Granetzny Andreas, Abd El-Aal Mohamad, Emam Elrady, Shalaby Alaa, Boseila Ahmad
Department of Thoracic Surgery, Klinikum Evangelisches Krankenhaus Duisburg-Nord, Fahrner Str. 133, Duisburg 47169, Germany.
Interact Cardiovasc Thorac Surg. 2005 Dec;4(6):583-7. doi: 10.1510/icvts.2005.111807. Epub 2005 Sep 15.
Through a prospective randomized comparative study, treatment of flail chest by a non-surgical method of packing, strapping, and mechanical ventilation vs. surgical fixation were compared. After management, stability of the chest wall occurred in 85% of the patients in the surgical group. Forty-five percent of patients in this group required ventilatory support after fixation for an average of 2 days. Whereas in the conservative group, stability occurred in 50% of their patients, and 35% of patients required ventilatory support for an average of 12 days. Chest wall deformity in the form of stove-in chest and crowding of ribs was still obvious in 9 patients among the conservatively treated group, compared to only one patient who developed chest wall deformity in the surgically treated group. The pulmonary functions tested two months after management indicated that in the surgical group the patients had a significantly less restrictive pattern. Thus, surgical fixation of a flail segment is a method of great value in the treatment of flail chest, in which stability is achieved without deformity of the chest wall and patients have less restrictive impairment of pulmonary functions.
通过一项前瞻性随机对照研究，比较了采用包扎、捆绑及机械通气的非手术方法与手术固定治疗连枷胸的效果。治疗后，手术组85%的患者胸壁实现稳定。该组45%的患者固定后需要通气支持，平均持续2天。而在保守治疗组，50%的患者实现稳定，35%的患者需要通气支持，平均持续12天。保守治疗组中有9例患者仍存在胸壁凹陷和肋骨拥挤形式的胸壁畸形，而手术治疗组中只有1例患者出现胸壁畸形。治疗后两个月进行的肺功能测试表明，手术组患者的限制性模式明显较轻。因此，连枷节段的手术固定是治疗连枷胸的一种非常有价值的方法，该方法可实现胸壁稳定且无畸形，患者肺功能的限制性损害较小。
