摘要
目的探讨聚左旋乳酸钉（poly—L-lactic acid screws，PLLAs）固定肋骨骨折的疗效。方法回顾分析2002年1月～2008年10月收治的177例多发肋骨骨折患者的治疗效果，56例行PLLAs内固定手术，术后均行机械通气治疗，记录内固定手术耗时、术后需机械通气时间、ICU时间及预后等指标。前期接受克氏针加钢丝固定（23例）及保守治疗（98例）患者为对照组，对比不同治疗方法的治疗效果。结果不同治疗组具有可比性（P〉0．05）；PLLAs组中49例治愈（87．5％），7例死亡（12．5％）；平均使用PLLAs2．6枚；平均固定3．8根肋骨，平均ICU时间为8．6天、机械通气时间11．9天、住院天数为28．6天，较对照组明显缩短（P〈0．05）；并发症明显低于对照组（P〈0．05）。结论PLLAs内固定肋骨骨折，具有操作简便、并发症少、无二次手术等优点，可缩短术后机械通气时间及ICU治疗时间，是一种有效和较为理想的方法。
Objective To assess the effect of operative stabilization of multiple rib fractures by using a kind of absorbable screws named poly-L-lactic acid screws（PLLAs）. Methods A total of 177 patients with multiple rib fractures from Jan. 2002 to Oct. 2008 were reviewed retrospectively. Fifty-six cases were operated with PLLAs for stabilizing chest wall and given mechanical ventilation postoperatively. Twenty-three cases managed by Kirschner wire locking and 98 cases who accepted conservative treatment with mechanical ventilation and external fixation were grouped as control. The time for internal fixation, mechanical ventilation, staying in ICU,and treatment effect and outcome of each group were analyzed respectively and compared. Results There was comparability between the PLLAs group and control group（P 〉 0.05）. Forty-nine cases healed （87.5%） ,and 7 cases died（ 12.5% ） in PL- LAs group. The mean number of PLLAs application was 2.6 and the mean fixed rib number was 3.8. The mean time of ICU staying,mechanical ventilation,hospital staying was 8.6,11.9,28.6 days respectively. All of these in- dex besides complication were significantly lower than those in the control group （ P 〈 0. 05 ）. Conclusion Opera- tive stabilization of multiple rib fractures by using PLLAs is a perfect procedure, which has advantages, such as easy operation,less time for mechanical ventilation and staying in ICU,fewer compfications,no secondary surgery to take out internal fixation materials.
出处
《创伤外科杂志》
2009年第4期316-319,共4页
Journal of Traumatic Surgery
关键词
创伤
肋骨骨折
聚左旋乳酸钉
内固定
trauma
rib fracture
poly-L-lactie acid screws
internal fixation
