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find Keyword "内固定手术" 5 results
  • 胸腔镜辅助爪形接骨板内固定手术治疗多发性肋骨骨折24例

    目的 探讨胸腔镜辅助爪形接骨板内固定手术治疗多发性肋骨骨折的临床疗效。 方法 回顾性分析2007年7月至2011年9月河北省沧州市中心医院收治24例多发性肋骨骨折患者的临床资料,男18例,女6例;中位年龄37.3 (17~53) 岁;肋骨骨折6 (3~14)处。交通伤19例,高空坠落伤3例,挤压伤2例。全组患者均在全身麻醉,胸腔镜辅助下行肋骨骨折复位爪形接骨板内固定手术治疗。 结果 全组患者术后胸廓外观正常,反常呼吸消失,复查胸部X线片显示两肺膨胀良好,骨折对位满意。其中14例术后呼吸机辅助治疗32 h (6 h~7 d),所有患者均痊愈出院,平均住院时间18 d,随访23例,随访时间3~13个月,患者恢复良好。 结论 胸腔镜辅助爪形接骨板内固定手术治疗多发性肋骨骨折疗效满意,可有效弥补传统开胸行肋骨骨折内固定手术的不足,但应严格掌握手术适应证。

    Release date:2016-08-30 05:50 Export PDF Favorites Scan
  • 记忆合金环抱器在创伤性连枷胸治疗中的应用

    目的 总结记忆合金环抱器在创伤性连枷胸治疗中的应用经验。 方法 2008年10月至2011年8月甘肃省酒泉市人民医院应用镍钛记忆合金环抱器内固定治疗创伤性连枷胸38例,其中男31例,女7例;年龄 19~62 (42.6±12.5)岁。致伤原因为交通伤31例,高处坠落伤4例, 塌方挤压伤2例, 殴打外伤1例。对其手术时机、适应证选择及临床效果等进行分析。 结果 本组无手术相关死亡,随访34例,随访率91.89% (34/37),随访1~16 (10.3±2.6)个月。随访时胸部X线片或胸部CT提示肋骨骨折端对位好,双侧胸廓基本对称,连枷胸得到满意矫正,患者呼吸良好,无长期疼痛等并发症。全组无1例因环抱器有排斥反应、不适等需取出者。 结论 创伤性连枷胸患者早期行记忆合金环抱器内固定治疗可以使连枷胸得到有效的矫正,改善和恢复呼吸功能,降低病死率及各类并发症的发生率。

    Release date:2016-08-30 05:50 Export PDF Favorites Scan
  • 微创小切口肋骨内固定术治疗多根多处肋骨骨折及连枷胸

    目的 总结微创小切口肋骨内固定术治疗多根多处肋骨骨折及连枷胸的临床经验。 方法 回顾性分析2009年1月至2010年1月上海交通大学附属第六人民医院奉贤分院54例胸部创伤患者行爪型钛板微创小切口肋骨内固定术的临床资料,其中男39例,女15例;平均年龄48.7 (19~75)岁。4例患者入院即刻手术,50例于入院1~9 d内手术。手术方式:行单纯肋骨内固定手术34例,同期固定胸骨2例,行肺修补手术6例,膈肌修补术1例,肺叶切除术1例,心包开窗手术1例,骨科手术9例。经肩胛骨下、内侧切口手术16例,侧胸壁切口手术31例,前胸壁切口手术7例。切口长度4~20 cm,肋骨骨折固定范围第2~12肋骨。 结果 本组患者无死亡,均在术后1~3 d内拔除气管内插管,全部治愈出院。术后发生肺部感染4例,气管切开1例,精神障碍1例,经相应的处理治愈。平均住院时间20.6 (12.0~38.0) d。术后随访47例。随访时间3~6个月,骨折全部愈合,无肋间神经压迫症状,患者恢复正常生活和工作;失访7例。 结论 采用爪型钛板进行肋骨内固定,不苟于传统,根据骨折部位采用微创小切口,钛板不接触骨折处,不破坏骨折处局部血运,不影响骨折愈合,可对包括第2肋骨在内的所有部位的肋骨骨折进行内固定。如骨折处位于胸骨或胸椎体结合部,则不宜用钛板固定。

    Release date:2016-08-30 05:50 Export PDF Favorites Scan
  • 连枷胸内固定手术方法的临床应用比较

    摘要: 目的 比较4种对多根、多段肋骨骨折内骨的内固定方法,总结其治疗经验。 方法 2006年7月至2009年7月三峡大学仁和医院收治75例多根、多段肋骨骨折患者,男51例,女24例;年龄17~74岁,平均年龄43.50岁。致伤原因为:交通伤44例,高处坠落伤21例,撞击伤10例;采用钢丝固定5例,钢板固定12例,Judet固定架固定51例,人工合成树脂骨内固定7例。 结果 75 例患者均采用内固定手术治疗,术后胸廓恢复正常形态,纵隔摆动消失,疼痛和呼吸困难明显改善;随访6个月~2年,复查胸部X线片示:钢丝固定的患者中有2例发生2处固定移位,其余患者无再次移位,恢复良好。 结论 内固定手术治疗是治疗多根、多段肋骨骨折患者的有效方法,但各有利弊,应严格掌握手术适应证。

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  • Efficacy and Safety of Internal Rib Fixation for Multiple Rib Fractures: A Randomized Controlled Trial

    ObjectiveTo investigate the efficacy and safety of internal rib fixation for patients with multiple rib fractures. MethodsA total of 141 patients with multiple rib fractures who were admitted to Department of Thoracic Surgery of the Sixth Affiliated Hospital of Xinjiang Medical University between January 2010 and January 2013 and whose chest trauma score (AIS-ISS) was 9-20 (16±2) were recruited in this study. Using the random number generator of SPSS, all the patients were randomly divided into an internal fixation group [69 patients including 41 males and 28 females with their age of 25-61 (37±4) years] who underwent internal rib fixation, and a control group [72 patients including 43 males and 29 females with their age of 24-63 (35±5) years] who received conservative therapy. Plasma C-reactive protein (CRP) patients' satisfaction degree with thoracic appearance,incidence of lung infection,pain-relieving efficacy,postoperative chest drainage duration and length of hospital stay were compared between the 2 groups. ResultsPlasma CRP levels of the internal fixation group were not statistically different from those of the control group in 1-3 days after injury (P>0.05) but were significantly lower than those of the control group in 4-12 days after injury (P<0.05). Patients' satisfaction degree with thoracic appearance (97.1% vs. 48.6%,P<0.05) and pain-relieving efficiency (91.3% vs. 68.1%,P<0.05) of the internal fixation group were significantly higher than those of the control group. Incidence of lung infection of the internal fixation group was significantly lower than that of the control group(11.6% vs. 37.5%,P<0.01). Postoperative chest drainage duration [(3±2) d vs. (7±4) d,P<0.05] and length of hospital stay [(9±4) d vs. (15±7) d,P<0.05] of the internal fixation group were significantly shorter than those of the control group. ConclusionsFor patients with multiple rib fractures and stable vital signs,internal fixation surgery is helpful to shorten length of hospital stay, relieve chest pain and improve thoracic appearance. It can also reduce lung inflammation and increase surgical safety so as to improve treatment outcomes of multiple rib fractures.

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