连枷胸切开复位内固定荟萃分析

发布时间：2018-06-08 17:53

本文选题：连枷胸 + 肋骨骨折　；参考：《河北医科大学》2017年硕士论文

【摘要】：目的:连枷胸是重症胸部创伤中高死亡率的威胁生命的严重胸部创伤。连枷胸的非手术治疗包括呼吸机支持和镇痛等方法。这种非手术治疗往往由于呼吸功能不足及并发症而导致肺炎发生率、气管切开率、死亡率增高、重症监护室(ICU)日和总住院日延长等的不良后果。本文的研究的目的是对比连枷胸的手术治疗与非手术处理的效果异同。方法:系统的回顾了先前发表的1995年到2015年有关手术和非手术治疗连枷胸对比研究的文献。我们通过PubMed,Medline,and Google Scholar进行了一个全面的文献检索。我们将成人连枷胸患者在手术治疗组和非手术治疗组进行对比。我们通过这些选取的文献的死亡率、肺炎率、机械通气时间、ICU住院日、总住院日、气管切开率的数据进行统计学计算。结果:在这篇系统综述中包括了3篇随机对照研究和4篇回顾性研究。总计,有112名患者接受手术治疗和有198名患者接受非手术治疗。与非手术治疗相比,手术治疗连枷胸可有效降低死亡率(OR=0.25,95%CI:0.094-0.679),肺炎发生率(0.22,95%CI:0.07 0.69),气管切开率(0.26,95%CI:0.1 0.68),也可缩ICU住院日(ES:-1.32day95%CI:-2.25 to-0.39),住院总日(-3.74days;95%CI:-10 to-0.2.53)。结论:本次荟萃分析涵盖的相关患者较少,但是研究表明手术治疗连枷胸创伤在诸多方面有实质性的益处。目前,分析这类研究主要是基于回顾性研究。因此,相类似这方面的研究调查需要大型随机对照试验研究,同时研究的内容也应该较以前的丰富。
[Abstract]:Objective: flail chest is a life-threatening severe chest trauma in severe chest trauma. Non-operative treatment of flail chest includes ventilator support and analgesia. This non-surgical treatment often results in the incidence of pneumonia, tracheotomy, mortality, prolonged ICU and total hospital stay due to respiratory insufficiency and complications. The purpose of this study is to compare the effects of surgical treatment and non-operative treatment of flail chest. Methods: a systematic review of previous literature published from 1995 to 2015 on the comparative study of surgical and non-surgical treatment of flail chest was made. We conducted a comprehensive literature search through PubMeden Medline and Google Scholar. We compared adult flail chest patients in surgical and non-operative groups. We calculated the mortality rate, pneumonia rate, mechanical ventilation time of ICU, total hospital stay and tracheotomy rate statistically. Results: three randomized controlled studies and four retrospective studies were included in this systematic review. In total, 112 patients received surgical treatment and 198 patients received non-surgical treatment. Compared with non-operative treatment, surgical treatment of flail chest can effectively reduce the mortality rate. The incidence rate of pneumonia is 0.22 ~ 95CI: 0.07: 0.07, and the rate of tracheotomy is 0.26 ~ 95CI: 0.1 ~ 0.68. It can also be reduced to ESW -1.32day95CI-2.25 to 0.39%, total day of hospitalization -3.74days95CIU -10 to 0.2.53. Conclusion: this meta-analysis covers relatively few patients, but studies have shown that surgical treatment of flail chest trauma has substantial benefits in many ways. At present, the analysis of this kind of research is mainly based on retrospective research. Therefore, similar studies need large randomized controlled trials, and the contents of the studies should be more abundant than before.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R655

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