肺挫伤对连枷胸手术内固定疗效的影响

目的：探讨手术内固定治疗连枷胸合并肺损伤的疗效以及肺挫伤对疗效的影响。方法：回顾性分析2002年1月至2011年12月深圳市第二人民医院收治的62例连枷胸合并肺损伤患者的临床资料，其中内固定组24例、保守治疗组38例，肺挫伤简易评分法0～6分37例（A组，其中保守治疗22例、内固定15例）、7～18分25例（B组，其中保守治疗16例、内固定9例），比较呼吸机支持例数、呼吸机支持时间、住院时间及死亡例数等指标的差异．、结果：（1）保守治疗组和内固定组呼吸机支持例数、呼吸机支持时间、住院时间、死亡例数比较，差异无统计学意义（P〉0．05）。（2）A组中保守治疗和内固定治疗患者呼吸机支持例数、呼吸机支持时间、住院时间比较，差异有统计学意义（P〈0．05）。（3）B组中保守治疗和内固定治疗患者患者呼吸机支持例数、呼吸机支持时间、住院时间分、死亡例数比较，差异无统计学意义（P〉0．05）．结论：连枷胸合并轻度肺挫伤经内固定治疗，可迅速改善患者呼吸功能；而合并严重肺挫伤的连枷胸患者内固定术后呼吸功能改善不够理想。

Internal fixation for traumatic flail chest with concomitant pulmonary contusion

Objective：To study the effects of internal fixation for the treatment of traumatic flail chest with concomitant lung injury and puhnonary contusion. Methods： We did a retrospective analysis on the clinical profiles of 62 patients with traumatic flail chest and concomitant lung injury admitted to Shenzhen Second People＇ s Hospital between January 2002 and December 2011, of whom 38 received conservative treatment and 24 internal fixation. 37 patients rated the score of 0 to 6 for simple pulmonary contusion scale （group A, in whom 22 received conservative treatment and 15 internal fixation） , and 25 patients rated the score of 7 to 18 for simple pulmonary contusion scale （group B, in whom 16 received conservative treatment and 9 internal fixation）. The difference in the number of cases requiring and the duration of mechanical ventilation, length of hospital stay and mortality was compared. Results： The difference in the number of cases requiring and the duration of mechanical ventilation, length of hospital stay and mortality between conservative treatment group and internal fixation group was unremarkable （ all P 〉 0.05）. Compared with these groups, group A yielded a significant difference in the number of cases requiring and the duration of mechanical ventilation and length of hospital stay （ all P 〈 O. 05 ）. The diffe3rence in the number of cases requiring and the duration of mechanical ventilation, length of hospital stay and mortality between group B and conservative treatment group or internal fixation group did not reach statistical significance （ all P 〉 0.05 ）. Conclusion ： Internal fixation is effective for prompt amelioration of respiratory distress in patients with traumatic flail chest and concomitant mild pulmonary contusion, but not in those with severe puhnonary contusion.