创伤性肋骨骨折治疗进展及未来展望
Journal: Basic Medical Theory Research DOI: 10.12238/bmtr.v8i2.18867
Abstract
肋骨骨折的手术治疗近年来普及，但仍具争议，因患者在流行病学上差异较大。本文综述了肋骨骨折的治疗方法及长期结局，特别是手术治疗。CT已被确认为最有效的检测手段，高达50%的肋骨骨折在其他成像方式中被遗漏。非手术治疗仍是基础，使用患者定制的多模式疼痛管理。对于伴胸壁不稳定或生理紊乱的移位性骨折，需在72小时内进行手术治疗，创伤性脑损伤（TBI）和肺挫伤不是严格禁忌症，钢板接骨术是常规方法。肋骨骨折的手术稳定（SSRF）目前仅适用于特定患者，相关研究仍在继续。未来可能包括经皮肋间神经冷冻消融、3D打印和生物可吸收材料的应用。
Keywords
肋骨骨折；胸部损伤；非手术治疗；肋骨骨折的手术稳定（SSRF）
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[3] Sermonesi G, Bertelli R, Pieracci F M, et al. Surgical stabilization of rib fractures (SSRF): the WSES and CWIS position paper[J]. World journal of emergency surgery: WJES, 2024, 19(1): 33.
[4] Van Wijck SFM, Pieracci FM, Smith EF, et al. Rib fixation in patients with severe rib fractures and pulmonary contusions: Is it safe?[J]. J Trauma Acute Care Surg 2022;93:721-6.
[5] Prins JTH, Van Lieshout EMM, Ali-Osman F, et al. Outcome after surgical stabilization of rib fractures versus nonoperative treatment in patients with multiple rib fractures and moderate to severe traumatic brain injury(CWIS-TBI)[J]. J Trauma Acute Care Surg 2021;90:492-500.
[6] 中华医学会创伤学分会、中国医师协会创伤外科医师分会.创伤性肋骨骨折手术治疗中国专家共识 ( 2021 版) [J]. 中华创伤杂志,2021,37(10) : 865-875.
[7] Mischler D, Schopper C, Gasparri M, et al. Is intrathoracic rib plate fixation advantageous over extrathoracic plating?[J]. A biomechanical cadaveric study. J Trauma Acute Care Surg 2022;92:574-80.
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[9] Xue H, Zhang Z, Liu M, et al. Finite element analysis of different fixation methods of screws on absorbable plate for rib fractures[J]. Frontiers in Bioengineering and Biotechnology, 2022, 10: 960310.
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