[创伤性肋骨骨折的治疗]
Ruben J Hoepelman1, Charlotte C Kik1, Frank J P Beeres
1UMC Utrecht, afd. Traumachirurgie, Utrecht.
Nederlands tijdschrift voor geneeskunde
|September 24, 2023
概括
肋骨骨折的治疗有所不同,重点是缓解疼痛和呼吸练习. 手术肋骨固定越来越多地用于严重的病例,如胸部,改善结果,但带有诸如植入物刺激等风险.
科学领域:
- 创伤外科 手术 创伤外科
- 整形外科 整形外科 整形外科
- 胸部医学 胸部医学
背景情况:
- 肋骨骨折呈现出由全科医生和创伤外科医生管理的多样化的患者群体.
- 肋骨骨折的治疗策略因胸部创伤的严重程度而异.
- 适当的止痛和呼吸练习是肋骨骨折管理的基础.
研究的目的:
- 为了突出肋骨骨折患者呈现和治疗的异质性.
- 审查手术肋骨固定的不断变化的作用和指示.
- 讨论与肋骨固定相关的并发症和结果.
主要方法:
- 三名患有不同程度肋骨骨折和胸部创伤的患者的病例系列介绍.
- 关于肋骨骨折管理和手术固定现有文献的综述.
- 对治疗结果的分析,包括疼痛,呼吸障碍和非联合.
主要成果:
- 手术肋骨固定已经在机械呼吸的胸部患者中显示出有效性,减少了重症监护和住院时间和死亡率.
- 肋骨骨折的非结合会导致长时间的疼痛,呼吸不良或点击感.
- 肋骨固定可以缓解约60%的患者的非结合症状,尽管植入物刺激和切除手术很常见.
结论:
- 虽然镇痛和呼吸练习仍然至关重要,但对于特定的严重肋骨骨折病例,手术肋骨固定是一种有价值的选择.
- 对肋骨固定的准确指示需要进一步定义.
- 肋骨骨折的管理应考虑潜在的并发症,如非结合和与手术固定相关的风险.
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