本文選題：連枷胸 + 肋骨骨折�。� 參考：《河北醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:連枷胸是重癥胸部創(chuàng)傷中高死亡率的威脅生命的嚴(yán)重胸部創(chuàng)傷。連枷胸的非手術(shù)治療包括呼吸機(jī)支持和鎮(zhèn)痛等方法。這種非手術(shù)治療往往由于呼吸功能不足及并發(fā)癥而導(dǎo)致肺炎發(fā)生率、氣管切開率、死亡率增高、重癥監(jiān)護(hù)室(ICU)日和總住院日延長等的不良后果。本文的研究的目的是對比連枷胸的手術(shù)治療與非手術(shù)處理的效果異同。方法:系統(tǒng)的回顧了先前發(fā)表的1995年到2015年有關(guān)手術(shù)和非手術(shù)治療連枷胸對比研究的文獻(xiàn)。我們通過PubMed,Medline,and Google Scholar進(jìn)行了一個全面的文獻(xiàn)檢索。我們將成人連枷胸患者在手術(shù)治療組和非手術(shù)治療組進(jìn)行對比。我們通過這些選取的文獻(xiàn)的死亡率、肺炎率、機(jī)械通氣時間、ICU住院日、總住院日、氣管切開率的數(shù)據(jù)進(jìn)行統(tǒng)計學(xué)計算。結(jié)果:在這篇系統(tǒng)綜述中包括了3篇隨機(jī)對照研究和4篇回顧性研究。總計,有112名患者接受手術(shù)治療和有198名患者接受非手術(shù)治療。與非手術(shù)治療相比,手術(shù)治療連枷胸可有效降低死亡率(OR=0.25,95%CI:0.094-0.679),肺炎發(fā)生率(0.22,95%CI:0.07 0.69),氣管切開率(0.26,95%CI:0.1 0.68),也可縮ICU住院日(ES:-1.32day95%CI:-2.25 to-0.39),住院總?cè)?-3.74days;95%CI:-10 to-0.2.53)。結(jié)論:本次薈萃分析涵蓋的相關(guān)患者較少,但是研究表明手術(shù)治療連枷胸創(chuàng)傷在諸多方面有實質(zhì)性的益處。目前,分析這類研究主要是基于回顧性研究。因此,相類似這方面的研究調(diào)查需要大型隨機(jī)對照試驗研究,同時研究的內(nèi)容也應(yīng)該較以前的豐富。
[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.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R655

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本文編號：1996672