Ockelmann M, Terbrüggen D
Prax Klin Pneumol. 1979 Apr;33 Suppl 1:408-13.
Every year 8,000 persons involved in road accidents die of irreversible respiratory insufficiency caused by chest injuries. Fractures of the ribs extendig over a number of ribs are present in 70% of the cases and in 15% of them they are accompanied by instability of the thorax and "paradoxical" respiration. Treatment of the instability by "internal pneumatic splinting" (Avery) and by surgical measures is reviewed. Indications for the latter are: (1) open fractures of the chest wall; (2) instability of the thorax combined with intrathoracic injuries; (3) instability of the chest wall with severe therapy-resistant respiratory insufficiency. In a series of animal experiments unilateral instability of the chest wall was induced by multiple rib fractures. By measuring oscillatory resistance before and after stabilization of chest wall the effects of the latter on the impaired lung function could be demonstrated. The results of the experiments indicate that with this type of surgical treatment mortality from combined thoracic injuries with paradoxical breathing can be reduced.
每年有8000名道路交通事故受害者死于胸部损伤导致的不可逆呼吸功能不全。70%的病例存在多根肋骨骨折，其中15%伴有胸廓不稳定和“反常”呼吸。本文综述了通过“内部充气固定”（艾弗里法）和手术措施治疗胸廓不稳定的情况。手术治疗的指征为：（1）胸壁开放性骨折；（2）胸廓不稳定合并胸内损伤；（3）胸壁不稳定伴严重的、对治疗有抵抗的呼吸功能不全。在一系列动物实验中，通过多处肋骨骨折诱导胸壁单侧不稳定。通过测量胸壁稳定前后的振荡阻力，可以证明胸壁稳定对受损肺功能的影响。实验结果表明，采用这种手术治疗方法可降低合并胸廓损伤伴反常呼吸的死亡率。
