|
|
|
| Influence of different operation timing on perioperative safety of patients with multiple rib fractures |
| HU Wenfeng HONG Wei▲ |
| Department of Thoracic Surgery, Huangshan City People′s Hospital, Anhui Province, Huangshan 245000, China |
|
|
|
Abstract Objective To explore the influence of different operation timing on perioperative safety of patients with multiple rib fractures. Methods A total of 54 patients with multiple rib fractures from August 2015 to August 2019 in Huangshan City People′s Hospital, Anhui Province were selected as the study subjects. According to the time from injury to intraoperative fixation, the patients were divided into the early group (≤72 h, 26 cases) and the late group (> 72 h, 28 cases). The operation conditions (length of hospital stay, incision length, chest tube indwelling time and fracture healing time) of the two groups were compared and the laboratory indicators (C-reactive protein [CRP], procalcitonin [PCT]) before and after operation and the total incidence of complications were compared between the two groups. Results There were no significant differences in length of hospital stay, incision length and chest tube indwelling time between the two groups (P ＞ 0.05). Fracture healing time in the early group was shorter than that in the late group, and the difference was statistically significant (P ＜ 0.05). Comparison of CRP and PCT before operation between the two groups showed no significant difference (P ＞ 0.05). CRP and PCT after operation in the early group were lower than those before operation and after operation in the late group, with statistically significant differences (all P ＜ 0.05). The total incidence of complications in the early group was lower than that in the late group, with statistically significant difference (P ＜ 0.05). Conclusion Early surgical treatment of patients with multiple rib fractures can improve the efficacy, reduce the level of inflammation in the body, and have high safety, which is worthy of clinical promotion.
|
|
|
|
|
|
[1] Hamilton DL，Manickam B. Erector spinae plane block for pain relief in rib fractures [J]. Br J Anaesth，2017，118（3）：474-475.
[2] 宋磊，张强，宁少南，等.3D打印在肋骨骨折内固定中的应用[J].中华胸心血管外科杂志，2018，34（5）：288-291.
[3] 徐凤阳，王楠，任佳，等.解剖型和爪形接骨板固定肋骨骨折的疗效比较[J].中华急诊医学杂志，2019，28（2）：232-235.
[4] 兰纲，王细勇，郭大为，等.手术治疗时机对多发肋骨骨折内固定术后并发症的影响[J].第二军医大学学报，2018， 39（5）：106-109.
[5] 孙琴.急诊胸腔镜手术治疗多发肋骨骨折合并肺撕裂伤患者的临床疗效[J].医学临床研究，2019，36（3）：587-589.
[6] 张迎春，刘永春，叶宁，等.胸腔镜辅助经胸内固定手术治疗多发性肋骨骨折合并血气胸效果观察[J].心肺血管病杂志，2018，37（7）：659-662.
[7] 白娟，荣阳.肋骨骨折的影像学诊断价值分析与临床研究[J].中国医药指南，2018，16（24）：119-120.
[8] 李良民，孔维成，石旭钢，等.胸腔镜辅助下应用“捆绑式外固定”治疗肋骨骨折错位及浮动胸壁体会[J].中华急诊医学杂志，2015，24（7）：795-797.
[9] 杜俊凯，王军，李治延，等.微创内固定治疗多根多处肋骨骨折临床效果和安全性评价[J].解放军医药杂志，2017， 29（10）：38-41.
[10] Ringl H，Lazar M，T?觟pker M，et al. The ribs unfolded - a CT visualization algorithm for fast detection of rib fractures： effect on sensitivity and specificity in trauma patients [J]. Eur Radiol，2015，25（7）：1865-1874.
[11] El-Boghdadly K，Wiles MD. Regional anaesthesia for rib fractures：too many choices，too little evidence [J]. Anaesthesia，2019，74（5）：564-568.
[12] Wang K，Hui L，Jia L，et al. A Comprehensive Model Coupling Embedded Discrete Fractures，Multiple Interacting Continua，and Geomechanics in Shale Gas Reservoirs with Multiscale Fractures [J]. Energ Fuel，2017，31（8）：7758-7776.
[13] 唐剑锋，叶仙，江拥军.早期切开复位内固定术治疗多根多处肋骨骨折52例临床观察[J].中国社区医师，2017， 33（18）：34-35.
[14] 刘金山，王树军.静脉持续镇痛联合肋骨内固定在多根多处肋骨骨折中的应用[J].蚌埠医学院学报，2015， 40（7）：886-888.
[15] 李世健，邢万红.切开复位内固定治疗外伤性多发肋骨骨折临床疗效及手术时机评价[J].中华创伤杂志，2016， 32（6）：533-535.
[16] Fischer C，Reiner C，Schmidmaier G，et al. Safety study： is there a pathologic IGF-1，PDGF and TGF-β cytokine expression caused by adjunct BMP-7 in tibial and femoral non-union therapy? [J]. Ther Clin Risk Manag，2018，14：691-697.
[17] 魏德胜.多发性肋骨骨折保守治疗与手术治疗的临床效果比较[J].中华全科医学，2015，13（3）：500-501.
[18] 韩旭，靳波，郭江，等.胸腔镜与传统手术治疗多根多处肋骨骨折的临床对比研究[J].检验医学与临床，2019， 16（17）：2447-2449.
[19] 张文华，党杰，李惠甫，等.早期胸腔镜探查同期肋骨骨折内固定治疗多发肋骨骨折并血气胸[J].创伤外科杂志，2016，18（9）：553-555.
[20] 赵天成，杨异，高宗礼，等.两种内固定方法治疗多发性肋骨骨折的病例对照研究[J].中国胸心血管外科临床杂志，2015，22（7）：704-706.
[21] 国建飞，张涛，邢琳琳，等.爪形接骨板内固定术治疗多发肋骨骨折98例效果观察[J].解放军医药杂志，2016， 28（8）：44-47.
[22] 康凯，白东昱，薛建利，等.骨折修复过程中骨形态发生蛋白2对趋化因子12表达的调控及其意义[J].中国骨与关节杂志，2017，6（11）：837-843.
[23] 王洪庆，宋利华，白庆兵，等.桡骨远端骨折掌侧锁定接骨板固定术后并发症的相关因素分析[J].疑难病杂志，2020，19（2）：151-154，159.
[24] 王大鹏，张桂梅，罗力佳.细胞生长因子修复骨骼肌损伤[J].中国组织工程研究，2016，20（2）：273-278.
[25] 任占良，任小朋，张泳，等.单孔胸腔镜联合环抱式接骨板治疗多根多处肋骨骨折的临床疗效观察[J].中华胸部外科电子杂志，2018，5（3）：180-183. |
|
|
|
