肋骨内固定与肋间神经阻滞联合应用治疗多发肋骨骨折

目的探讨肋骨内固定手术与肋间神经阻滞联合应用对于严重胸部创伤多发肋骨骨折患者的治疗效果。方法通过我院采用肋骨接骨板内固定手术联合肋间神经阻滞方法（2009年1月～2011年6月）与非手术方法治疗（2006年1月～2008年12月）多发肋骨骨折患者的对比分析,比较两组患者的疗效及并发症情况。结果手术组80例患者术后随访复查胸部X线片显示骨折愈合良好,其住院时间、疼痛感觉、肺部感染、肺不张及呼吸衰竭等并发症发生率均明显少于非手术治疗组（P﹤0.05）。结论对严重多发肋骨骨折的病人,肋骨接骨板内固定与肋间神经阻滞的联合应用与非手术治疗相比较,能尽快恢复胸廓稳定性,及时有效镇痛,缩短ICU重症监护及住院时间,减少肺部感染及ARDS等并发症的发生率。

Curative effect of rib internal fixation combined with intercostals nerve block for multiple rib fractures

Objective To investigate the curative effect of rib internal fixation combined with intercostal nerve block for severe chest trauma with multiple rib fractures.Methods A comparative analysis of curative effect and complication was carried out between two groups of patients with multiple rib fractures who had been treated with open reduction and internal fixation by use of rib plate combined with intercostal nerve block from Jan.2009 to Jun.2011 and nonsurgical treatment from Jan.2006 to Dec.2008 in our hospital,respectively.Results The 80 patients in surgical group were all cured as confirmed by chest X-ray examination during follow-up.The hospital stay,pain perception,incidence rate of lung infection,atelectasis,respiratory failure and other complications were significantly less than nonsurgical treatment group(P<0.05).Conclusion The treatment of rib plate fixation combined with intercostal nerve block for patients with severe multiple rib fractures has advantages over conservative treatment as it can make the thorax restore stability,acquire timely and effective pain relief,reduce hospital stay,and lessen the incidence of complications such as lung infection and ARDS.