王礼俊

[摘要] 目的 研究鎳钛记忆合金接骨板切开复位内固定治疗胸外伤合并多发性肋骨骨折的效果。 方法 选取2015年12月—2019年9月解放军第九○二医院胸外科接诊的55例胸外伤合并多发性肋骨骨折的患者作为研究对象。将其按照随机数字表法分为研究组（35例）与对照组（20例）。对照组给予传统切开复位内固定的手术疗法治疗，观察组给予镍钛记忆合金接骨板切开复位内固定疗法。比较两组手术治疗效果、手术相关指标及术后并发症发生率。 结果 研究组手术治疗总有效率明显高于对照组，差异有统计学意义（P < 0.05）。研究组术中出血量少于对照组，手术时间、拔管时间、住院时间、骨折愈合时间短于对照组，差异均有统计学意义（均P < 0.05）。研究组术后并发症发生率明显低于对照组，差异有统计学意义（P < 0.05）。 结论 镍钛记忆合金接骨板切开复位内固定治疗胸外伤合并多发性肋骨骨折患者，可有效提高治疗效果，降低手术并发症发生率，值得临床推广应用。

[关键词] 胸外伤;多发肋骨骨折;镍钛记忆合金;疗效;并发症

[中图分类号] R683          [文献标识码] A          [文章编号] 1673-7210（2020）07（c）-0096-04

Effect of Nickel-titanium memory alloy plate open reduction and internal fixation in the treatment of thoracic trauma with multiple rib fractures

WANG Lijun

Department of Thoracic Surgery， 902th Hospital of People′s Liberation Army， Anhui Province， Bengbu   233000， China

[Abstract] Objective To study the effect of Nickel-titanium memory alloy plate open reduction and internal fixation in the treatment of thoracic trauma with multiple rib fractures. Methods From December 2015 to September 2019， 55 patients with chest trauma and multiple rib fractures in the Department of Thoracic Surgery of 902th Hospital of People′s Liberation Army were selected as the subjects. They were divided into study group （35 cases） and control group （20 cases）. The control group was treated with traditional open reduction and internal fixation， while the observation group was treated with Nickel-titanium memory alloy plate. The effect of operation， operation related indexes and postoperative complications were compared between the two groups. Results The total effective rate of operation in the study group was significantly higher than that in the control group， the difference was statistically significant （P < 0.05）. The amount of intraoperative blood loss in the study group was less than that in the control group， and the operative time， extubation time， hospital stay time and fracture healing time were shorter than those in the control group， with statistically significant differences （all P < 0.05）. The incidence of postoperative complications in the study group was significantly lower than that in the control group， the difference was statistically significant （P < 0.05）. Conclusion Nickel-titanium memory alloy can effectively improve the effect of treatment and reduce the incidence of surgical complications when it is used to treat patients with thoracic trauma and multiple rib fractures.

[Key words] Chest trauma; Multiple rib fractures; Nickel-titanium memory alloy; Efficacy; Complications

在胸外科胸外伤合并多发性肋骨骨折是最常见的肋骨创伤性骨折，车祸等直接与间接的外部暴力作用是导致多发性肋骨骨折合并胸外伤的主要原因[1]。根据肋骨骨折的数量又将其分为单纯性肋骨骨折和多发性肋骨骨折，肋骨骨折<3根的为单纯性肋骨骨折，≥3根的称为多发性骨折，多发性骨折患者常会合并血管或软组织被损伤而出现血气胸[2]。低氧血症、反常呼吸为多发性肋骨骨折患者最为常见的症状[3]。同时，患者常会合并出现明显的胸痛、血气胸等症状，极易引发肺部炎症、膨胀不全、肺不张等危险性较高的并发症。血气胸常会危及患者的生命安全，且处理方法困难，常规传统手术经胸内固定方式为临床常用的治疗方法，虽然可以在一定程度上对患者反常呼吸情况进行抑制，但会影响胸壁正常的呼吸活动[4]。为了提高手术的安全性与疗效解放军第九○二医院（以下简称“我院”）胸外科就镍钛记忆合金接骨板切开复位内固定治疗胸外伤合并多发性肋骨骨折的效果进行研究。具体报道如下：

1 资料与方法

1.1 一般资料

选择我院胸外科2015年12月—2019年9月接诊的55例多发性肋骨骨折合并胸外伤的患者进行研究。纳入标准：①确诊为多发性肋骨骨折合并胸外伤者;②存在顽固性疼痛合并呼吸困难者;③胸廓软化不稳地，胸壁存在明显的塌陷畸形;④存在多段明显骨折位移者;⑤年龄18～70岁者。排除标准：①合并恶性肿瘤者;②合并重要脏器严重病变者;③存在全身免疫疾者;④肝、肾功能异常者;⑤凝血功能异常者。将所有患者按照随机数字表法，分为研究组与对照组。……