Andelić N, Balenović M, Basić M
Klinicki centar Srbje, Urgentni centar.
Acta Chir Iugosl. 1994;41(1):59-62.
In the one-year prospective study 71 injured patients were observed (75% male and 25% female). Traffic traumatism was the dominant case (45%). The wounded are divided in the groups with one side fracture of ribs (left/right) and on both sides fracture of ribs considering the side of fracture, and there is consideration about the kind of fracture--there are single fracture of ribs and serial fracture of ribs. The samples of artery blood were followed in PaCO2, %SaO2 and level pH in three points of time: when the patients came, after 24 and after 48 hours. In the group with the both side fracture of the ribs, the fall of worth pH was observed after 48 hours, PaCO2 is increasing to the 6.98 kPa. PaO2 is falling after 48 hours. In %SaO2 there is no considerable difference at any time, but%SaO2 is the highest in the second group. With the serial fracture of ribs wounded are considerate the fall of worth pH which is progressively increasing and is the highest after 48 hours. PaCO2 is increasing in the both groups, but with the serial fracture the worth are considerably higher. PaO2 and %SaO2 are much lower after 48 hours. The authors conclude that the wounded on both sides and wounded with serial fracture along one or several lines of with fracture of all ribs suffer the highest respiratory insufficiency (ARI), so they need artificial ventilation as respiratory support.
在这项为期一年的前瞻性研究中，观察了71例受伤患者（男性占75%，女性占25%）。交通创伤是主要病例（45%）。根据骨折部位，将伤者分为单侧肋骨骨折（左侧/右侧）组和双侧肋骨骨折组，并考虑骨折类型——肋骨单处骨折和肋骨多处骨折。在三个时间点对动脉血样本进行PaCO2、%SaO2和pH值水平的跟踪：患者入院时、24小时后和48小时后。在双侧肋骨骨折组中，48小时后观察到pH值下降，PaCO2升高至6.98 kPa。48小时后PaO2下降。在任何时候，%SaO2都没有显著差异，但第二组的%SaO2最高。对于肋骨多处骨折的伤者，考虑到pH值下降，其逐渐增加且在48小时后最高。两组的PaCO2均升高，但多处骨折组的值明显更高。48小时后PaO2和%SaO2低得多。作者得出结论，双侧受伤以及沿一条或多条线多处骨折或所有肋骨骨折的伤者呼吸功能不全（ARI）最严重，因此他们需要人工通气作为呼吸支持。
