CAJ | 학술논문

目的：比较三种外固定方法在连枷胸急救治疗中的效果。方法选取2013年6月至2015年2月本院胸外科收治的连枷胸患者68例为研究对象。按治疗方法不同将入选患者分为钢丝针缝合组（22例）、手巾钳牵引组（25例）及多头带全胸壁带垫加压组（21例）。比较三组患者肺功能改善情况及治疗效果。结果所有患者治疗后肺功能均较治疗前明显改善（P＜0.05），疼痛缓解，痊愈出院。钢丝针缝合组和手巾钳牵引组患者动脉血氧分压（PaO2）、动脉血氧饱和度（SaO2）、氧合指数（PaO2/FiO2）改善程度比较差异均无显著性（P＞0.05），但均优于多头带全胸壁带垫加压组（P＜0.05）。钢丝针缝合组和手巾钳牵引组患者住院时间明显短于多头带全胸壁带垫加压组（P＜0.05），多头带全胸壁带垫加压组患者优良率低于其他两组（P＜0.05），手巾钳牵引组患者并发症发生率低于其他两组（P＜0.05），三组患者镇痛药物使用率、肺部感染率比较均无显著差异（P＞0.05）。结论手巾钳牵引外固定法在患者受伤后即可行急诊手术，使肋骨骨折复位，迅速纠正胸壁畸形，明显减轻疼痛，有效改善患者的肺功能，显著缩短住院时间，且并发症较少，是连枷胸外伤急救中较为理想的治疗方法。
목적：비교삼충외고정방법재련가흉급구치료중적효과。방법선취2013년6월지2015년2월본원흉외과수치적련가흉환자68례위연구대상。안치료방법불동장입선환자분위강사침봉합조（22례）、수건겸견인조（25례）급다두대전흉벽대점가압조（21례）。비교삼조환자폐공능개선정황급치료효과。결과소유환자치료후폐공능균교치료전명현개선（P＜0.05），동통완해，전유출원。강사침봉합조화수건겸견인조환자동맥혈양분압（PaO2）、동맥혈양포화도（SaO2）、양합지수（PaO2/FiO2）개선정도비교차이균무현저성（P＞0.05），단균우우다두대전흉벽대점가압조（P＜0.05）。강사침봉합조화수건겸견인조환자주원시간명현단우다두대전흉벽대점가압조（P＜0.05），다두대전흉벽대점가압조환자우량솔저우기타량조（P＜0.05），수건겸견인조환자병발증발생솔저우기타량조（P＜0.05），삼조환자진통약물사용솔、폐부감염솔비교균무현저차이（P＞0.05）。결론수건겸견인외고정법재환자수상후즉가행급진수술，사륵골골절복위，신속규정흉벽기형，명현감경동통，유효개선환자적폐공능，현저축단주원시간，차병발증교소，시련가흉외상급구중교위이상적치료방법。
ObjectiveTo compare the curative effects of flail chest treated by three external fixation methods.Method68 cases of patients with lfail chest from June 2013 to February 2015 in our hospital were chose as the research objects. According to the different treatment methods, they were divided into steel wire suture group (22 cases), towel clamp traction group (25 cases) and long belt full chest wall belt pad pressure group (21 cases). Compared the three groups of patients with pulmonary function improvement and treatment effects.ResultThe pulmonary function of all patients were signiifcantly improved after treatment (P<0.05), and the pain were relieved, patients were discharged from hospital. There were no signiifcant differences with arterial blood oxygen partial pressure (PaO2), arterial blood oxygen saturation (SaO2), improved oxygenation index (PaO2/FiO2) between steel wire suture group and towel clamp traction group (P>0.05), but were all better than long belt full chest wall belt pad pressure group (P<0.05). The length of stay of steel wire suture group and towel clamp traction group were far less than long belt full chest wall belt pad pressure group (P<0.05). The good rate of the patients with long full chest wall pad pressure group were lower than the other two groups (P<0.05). The incidence of complications in patients with towel clamp traction group were lower than the other two groups (P<0.05). There were no signiifcant differences between the three groups in the rate of analgesic drug use and pulmonary infection (P>0.05).ConclusionExteral ifxation by towel forceps can undergo emergency surgery to reset the rib fracture after injury, rectify thoracic deformity rapidly, ease the pain obviously, improve pulmonary function parameters effectively, shorten length of stay signiifcantly, and less complications. So the method of external ifxation by towel forceps is the ideal emergency treatment for patients with lfail chest.