梁锐宇 梁锦崧 饶新辉 张自正 李剑明 钟海辉 张焕荣

[摘要]目的 比較肋骨骨折内固定术与传统保守治疗在多发肋骨骨折中的效果。方法 选取我院胸外科2012年11月～2017年8月收治的54例多发肋骨骨折患者作为研究对象，按照随机数字表法分为对照组与观察组，每组各27例。对照组患者采用传统保守治疗，观察组患者采用肋骨骨折内固定术治疗，对比两组患者治疗前后疼痛程度、术后各指标恢复情况。结果 观察组患者总有效率为100.00%，高于对照组（85.19%），差异有统计学意义（P<0.05）；治疗前与治疗后第1天，两组患者VAS疼痛程度评分比较，差异无统计学意义（P>0.05），治疗后第3天与第7天，观察组VAS疼痛评分明显低于对照组，差异有统计学意义（P<0.05）；观察组患者强迫卧床体位时间、胸管留置时间、镇痛药物使用时间以及住院时间均短于对照组，且观察组胸腔引流量明显少于对照组，差异均有统计学意义（P<0.05）。结论 与传统保守治疗比较，采用内固定手术治疗多发肋骨骨折效果更加确切可靠，能够有效减轻患者疼痛，缩短骨折恢复时间，对促进患者早日康复具有至关重要的作用。

[关键词]内固定手术；保守疗法；多发肋骨骨折；效果

[中图分类号] R678.3 [文献标识码] A [文章编号] 1674-4721（2018）4（a）-0083-03

Application effect comparison of internal fixation and conservative treatment in the treatment of multiple fractures of the ribs

LIANG Rui-yu LIANG Jin-song RAO Xin-hui ZHANG Zi-zheng LI Jian-ming ZHONG Hai-hui ZHANG Huan-rong

Department of Thoracic Surgery，Meizhou People′s Hospital，Guangdong Province，Meizhou 514031，China

[Abstract]Objective To compare the curative effect of internal fixation and conservative therapy on treating multiple rib fractures of the ribs.Methods A total of 54 patients with multiple rib fractures from November 2012 to August 2017 admitted into our hospital were selected as research objects.They were evenly divided into control group （conservative therapy） and observation group （internal fixation） by a random number table，27 cases in each group.The degree of pain and postoperative recovery of the indicators before and after treatment were compared in the two groups.Results The total effectiveness rate in the observation group was 100.00%，significantly higher than that in the control group accounting for 85.19%（P<0.05）.There was no significant difference in visual analogue scale （VAS） score before treatment and first day after therapy in the two groups（P>0.05）.On days 3 and 7 after treatment，the scores of VAS in the observation group were significantly lower，compared with that in the control group（P<0.05）.In the observation group，the time of being forced to stay in bed，pleural canal indwelling time，time of using analgesics，and hospital stay were all shorter compared with those in the control group.The thoracic cavity drainage in the observation group was significantly less compared with that in the control group，with a statistical difference（P<0.05）.Conclusion Compared with traditional conservative therapy，application of internal fixation in the treatment of multiple fractures of the ribs can obtain more reliable and definite effects by effectively relieving patient′s suffering and shortening the recovery of fractures，which plays a critical role in promoting the early recovery of patients.

[Key words]Internal fixation；Conservative therapy；Multiple rib fractures；Effect

肋骨骨折是胸部外伤中常见疾病，指以肋骨局部肿痛，深呼吸、咳嗽或喷嚏时疼痛加剧，局部压痛明显等主要表现的骨折[1]，多由外力造成，尤其是直接外力，骨折部位好发于4～7肋。多发肋骨骨折的患者傷情较重，可存在大面积胸内软化及反常呼吸运动，且可并存气胸、肺挫伤及肺水肿、甚至休克，并可能伴随严重的呼吸困难，若治疗不及时或处理不当，易因呼吸、循环衰竭致死[2-3]。目前临床以保守治疗和手术固定为主要手段，但不同的治疗方法疗效不一[4]。为进一步探讨两种治疗手段的临床效果，本研究对多发肋骨骨折患者分别采用传统保守治疗与手术内固定治疗，现报道如下。

1资料与方法

1.1一般资料

临床纳入54例2012年11月～2017年8月我院收治的多发肋骨骨折患者，按照随机数字表法将其分为对照组与观察组，每组各27例。……