连枷胸损伤手术固定的临床结果
Clinical Outcomes of Surgical Stabilization of Flail Chest Injury.
作者信息
Taylor Benjamin C, Fowler T Ty, French Bruce G, Dominguez Neysa
机构信息
From the Grant Medical Center, Columbus, OH (Dr. Taylor, Dr. French, and Ms. Dominguez), and the Mount Carmel Medical Center, Columbus (Dr. Fowler).
出版信息
J Am Acad Orthop Surg. 2016 Aug;24(8):575-80. doi: 10.5435/JAAOS-D-15-00476.
INTRODUCTION
Recent reported success in surgical stabilization of flail chest has been described in small series, but scant evidence exists for this procedure in the orthopaedic literature.
METHODS
We reviewed 88 consecutive patients who underwent surgical stabilization of flail chest, along with 88 consecutive patients with flail chest who underwent traditional closed management before initiation of our algorithm change to surgical management.
RESULTS
Surgical stabilization of flail chest injuries led to statistically significant decreases in hospital length of stay, ventilator-dependency time, pneumonia, tracheostomy, and mortality rate. In addition, the presence of pulmonary contusion did not eliminate the significant improvements in the aforementioned variables.
DISCUSSION
Surgical stabilization of flail chest with modern techniques and implants provides significant improvements in both mortality and short-term outcomes. Although pulmonary contusion decreased overall outcomes across both cohorts, this factor did not alter the ability of rib fixation to improve outcomes.
引言
近期有报道称，在小样本研究中，连枷胸手术固定取得了成功，但骨科文献中关于该手术的证据却很少。
方法
我们回顾了88例连续接受连枷胸手术固定的患者，以及在我们将治疗方案改为手术治疗之前，88例连续接受传统闭合治疗的连枷胸患者。
结果
连枷胸损伤的手术固定在统计学上显著缩短了住院时间、减少了呼吸机依赖时间、降低了肺炎、气管切开术的发生率以及死亡率。此外，肺挫伤的存在并未消除上述变量的显著改善。
讨论
采用现代技术和植入物对连枷胸进行手术固定，在死亡率和短期预后方面都有显著改善。尽管肺挫伤降低了两个队列的总体预后，但这一因素并未改变肋骨固定改善预后的能力。
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