05）.Conclusion The sternal fixation ribs have apparent advantages on reducing the number of days of ICU stay and hospital stay, as well as reducing the duration of mechanical ventilation, respiratory infections and other complications.Therefore,it is an ideal method for the treatment of flail chest.