形状记忆环抱接骨板与肋骨外固定护板治疗老年双侧多发肋骨骨折疗效比较^*

Comparison of the effect of shape memory encircling bone plate and rib external fixation plate in the treatment of bilateral multiple rib fractures in the elderly

摘要

目的 比较形状记忆环抱接骨板与肋骨外固定护板治疗老年双侧多发肋骨骨折的疗效。方法 选取2023年在中国人民解放军联勤保障部队第九○四医院收治的老年双侧多发肋骨骨折患者进行回顾性分析。将接受形状记忆环抱接骨板治疗的52例纳入内固定组, 将接受肋骨外固定护板治疗的16例纳入外固定组, 比较两组术后临床疗效, 治疗前、治疗后的动脉血氧分压(PaO ₂)、动脉血二氧化碳分压(PaCO ₂), 同时统计胸痛持续时间、下床活动时间、住院时间, 术后并发症发生情况。结果 内固定组优良率高于外固定组(P<0.05)。治疗前两组血气分析指标比较, 差异无统计学意义(P>0.05); 治疗后, 两组PaO ₂、PaCO ₂与治疗前比较差异均有统计学意义(P<0.05); 治疗后内固定组PaO ₂高于外固定组(P<0.05), PaCO ₂低于外固定组(P<0.05)。内固定组胸痛持续时间、下床活动时间、住院时间均短于外固定组(P<0.05); 内固定组术后肺部感染、肺不张发生率均低于外固定组(P<0.05)。结论 在老年双侧多发肋骨骨折治疗中, 形状记忆环抱接骨板可显著提升临床疗效, 有效改善患者血气状态, 缩短术后康复进程, 同时降低肺部感染、肺不张等术后并发症发生, 相较于肋骨外固定护板具有更优越的治疗效果, 为老年双侧多发肋骨骨折患者提供了更理想的治疗选择。

Abstract

Objective To compare the effect of shape memory encircling bone plate and rib external fixation plate in the treatment of bilateral multiple rib fractures in the elderly. Methods Clinical data of elderly patients with bilateral multiple rib fractures admitted to The 904th Hospital of Joint Logistic Support Force of PLA in 2023 were selected and retrospectively analyzed. A total of 52 patients receiving shape memory circular bone plate treatment were included in the internal fixation group, and ther 16 patients receiving rib external fixation plate treatment were included in the external fixation group. The postoperative clinical efficacy of the two groups were analyzed. The partial pressure of arterial blood oxygen (PaO ₂) and partial pressure of arterial blood carbon dioxide (PaCO ₂) were measured before and after treatment. Meanwhile, the duration of chest pain, the time of getting out of bed, the time of hospitalization, and the incidence of postoperative complications were also measured. Results The excellent rate of the internal fixation group was higher than that the external fixation group (P<0.05). There was no statistically significant difference in blood gas analysis indicators between the two groups before treatment (P>0.05); After treatment, both groups showed statistically significant differences in PaO ₂ and PaCO ₂ compared wih before treatment (P<0.05). The PaO ₂ in the internal fixation group was higher than that in the external fixation group (P<0.05), while the PaCO ₂ was lower than that in the external fixation group (P<0.05). The duration of chest pain, mobilization time, and hospitalization time in the internal fixation group were shorter than those in the external fixation group (P<0.05). The incidence of postoperative complications such as pulmonary infection and atelectasis in the internal fixation group was lower than that in the external fixation group (P<0.05). Conclusion In the treatment of bilateral multiple rib fractures in the elderly, the shape memory hugging bone plate can significantly enhance clinical efficacy, more effectively improve the blood and gas status of patients, shorten the postoperative recovery process, and simultaneously reduce the incidence of postoperative complications such as pulmonary infection and atoriasis. Compared with external rib fixation guard plates, it has a more superior therapeutic effect and provides a more ideal treatment option for elderly patients with such fractures.

关键词

多发肋骨骨折 / 形状记忆环抱接骨板 / 肋骨外固定护板

Key words

Multiple rib fracture / Shape memory encircling bone plate / Rib external fixation plate

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基金资助

^*国家自然科学基金项目青年项目(81602728)