The Clinical Application Of Nitinol Alloy Rib-connecting-plates In Treatment Of Multiple Fractured Ribs

Objective To explore the clinical application and curative effect of internal fixation treatment of multiple fractured ribs with nitinol alloy rib-connecting-plates and discuss approaches of the operation,operation indications,operation opportunity and application value.Methods From August 2013 to August 2015 in Department of cardiothoracic Surgery of Anqing municipal Hospital,69 patients with multiple fractured ribs were treated and divided with 39 patients in surgical treatment group and 30 cases in conservative treatment group.Surgical treatment group included 28 males and 11 females, the age was from 36 to 74 years with an average of 55.5 ± 10.2 years.Conservative treatment group included 22 males and 8 females,the age was from 32 to 70 years with an average of 53.8±9.7 years.Surgical group were treated with nitinol alloy rib-connecting-plates.Conservative group were treated with analgesia,external fixation and prevention of infection.The clinical dates,such as blood gas analysis,pulmonary ventilation function,VAS, excellent and good rates,chest tube withhold time,chest tube output,time of independent off-bed activity,complications,length of stay and cost.Results General information such as age,gender and injury cause had no statistic difference(P<0.05),the cases of hemopneumothorax and flail chest,and the number of fractures were more than conservative group.VAS of surgical treatment group after 1,3,5 days were lower than conservative treatment group(P<0.05).The chest tube withhold time,chest tube output,time of independent off-bed activity,length of stay and cost were shorter than conservative group(P<0.05).The rates of complications such as encapsulated pleural effusion,pulmonary infection,pulmonary atelectasis,late-onset hemopneumothorax and displacement fracture were inferior to in surgical treatment group(P<0.05),but the cost was higher(P<0.05).Pa O2 after 24 h of operation was obviously higher than that of the conservative group,Pa CO2 is lower than the conservative group.Comparing the two groups were statistically significant,P<0.05.Two groups of patients after 1 week of FEV1 percentage is no statistical difference,P>0.05,but the MVV is better than the conservative group,P < 0.05.One month after the surgical treatment of FEV1 percentage and MVV is better than the conservative group,,P < 0.05.According to the clinical criteria,39 cases(100%) got excellent or good result in surgical group,with 21cases(70%) getting excellent or good result in conservative group.The excellent and good rates had statistic difference(P<0.05).Conclusion Operation internal fixation treatment can obviously reduce the patients’ pain,reduce the chest tube withhold time and the quantity,quicken patients’ independent ambulation, significantly reduce the incidence of complications,and speed up the patients’ discharge time.It is safe and effective to use nitinol alloy rib-connecting-plates for treating fracture of multiple ribs by mastering the operation indications strictly and selecting the reasonable operation opportunity.This method is simple,firm,fewer complications and high curative rate.The curative effect is better,so it is worth to promote.