The Warren Alpert Medical School of Brown University, Providence, RI, United States.
Department of Anesthesia, Yale University, New Haven, CT, United States; Yale University School of Medicine, New Haven, CT, United States.
Injury. 2019 Jun;50(6):1159-1165. doi: 10.1016/j.injury.2019.04.020. Epub 2019 Apr 22.
Rib fractures are common injuries associated with significant morbidity and mortality, largely due to pulmonary complications. Despite equivocal effectiveness data, incentive spirometers are widely utilized to reduce pulmonary complications in the postoperative setting. Few studies have evaluated the effectiveness of incentive spirometry after rib fracture. Multiple investigations have demonstrated incentive spirometry to be an important screening tool to identify high-risk rib fracture patients who could benefit from aggressive, multidisciplinary pulmonary complication prevention strategies. This review evaluates the epidemiology of rib fractures, their associated pulmonary complications, along with the evidence for optimizing their clinical management through the use of incentive spirometry, multimodal analgesia, and surgical fixation.
肋骨骨折是常见的损伤,与较高的发病率和死亡率相关,主要是由于肺部并发症所致。尽管激励式肺活量计的有效性数据存在争议,但它仍被广泛用于减少术后肺部并发症。很少有研究评估激励式肺活量计在肋骨骨折后的效果。多项研究表明,激励式肺活量计是一种重要的筛查工具,可以识别出可能受益于积极的多学科肺部并发症预防策略的高危肋骨骨折患者。本综述评估了肋骨骨折的流行病学、相关肺部并发症,以及通过使用激励式肺活量计、多模式镇痛和手术固定来优化其临床管理的证据。