目的探讨肋骨骨折导致的创伤性肺不张治疗中应用电子支气管镜肺段灌洗治疗的效果 方法回顾性分析新疆医科大学第六附属医院2009年10月至2013年4月肋骨骨折导致创伤性肺不张73例行电子支气管镜肺段灌洗治疗患者的临床资料，其中男52例、女21例，年龄29～83（36± 5）岁。按治疗方式将患者分为两组：灌洗组（37例）行电子支气管镜肺段灌洗，对照组（36例）采用肺不张的常规治疗。比较两组临床效果。 结果灌洗组呼吸频率及心率减慢，动脉血氧饱和度升至95%以上，肺复张明显好于对照组，差异有统计学意义（P < 0.05）。 结论电子支气管镜肺段灌洗治疗肋骨骨折导致的创伤性肺不张直视下诊断明确，起效快，创伤小，疗效确切。
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.