摘要
目的评价不同治疗方法对连枷胸的临床疗效,优化治疗方案。方法回顾性分析2005年～2010年我科收治的69例重度损伤合并连枷胸病人的临床资料,分成A组(加压包扎胸带外固定组)30例、B组(呼吸机内固定组)21例、C组(手术内固定组)18例,对3组治疗近、远期效果进行对比,以P<0.05为差异具有统计学意义。结果与A组比较,B组呼吸、循环指标明显改善(P<0.001),肺感染率增高(P<0.05)、胸廓畸形率、活性药物使用率、ICU天数、总住院天数减少(P<0.05);C组呼吸、循环指标明显改善(P<0.001),肺感染率、胸廓畸形率、活性药物使用率、ICU天数、总住院天数减少(P<0.05)。C组与B组比较,治疗后24h,呼吸、PaO2、PaCO2指标无统计学意义(P>0.05),C组循环指标更稳定,肺部感染率、胸廓畸形率、活性药物使用率、ICU天数、总住院天数减少具有统计学意义(P<0.05),C组快速促进肺功能恢复,A、B、C组死亡率无统计学差异。结论手术治疗快速稳定胸壁,促使呼吸、循环稳定,减少并发症,减少住院时间,促进肺功能恢复,是连枷胸的理想治疗方法。
Objective To compare the curative effect of different treatments for flail chest, optimize the therapeutic strategies. Methods The clinical data of 69 patients with flail chest in our hospital from 2005 to 2010 were studied retrospectively. The patients were divided into： group A （pressure dressing group I with 30 eases, group B （ respirator group） with 21 cases and group C （ surgical fixation group） with 18 cases. Indicators of three different treatments were compared. It was considered statistically significant when P 〈 0.05. Results Compared with group A, patients in group B indicated remarkable improvement of respiratory and circulation indicators （ P 〈 0. 001 ） , higher incidence of pneumonia （ P 〈 0.05 ） , lower incidence of chest deformity and vasoactive drugs utilization（ P 〈 0.05） , shorter ICU stay and total hospital stay（P 〈 0.05）. Compared with group A and group C,indica- tots of breath and circulation were obviously improved（ P 〈 0. 001 ） , there was statistical difference in incidence of pneumonia,chest deformity and vasoactive drugs utilization （ P 〈 0.05 ） , ICU stay and total hospital stay （ P 〈 0.05 ）. Compared with group B and group C, there was no statistical difference in RR, PaO2 , PaCO2 （ P 〉 0.05 ） , but statistical difference in incidence of pneumonia, chest deformity and vasoaetive drugs utilization （ P 〈 0.05 ） , ICU stay and total hospital stay（P 〈 0.05） ,indicators of circulation （P 〈 O. 05）. Patients in group C were found quick lung function recovery＇. There was no statistical difference in incidence of death of three groups. Conclusion Surgical intervention rapidly stabilizes the chest wall, impels stability of breath and circulation, reduces complications, reduces hospital stays, promotes lung function recovery. It is the best treatment way of flail chest.
出处
《创伤外科杂志》
2013年第1期19-22,共4页
Journal of Traumatic Surgery
关键词
连枷胸
包扎
呼吸机
内固定
手术
flail chest
dressing
respirator
internal fixation
operation
