目的探討肋骨骨折導致的創傷性肺不張治療中應用電子支氣管鏡肺段灌洗治療的效果 方法回顧性分析新疆醫科大學第六附屬醫院2009年10月至2013年4月肋骨骨折導致創傷性肺不張73例行電子支氣管鏡肺段灌洗治療患者的臨床資料，其中男52例、女21例，年齡29～83（36± 5）歲。按治療方式將患者分為兩組：灌洗組（37例）行電子支氣管鏡肺段灌洗，對照組（36例）采用肺不張的常規治療。比較兩組臨床效果。 結果灌洗組呼吸頻率及心率減慢，動脈血氧飽和度升至95%以上，肺復張明顯好于對照組，差異有統計學意義（P < 0.05）。 結論電子支氣管鏡肺段灌洗治療肋骨骨折導致的創傷性肺不張直視下診斷明確，起效快，創傷小，療效確切。
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.