摘要肋骨骨折是胸部创伤中最常见的损伤,既往以非手术治疗为主,但高达50%的患者,尤其是合并连枷胸者,会出现慢性疼痛或胸壁畸形,超过30%的人会遗留长期残疾,而且往往无法重返全职工作。虽然肋骨骨折手术治疗取得良好救治结局,但普遍存在治疗不规范、疗效差异大等问题。国内外专家共识着重于整体治疗决策和方案的指导,国外相关临床实践指南缺少近几年肋骨骨折手术治疗进展。为此,由中华医学会创伤学分会、中国医师协会创伤外科医师分会组织全国多学科专家共同参与,遵循循证医学原则,本着科学性与实用性,制订了《创伤性肋骨骨折手术治疗中国专家共识》(2021版),对创伤性肋骨骨折的术前影像学评估、手术指征、手术时机、手术方式、手术固定部位选择、内固定方式和材料选择及肋骨骨折常见合并损伤的处理等7个方面提出建议,为创伤性肋骨骨折的手术治疗提供指导和参考。
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abstractsTraumatic rib fractures are the most common injury in thoracic trauma. Previously,the patients with traumatic rib fractures were mostly treated non-surgically,of which 50%,especially those combined with flail chest presented chronic pain or chest wall deformities and over 30% had long-term disabilities,being unable to retain a full-time job. In the past two decades,thanks to the development of internal fixation material technology,the surgical treatment of rib fractures has achieved good outcomes. However,there are still some problems in clinical treatment,including inconsistency in surgical treatment and quality control in medical services. The current consensuses on the management of regional traumatic rib fractures published at home and abroad mainly focus on the guidance of the overall treatment decisions and plans,and relevant clinical guidelines abroad lacks progress in surgical treatment of rib fractures in recent years. Therefore,the Chinese Society of Traumatology affiliated to Chinese Medical Association and Chinese College of Trauma Surgeons affiliated to Chinese Medical Doctor Association,in conjunction with national multidisciplinary experts,formulate the Chinese Consensus for Surgical Treatment of Traumatic Rib Fractures(2021)following the principle of evidence-based medicine,scientific nature and practicality. This expert consensus puts forward some clear,applicable,and graded recommendations from aspects of preoperative imaging evaluation,surgical indications,timing of surgery,surgical methods,rib fracture sites for surgical fixation,internal fixation methods and material selections,treatment of combined injuries in rib fractures,in order to provide references for surgical treatment of traumatic rib fractures.
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