Liu Yongjing, Xu Shun, Yu Qi, Tao Yu, Peng Leilei, Qi Shengbo, Han Hao, Chen Mengran
Department of Cardiothoracic Surgery, The 105th Hospital of Chinese People's Liberation Army, Hefei 230031, China.
Ann Transl Med. 2018 Nov;6(22):439. doi: 10.21037/atm.2018.10.12.
In this study, we aimed to evaluate the clinical effects of multiple rib fracture treatments using a rib plate fixator.
From June 2014 to December 2016, 110 cases of patients with multiple rib fractures were collected for our study from the 105th Hospital of PLA; 59 patients were treated by surgery, and 51 patients received conservative treatment. We compared surgical rib plate fixation with conservative treatment for patients with multiple rib fractures.
The hospital stay for the surgical group was 13.12±4.21 days, whereas for the conservative group, it was 18.57±5.39 days (P<0.001). The duration of the thoracic intensive care unit (ICU) stay was 4.02±1.41 days in the surgical group and 5.06±1.80 days in the conservative group (P=0.001). The indwelling thoracic drainage tube time was 5.85±1.52 days in the surgical group and 8.26±1.96 days in the conservative group (P<0.001). The index of partial pressure of arterial oxygen (PaO) was 91.05±10.88 mmHg 24 h after surgery whereas 86.49±11.69 mmHg 24 h after conservative treatment (P=0.036). The index of partial pressure of carbon dioxide (PaCO) was 37.80±2.86 mmHg 24 h after surgery and it was 39.08±2.46 mmHg 24 h after conservative treatment. The hospitalization cost was 6,206.44±371.42 USD for the surgical group and 4,544.61±524.79 USD for the conservative group (P<0.001). The number of rib displacement cases after treatment was 1 case in the surgical group and 2 cases in the conservative group (P=0.475). Atelectasis occurred in 10 cases in the surgical group and in 17 cases in the conservative group (P=0.046). Delayed hemopneumothorax occurred in 7 cases in the surgical group and in 16 cases in the conservative group (P=0.012).
Surgical treatment is a safe and effective therapy for multiple rib fractures. Our data suggested that surgical treatment can significantly shorten the patients' pain-endurance time, hospitalization time, and can reduce complication incidence. Severe rib fracture patients might benefit from surgical fixation.
在本研究中，我们旨在评估使用肋骨接骨板固定器治疗多发性肋骨骨折的临床效果。
2014年6月至2016年12月，从解放军第105医院收集110例多发性肋骨骨折患者进行研究；59例患者接受手术治疗，51例患者接受保守治疗。我们比较了多发性肋骨骨折患者手术肋骨接骨板固定与保守治疗的效果。
手术组的住院时间为13.12±4.21天，而保守组为18.57±5.39天（P<0.001）。手术组在胸外科重症监护病房（ICU）的停留时间为4.02±1.41天，保守组为5.06±1.80天（P=0.001）。手术组胸腔闭式引流管留置时间为5.85±1.52天，保守组为8.26±1.96天（P<0.001）。术后24小时动脉血氧分压（PaO）指标手术组为91.05±10.88 mmHg，保守治疗后24小时为86.49±11.69 mmHg（P=0.036）。术后24小时二氧化碳分压（PaCO）指标手术组为37.80±2.86 mmHg，保守治疗后24小时为39.08±2.46 mmHg。手术组住院费用为6206.44±371.42美元，保守组为4544.61±524.79美元（P<0.001）。治疗后肋骨移位病例数手术组为1例，保守组为2例（P=0.475）。手术组发生肺不张10例，保守组发生17例（P=0.046）。手术组发生迟发性血气胸7例，保守组发生16例（P=0.012）。
手术治疗是多发性肋骨骨折安全有效的治疗方法。我们的数据表明，手术治疗可显著缩短患者的疼痛耐受时间、住院时间，并可降低并发症发生率。严重肋骨骨折患者可能从手术固定中获益。
