沿肋间并行小切口与传统大开胸行连枷胸内固定术的临床对照研究(1)
[摘要] 目的 探讨传统切口大开胸与沿肋间并行小切口在连枷胸患者的镍肽合金环抱器固定术中的临床疗效予以分析对比。方法 方便选取该院2012年3月—2017年3月该院26例传统大开胸以镍肽合金环抱器内固定术治疗多根多处肋骨骨折和21例采用新式小切口(沿肋间并行双小切口)以镍肽合金环抱器内固定术治疗多根多处肋骨骨折案例做为对比分析对象，对比两组患者比较两组患者下床时间、疼痛缓解程度、术后拔除引流管时间、患者满意度及住院时间等指标。 结果 观察组术后疼痛缓解(8.5±2.1)d、胸腔闭式引流管平均放置时间(4.8±1.6)d、平均下床时间(5.3±2.1)d及平均住院时间(10.5±1.8)d均低于对照组[(12.4±1.8)、(8.3±3.4)、(9.7±2.9)、(21.6±3.5)d]，差异有统计学意义(t=6.855、4.339、5.823、13.175，P<0.05)；观察组患者的总满意度为95.24%，对照组患者的总满意度为73.08%，差异有统计学意义(χ2=4.039，P<0.05)。 结论 沿肋间并行双小切口在多根多处肋骨骨折内固定术中较传统大开胸方式有诸多优势，更能为患者接受，可以适当推荐。
[关键词] 并行小切口；多发性肋骨骨折；内固定；镍肽合金抱全器
[中图分类号] R687.3 [文献标识码] A [文章编号] 1674-0742(2019)03(b)-0036-03
[Abstract] Objective To investigate the clinical efficacy of traditional incision large thoracotomy and small intercostal incision in the fixation of nickel-peptide alloy embracing fixator in patients with flail chest. Methods Convenient select from March 2012 to March 2017， 26 cases of traditional large open chest in our hospital were treated with nickel-peptide alloy embracing fixator for the treatment of multiple rib fractures and 21 cases with new small incisions (double small incisions were made in parallel along the intercostal space) was treated with nickel-peptide alloy embracing fixator for the treatment of multiple rib fractures. The comparison between the two groups was compared between the two groups， the time of getting out of bed， the degree of pain relief， the time of removal of the drainage tube， and the indicators such as patients' satisfaction and hospitalization time. Results The postoperative pain relief (8.5±2.1)d， the average thoracic closed drainage time (4.8±1.6)d， the average bedtime (5.3±2.1)d and the average hospitalization time (10.5±1.8)d were lower in the observation group than in the control group of [(12.4±1.8)，(8.3±3.4)，(9.7±2.9)，(21.6±3.5)d]， the difference was statistically significant(t=6.855， 4.339， 5.823， 13.175， P<0.05)； the total satisfaction of the observation group was 95.24%， the control group patients' overall satisfaction was 73.08%， and the difference was statistically significant(χ2=4.039， P<0.05). Conclusion The double-small incision along the intercostal space has many advantages over the traditional large thoracotomy in the multiple internal rib fracture fixation. It is more acceptable for patients and can be recommended.
[Key words] Parallel small incision； Multiple rib fracture； Internal fixation； Nickel peptide alloy
多根多處肋骨骨折常常会引起连枷胸、胸壁塌陷、反常呼吸，临床治疗上以手术内固定治疗为主，具有操作简单、对患者创伤小、手术时间短、术后恢复快速等优势[1-2] ，该文通过对2012年3月—2017年3月该院收治的47例胸部创伤多根多处肋骨骨折及连枷胸的患者，采取微创小切口肋骨内固定术治疗，现报道如下。, http://www.100md.com(何北)
[关键词] 并行小切口；多发性肋骨骨折；内固定；镍肽合金抱全器
[中图分类号] R687.3 [文献标识码] A [文章编号] 1674-0742(2019)03(b)-0036-03
[Abstract] Objective To investigate the clinical efficacy of traditional incision large thoracotomy and small intercostal incision in the fixation of nickel-peptide alloy embracing fixator in patients with flail chest. Methods Convenient select from March 2012 to March 2017， 26 cases of traditional large open chest in our hospital were treated with nickel-peptide alloy embracing fixator for the treatment of multiple rib fractures and 21 cases with new small incisions (double small incisions were made in parallel along the intercostal space) was treated with nickel-peptide alloy embracing fixator for the treatment of multiple rib fractures. The comparison between the two groups was compared between the two groups， the time of getting out of bed， the degree of pain relief， the time of removal of the drainage tube， and the indicators such as patients' satisfaction and hospitalization time. Results The postoperative pain relief (8.5±2.1)d， the average thoracic closed drainage time (4.8±1.6)d， the average bedtime (5.3±2.1)d and the average hospitalization time (10.5±1.8)d were lower in the observation group than in the control group of [(12.4±1.8)，(8.3±3.4)，(9.7±2.9)，(21.6±3.5)d]， the difference was statistically significant(t=6.855， 4.339， 5.823， 13.175， P<0.05)； the total satisfaction of the observation group was 95.24%， the control group patients' overall satisfaction was 73.08%， and the difference was statistically significant(χ2=4.039， P<0.05). Conclusion The double-small incision along the intercostal space has many advantages over the traditional large thoracotomy in the multiple internal rib fracture fixation. It is more acceptable for patients and can be recommended.
[Key words] Parallel small incision； Multiple rib fracture； Internal fixation； Nickel peptide alloy
多根多處肋骨骨折常常会引起连枷胸、胸壁塌陷、反常呼吸，临床治疗上以手术内固定治疗为主，具有操作简单、对患者创伤小、手术时间短、术后恢复快速等优势[1-2] ，该文通过对2012年3月—2017年3月该院收治的47例胸部创伤多根多处肋骨骨折及连枷胸的患者，采取微创小切口肋骨内固定术治疗，现报道如下。, http://www.100md.com(何北)