Which is better to multiple rib fractures, surgical treatment or conservative treatment?

نویسندگان

  • Wei-Ming Wu
  • Yi Yang
  • Zong-Li Gao
  • Tian-Cheng Zhao
  • Wei-Wei He
چکیده

To compare the surgery and conservative treatment of multiple fractured ribs, we designed a randomized controlled trial in the single center of thoracic surgery ward. After admission condition assessment (general clinical evaluation, operation condition assessment, the digital method of pain assessment), the selected multiple fractured rib patients were told to choose surgery or conservative treatment, according to the patient will undergo surgery or conservative treatment. In the acute phase, compared with conservative treatment, patients with mechanical ventilation in time (mechanical ventilation time MV) (3.7 ± 1.4 vs. 9.5 ± 4.3), ICU stay time (8.2 ± 4.3 vs. 14.6 ± 3.2), total hospitalization days (15.3 ± 6.4 vs. 26.5 ± 6.9), the incidence of pneumonia (6.7% vs. 19.1%), mortality (1.3% vs. 5.3%) and pain score on patients (3.3 vs. 5.8) of surgical treatment group were significant lower (P < 0.05). The number of tracheostomy in surgical patients with conservative treatment (4 vs. 7) was no statistically significant difference (P > 0.05). In chronic phase, the surgical patients compared with patients with conservative treatment in the chest wall pain (2.9 ± 1.2 vs. 5.6 ± 1.7), chest wall tension (13.3% vs. 57.3%), dyspnea (5.3% vs. 22.4%) and chest wall deformity rate (4% vs. 93.5%) were lower significantly (P < 0.05). In conclusion, the surgical treatment of multiple fractured ribs could ease the acute chest pain, reduce the mechanical ventilation time and incidence of pneumonia, shorten the hospitalization days and total hospitalization days in the ICU and alleviate the forward chest wall discomfort. The speedy recovery and long-term quality of patients' life had improved significantly.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Physical function and pain after surgical or conservative management of multiple rib fractures – a follow-up study

BACKGROUND There is scarce knowledge of physical function and pain due to multiple rib fractures following trauma. The purpose of this follow-up was to assess respiratory and physical function, pain, range of movement and kinesiophobia in patients with multiple rib fractures who had undergone stabilizing surgery and compare with conservatively managed patients. METHODS A consecutive series of...

متن کامل

نتایج درمان شکستگی تنه هومروس به روش میله‌گذاری اینترمدولاری

    Background & Aim: Most acute humeral shaft fractures can be successfully treated by conservative methods. Operation is recommended for certain fractures. Intramedullary nailing offers a dependable solution for the treatment of humeral shaft fractures, especially in polytrauma patients. The aim of this study was to evaluate intramedullary nailing outcomes and complications in humeral fractur...

متن کامل

Better short-term efficacy of treating severe flail chest with internal fixation surgery compared with conservative treatments

BACKGROUND The objective of the study is to provide evidence for selecting the best treatment approach for severe flail chest by comparing surgical and conservative treatments. METHODS This is a retrospective study in which 32 patients with severe flail chest were treated in the Fujian Provincial Hospital (China) between July 2007 and July 2012 with surgical internal rib fixation (n = 17) or ...

متن کامل

Bilateral chylothorax after blunt thoracic trauma: a case report.

Traumatic chylothorax other than iatrogenic thoracic duct injury is extremely rare in children. Chylothorax can cause cardiopulmonary abnormalities and significant nutritional, metabolic and immunologic consequences. The management of chylothorax ranges from conservative treatment to surgical intervention. We present a four-year-old boy who presented with respiratory difficulty due to multiple ...

متن کامل

A feasibility study of 60 consecutive patients operated for unstable thoracic cage

BACKGROUND About 10% of adult patients in high-energy trauma sustain multiple rib fractures. Some of these patients suffer from flail chest leading to respiratory insufficiency. During last years interest and results for operative treatment has improved. The literature today all show positive results for surgical versus conservative treatment, specifically with regard to time spent in mechanica...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:
  • International journal of clinical and experimental medicine

دوره 8 5  شماره 

صفحات  -

تاریخ انتشار 2015