镍钛环抱式接骨器内固定修复多发性肋骨骨折：与克氏针应用安全性比较王斌强【摘要】背景:传统治疗多发性肋骨骨折的方法有胸廓外加压包扎、肋骨钉固定等,术后具有较高的疼痛率和并发症率,治疗效果不理想.目的:分析镍钛环抱式接骨器内固定修复多发性肋骨骨折的临床疗效,分析其安全性.方法:纳入 90 例多发性肋骨骨折患者,以治疗方式为依据分为治疗组(n=45)和对照组(n=45),治疗组采用TiNi 环抱式接骨器进行内固定修复,对照组采用克氏针进行内固定修复.对比两组手术时间、呼吸机使用时间、住院时间、镇痛药物使用时间及并发症发生情况,以及修复前后的目测类比评分.结果与结论:两组修复后12,24,48 h的目测类比评分均低于修复前(P < 0.05),并且治疗组修复后12,24, 48 h的目测类比评分低于对照组(P < 0.05).治疗组手术时间、呼吸机使用时间、住院时间、镇痛药物使用时间、并发症发生率均少于对照组(P < 0.05).表明临床采用镍钛环抱式接骨器内固定治疗多发性肋骨骨折疗效显著,具有手术操作简单、损伤低、稳定性高、并发症率低、与组织良好相容等优点.%BACKGROUND:Traditional therapies for multiple rib fractures include extra-thoracic pressure dressing and rib fixation, but have no ideal outcomes because of a higher pain and complication incidence. OBJECTIVE:To discuss the clinical efficacy of internal fixation of TiNi encircling compressive connector on multiple rib fractures and to analyzes its security. METHODS: Ninety patients with multiple rib fractures were selected to be studied, and they were divided into treatment group (45 patients were subject to internal fixation of TiNi encircling compressive connector) and control group (45 patients were subject to internal fixationwith Kirschner wire. Surgical time, mechanical ventilation time, length of stay, duration of analgesic drug, and complication incidence were compared between two groups. Visual analog scale scores were measured before and after internal fixation. RESULTS AND CONCLUSION: The visual analog scale scores were significantly decreased in the both two groups at 12, 24, 48 hours after internal fixation (P < 0.05), moreover, the treatment group had lower scores on the visual analog scale than the control group at 12, 24, 48 hours after internal fixation (P < 0.05). Compared with the control group, the surgical time, mechanical ventilation time, length of stay, duration of analgesic drug, and complication incidence were al lower in the treatment group (P < 0.05). These findings indicate that the internal fixation of TiNi encircling compressive connector is effective in the treatment of multiple rib fractures, which is characterized as simple operation, smal injury, high stability, low complication incidence and good histocompatibility.【期刊名称】《中国组织工程研究》【年(卷),期】2015(019)021【总页数】5页(P3419-3423)【关键词】生物材料;骨生物材料;镍钛环抱式接骨器;多发性肋骨骨折;临床疗效;安全性【作者】王斌强【作者单位】南宁市第二人民医院心胸外科,广西壮族自治区南宁市 530000【正文语种】中文【中图分类】R318文章亮点：1镍钛环抱式接骨器属于新型内固定材料，具有无毒、耐腐蚀等优点，弹性模量接近于人体骨质，具有良好的组织相容性和生物学性能；具有优秀的抱合功能，对骨折作用力久，抗扭曲功效显著；可有效降低应力遮挡，保护骨皮质血液运行，促进骨折愈合。
镍钛环抱式接骨器内固定治疗无需钻孔，对骨骼损伤小，环抱骨折时是通过点面接触实现，对血液运行影响小且手术操作简单、耗时短、损伤小。
镍钛环抱式接骨器在低温环境下即可变形展开，机体体温可使其自动恢复至原状，具有手术时间短、操作简单等优点，在急诊肋骨骨折患者内固定治疗中具有重要意义，患者术后恢复佳且恢复迅速，并发症率低。
同时镍钛环抱式接骨器组织相容性佳，环抱臂产生环抱力包绕肋骨，术后骨折断端不会发生旋转位移，但环抱器的价格偏高。
2试验采用镍钛环抱式接骨器内固定和克氏针肋骨内固定两种方式治疗多发性肋骨骨折，发现镍钛环抱式接骨器内固定治疗多发性肋骨骨折具有明显的优势，综合多方面因素分析，其具有手术操作简单、患者恢复快、术后并发症率低、骨骼与内固定器材相容性好等优点。
目的：分析镍钛环抱式接骨器内固定修复多发性肋骨骨折的临床疗效，分析其安全性。
方法：纳入90例多发性肋骨骨折患者，以治疗方式为依据分为治疗组(n=45)和对照组(n=45)，治疗组采用TiNi环抱式接骨器进行内固定修复，对照组采用克氏针进行内固定修复。
对比两组手术时间、呼吸机使用时间、住院时间、镇痛药物使用时间及并发症发生情况，以及修复前后的目测类比评分。
结果与结论：两组修复后12，24，48 h的目测类比评分均低于修复前(P<0.05)，并且治疗组修复后12，24，48 h的目测类比评分低于对照组(P<0.05)。
治疗组手术时间、呼吸机使用时间、住院时间、镇痛药物使用时间、并发症发生率均少于对照组(P<0.05)。
表明临床采用镍钛环抱式接骨器内固定治疗多发性肋骨骨折疗效显著，具有手术操作简单、损伤低、稳定性高、并发症率低、与组织良好相容等优点。
王斌强.镍钛环抱式接骨器内固定修复多发性肋骨骨折：与克氏针应用安全性比较[J].中国组织工程研究，2015，19(21):3419-3423.OBJECTIVE:To discuss the clinical efficacy of internal fixation of TiNi encircling compressive connector on multiple rib fractures and to analyzes its security.METHODS:Ninety patients with multiple rib fractures were selected to be studied,and they were divided into treatment group(45 patients were subject to internal fixation of TiNi encircling compressive connector)and control group(45 patients were subject to internal fixation with Kirschner wire.Surgical time,mechanical ventilation time, length of stay,duration of analgesic drug,and complication incidence were compared between two groups.Visual analog scale scores were measured before and after internal fixation.RESULTS AND CONCLUSION:The visual analog scale scores were significantly decreased in the both two groups at 12,24,48 hours after internal fixation(P<0.05),moreover,the treatment group had lower scores on the visual analog scale than the control group at 12,24,48 hours after internal fixation(P<0.05).Compared with the control group,the surgical time,mechanical ventilation time,length of stay,duration of analgesicdrug,and complication incidence were all lower in the treatmentgroup(P<0.05).These findings indicate that the internalfixation of TiNi encircling compressive connector is effective in the treatment of multiplerib fractures,which is characterized as simple operation,small injury,high stability,low complication incidence and good histocompatibility.Wang BQ.Application security of TiNi encircling compressive connector versus Kirschner wire in the internal fixation of multiple ribfractures.Zhongguo Zuzhi Gongcheng Yanjiu.2015;19(21):3419-3423.胸部创伤中肋骨骨折属于常见类型，2根及以上的肋骨发生骨折临床上统称为多发性肋骨骨折[1]。