Comparison Of Clinical Efficacy Of Non-operative Treatment And Surgical Treatment For Multiple Rib Fractures

Objective:To compare and analyze the clinical effect of non-operative treatment and surgical treatment on multiple rib fractures.So as to provide a better theoretical basis and guidance for the choice of surgical treatment of multiple rib fractures in clinic..Methods:Patients with multiple rib fractures treated in Guangyuan CentralHospital from September 2019 to September 2021 were studied.The selected cases were randomly divided into two groups,A group of patients received non-operative treatment,mainly for drug analgesia,anti-infection,the use of chest band for chest wall fixation,mechanical ventilation,et al.B group received surgical treatment on the basis of non-operative treatment.The basic data(suchas age,sex,AIS score,number of rib fractures)and clinical treatment effects(such as time of mechanical ventilation,time of stay in ICU,time of hospitalization,time of getting out of bed spontaneously,time of fracture healing,cost of hospitalization,degree of pain after treatment,complications,cases of tracheostomy)of the two groups were compared.Results:1.During the study period,a total of 95 cases of multiple rib fractures were treated in our hospital,including 62 cases in accordance with the study conditions,32 cases in the non-operation group and 30 cases in the operation group.There was no significant difference in age,sex,chest injury abbreviated injury scale score and the number of rib fractures between the two groups(P>0.05).2.The comparison of related indexes between group B and group A was as follows:the time of mechanical ventilation was(58.13±23.58)h vs(85.98 ±24.69)h,the cases and proportion of mechanical ventilation time more than 72h was 8(26.6%)vs 20(62.5%),the time of stay in ICU was(2.03±0.58)d vs(5.13±2.56)d,the cases of the time of stay in ICU more than 2 days and the proportion was 13(43.3%)vs 28(87.5%),time of hospitalization was(10.53±2.11)d vs(16.83±3.97)d.The time of getting out of bed spontaneously was(6.67±1.66)days vs(11.93±1.05)days,the fracture healing time was(38.60±3.55)days vs(51.33±5.71)days,the cases and proportion of complications during treatment was 4(15.4%)vs 12(37.5%),the cases of tracheotomy and the proportion was 2(6.6%)vs 9(28.1%),the above indexes in group B were lower than those in group A,and there was significant difference between the two groups(P<0.05);moreover,the hospitalization cost and pain degree of patients in B group were higher than those in A group,and there was statistical difference between the two groups(P<0.05).Conclusion:Surgical treatment for patients with multiple rib fractures can shorten the time of mechanical ventilation,ICU stay,hospital stay,get out of bed voluntarily,fracture healing time,and reduce complications,reduce tracheostomy rate,but the cost of hospitalization and the degree of pain after treatment are higher than those in the conservative group.