| Objective: Flail chest is a serious chest injury.Severe injury can stimulate the body to release a majority of inflammatory factors to formate "waterfall-like" chain of amplification reactions.The moderate amount of factors plays defensive role while the excessive may cause tissue damage.At present,for the treatment of flail chest include traditional chest belt compression bandage fixation,the traditional open-chest rib plate fixation and other commonly used methods.However the research of new rib plate has not been reported.In this subject,we set up three groups,flail chest model group,pressure dressing fixed group and new rib plate fixed group.Trough detecting factors of blood,biochemical factor,inflammatory factors and the concentration of insulin-like growth factors I(IGF-I),we assessment the treatment of new rib plate fixation on flail chest and provide theoretical foundation for clinical application.Method:1 Select 30 normal healthy male New Zealand White rabbits purchased in Hebei Medical University laboratory animal Center.They were randomly divided into three groups: flail chest model control group,chest compression bandage fixation group and new rib plate internal fixation group.Animals in flail chest model control group only received animal model surgery.Animals in chest compression bandage fixation group received compression bandage fixation immediately after the model surgery while animals in new rib plate internal fixation group received new rib plate internal fixation after the model surgery for the treatment.Each animal frow 3 groups drew 3ml blood from the ear-vein on 1 day before surgery and the 1st day,the 3rd and the 7th day after surgery with anticoagulation tube and accelerating tube.2 The anticoagulant tubes of blood analysisd white blood cells,hemoglobin and C-reactionprotein(CRP).3 Centrifuging after blood coagulation,take the upper clear serum 2ml.Application of enzyme-linked immunosorbent assay(,ELISA)in serum Interleukin-6(IL-6),Interleukin-1(IL-1)and tumor necrosis factor-alpha(TNF-?)levels.4 Imaging observation: Using chest x-ray and chest CT to observe rib fracture healing after 21 th surgical day.5 Using ELISA to anlysis the concentration of IGF-I of rib fracture fragments.6 Pathological examination.Results:1 The trends of blood white cell,hemoglobin were significantly different in three groups(P<0.05).2 The trends of CRP concentrationgs were significantly different in three groups(P<0.05).3 The trends of serum inflammatory factors(the concentration of IL-6,IL-1,and TNF-?)were significantly different in the three groups(P<0.05).4 The concentration of the fracture fragments of IGF-I was signifitantly different in the three groups(P<0.05).5 New rib plate internal fixation group shows well recovering and fixation in using chenst x-ray and chest CT.6 Each group has shown different degrees of lung tissue edema.After HE staining flail chest model control group with a large number of inflammatory cells infiltration.Chest compression bandage fixationg group with regular lung inflammatory cells infiltration while new rib plate internal fixation group was only seen a small amount of inflammatory cells infiltration.Conclusion:1 Flail chest stimulates experimental animals to produce systemical inflammation by increasing the counts of white blood cells,the concentration of CRP and release a large number of inflammatory factors(IL-6,IL-1,TNF-?).New rib plate internal fixation group shows the most light of the response of inflammatory.The treatment of new rib plate internal fixation on flail chest is an effective cure.2 Broken ribs heal faster and the expression of IGF-I in broken ribs is high in new rib plate internal fixation group.New rib plate of minimally invasive internal fixation treatment plays a paramount role in promoting healing broken ribs.3 The damage of lung tissue in new rib plate internal fixation group is the lightest and with least inflammatory cells infiltration,of which shows that New rib plate of minimally invasive internal fixation treatment can obviously reduce the degree of lung injury caused by flail chest. |
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