MatrixRIB治疗肋骨骨折合并血气胸△

MatrixRIB used for surgical treatment of rib fractures complicated with hemopneumothorax

摘要:

[目的] 评价 MatrixRIB 治疗肋骨骨折合并血气胸手术治疗中的临床效果。[方法] 回顾性分析 2018 年—2023 年本院手术治疗肋骨骨折合并血气胸的 60 例患者的临床资料。依据术前医患沟通结果，30 例采用 MatrixRIB 内固定，另外 30 例采用传统爪形钢板内固定。比较两组早期临床与影像资料。[结果]MatrixRIB 组在手术时间 [(85.2±10.6) min vs (110.4±15.2) min, P= 0.035]、切口长度 [(10.5±1.8) cm vs (13.6±2.1) cm, P=0.042]、术中出血量 [(121.5±21.3) mL vs (182.6±37.6) mL, P=0.041]、住院时间 [(10.2±2.1) d vs (13.5±2.9) d, P=0.045]、总并发症发生率（10.0% vs 30.0%, P=0.032）均显著优于传统组。MatrixRIB 组恢复完全负重活动时间显著早于传统组 [(6.4±1.3) 周 vs (8.8±1.9) 周, vs=0.039]。随术后时间推移，两组患者疼痛 VAS 均显著下降（P＜0.05）； 术后 1、3、7 d 和 3 个月时，MatixRIB 组的疼痛 VAS 评分均显著低于传统组（P＜0.05）。影像方面，术后 3 个月 MatrixRIB 组的骨折愈合率（93.3% vs 83.3%, P=0.041）和血气胸完全吸收率（90.0% vs 73.3%, P=0.036）均显著优于传统组。[结论]MatrixRIB 治疗肋骨骨折合并血气胸手术具有显著优势，可缩短手术时间，减少术中出血量，减轻术后疼痛，促进骨折愈合和血气胸吸收， 降低并发症发生率。

Abstract:

[Objective] To evaluate the clinical outcome of MatrixRIB used as internal fixation implant for rib fractures complicated with hemopneumothorax. [Methods] A retrospective analysis was performed on 60 patients who underwent surgical treatment for rib fracture complicated with hemopneumothorax in our hospital from 2018 to 2023. According to the preoperative doctor-patient communication, 30 patients had the fractures fixed with MatrixRIB implants, while the other 30 patients were with traditional claw plate. The early-stage clinical and imaging data of the two groups were compared. [Results] The MatrixRIB group proved significantly superior to the traditional group in terms of operation time [(85.2±10.6) min vs (110.4±15.2) min, P=0.035], incision length [(10.5±1.8) cm vs (13.6±2.1) cm, P=0.042], intraoperative blood loss [(121.5±21.3) mL vs (182.6±37.6) mL, P=0.041], hospital stay [(10.2±2.1) days vs (13.5±2.9) days, P=0.045] and the overall complication rate (10.0% vs 30.0%, P=0.032). The MatrixRIB group returned to full weight-bearing activity significantly earlier than the traditional group [(6.4±1.3) weeks vs (8.8±1.9) weeks, P=0.039]. The pain VAS score was significantly decreased over time postoperatively in both groups (P＜0.05), which in the MatixRIB group were significantly lower than those in traditional group at 1, 3, 7 days and 3 months after surgery (P＜0.05). As for imaging 3 months postoperatively, the MatixRIB group was also significantly better than the traditional group in terms of fracture healing rate (93.3% vs 83.3% , P=0.041) and the complete absorption rate of hemopneumothorax (90.0% vs 73.3% , P= 0.036). [Conclusion] The MatrixRIB has significant advantages in the treatment of rib fracture complicated with hemopneumothorax, can shorten operation time, reduce intraoperative blood loss, alleviate postoperative pain, promote fracture healing and hemopneumothorax absorption, and reduce the incidence of complications.