Dadaş Erdoğan, Akbiyik Ayten Güner
Department of Thoracic Surgery, University of Health Sciences Sultan Abdulhamit Han Researching and Training Hospital, Istanbul 34668, Türkiye.
Department of Thoracic Surgery, Inönü University, Battalgazi, Malatya 44000, Türkiye.
Exp Ther Med. 2025 May 20;30(1):141. doi: 10.3892/etm.2025.12891. eCollection 2025 Jul.
The present prospective study aimed to analyze the effectiveness of surgery in treating the non-flail chest type of multiple rib fractures at the multivariate level. For this, patients with non-flail chest type multiple rib fractures were divided into two groups, namely the conservative therapy and surgery groups. Age, sex, the number of fractured and displaced ribs, injury severity, chest abbreviated scores, forced expiratory volume in one second (FEV1), narcotic drug dose, long-term FEV and forced vital capacity levels, drug additive (including pharmacological and individual agents for enhance of physicochemical properties, such as solvent systems), American Society of Anesthesiologists scores, duration of hospitalization, duration until feeling comfortable, follow-up duration, duration until return to workplace, discharge pain score, incidence of pneumothorax and pleural empyema, and pain levels were recorded and analyzed. The results showed that the baseline characteristics were not significantly different between the conservative treatment and surgery groups (P>0.05). In addition, the pain level was notably associated with the FEV1 (r=0.499; P<0.05), drug administration (r=-0.445; P<0.05) and duration of hospitalization (r=0.559; P<0.05) in the conservative treatment group. The discharge pain level was also markedly associated with narcotic drug usage (r=0.478; P<0.05) and drug additive (r=0.618; P<0.01) in the surgery group. Furthermore, the duration of hospitalization significantly affected discharge pain in the conservative group (B=0.237; P<0.01), while drug additive notably affected discharge pain in the surgery group (B=-2.547; P<0.01). Although surgery seemed to be more effective compared with the conservative method in terms of pain management, according to the multivariate analysis results, this effect was associated with the drug additive. Overall, the results of the present study indicated there was no significant difference between surgery and conservative therapy in the treatment of non-flail multiple rib fractures.
本前瞻性研究旨在从多变量层面分析手术治疗非连枷胸型多根肋骨骨折的有效性。为此，将非连枷胸型多根肋骨骨折患者分为两组，即保守治疗组和手术组。记录并分析患者的年龄、性别、骨折及移位肋骨数量、损伤严重程度、胸部简化评分、一秒用力呼气量（FEV1）、麻醉药物剂量、长期FEV和用力肺活量水平、药物添加剂（包括用于增强物理化学性质的药理学和个体化制剂，如溶剂系统）、美国麻醉医师协会评分、住院时间、感觉舒适所需时间、随访时间、返回工作岗位所需时间、出院时疼痛评分、气胸和胸膜腔积脓发生率以及疼痛水平。结果显示，保守治疗组和手术组的基线特征无显著差异（P>0.05）。此外，保守治疗组的疼痛水平与FEV1（r=0.499；P<0.05）、药物使用（r=-0.445；P<0.05）和住院时间（r=0.559；P<0.05）显著相关。手术组的出院疼痛水平也与麻醉药物使用（r=0.478；P<0.05）和药物添加剂（r=0.618；P<0.01）显著相关。此外，住院时间对保守治疗组的出院疼痛有显著影响（B=0.237；P<0.01），而药物添加剂对手术组的出院疼痛有显著影响（B=-2.547；P<0.01）。尽管在疼痛管理方面，手术似乎比保守方法更有效，但根据多变量分析结果，这种效果与药物添加剂有关。总体而言，本研究结果表明，在治疗非连枷性多根肋骨骨折方面，手术和保守治疗之间没有显著差异。
