目的: 对比手术与非手术治疗缓解粉碎/节段型肋骨骨折疼痛的效果。方法: 选择2014年1月1日-2020年12月31日赤峰学院附属医院收治的肋骨骨折患者51例,按简单随机抽样方法分为手术组20例与非手术组31例并进行为期1年的三种状态下(静息时、咳嗽时、改变体位时)疼痛随访,最后对两组疼痛数据进行统计分析。结果: 手术组与非手术组粉碎/节段型肋骨骨折患者的疼痛差异主要表现在伤后第1个月内以及伤后第6-12个月,在伤后第1个月内手术治疗缓解疼痛效果明显优于非手术治疗(P＜0.05);在伤后第6-12个月虽然统计结果显示非手术组患者疼痛程度低于手术组,但两组患者在此期间的疼痛程度集中趋势均已可忽略不计(VAS接近于0分)。结论: 对于粉碎/节段型肋骨骨折患者,在缓解疼痛方面,手术治疗的干预效果在伤后早期相比于非手术治疗更为明显,但疼痛并非肋骨骨折手术的独立适应证,其疼痛治疗方案应结合患者整体病情决定;伤后第6个月可能是肋骨骨折疼痛的一个重要分水岭。
Objective: To compare the pain relief effect on surgical and non-surgical treatment for comminuted/segmental rib fractures. Methods: 51 patients with rib fractures who were admitted to the Affiliated Hospital of Chifeng University from January 1, 2014 to December 31, 2020 were selected into this study. All selected patients were divided into the operation group and non-operation group with simple random sampling method. 1 year follow-up under three states (resting, coughing and body position changing) was performed to collect pain data. Finally, the pain data of the two groups of patients were statistically analyzed. Results: The pain difference between the operation group and the non-operation group was mainly reacted in the first month after fracture and the sixth to twelfth months after fracture. The pain relief effect of operation group within the first month after fracture was significantly better than that of the non-operation group, and the differences were statistically significant(P＜0.05). From the sixth month to the twelfth month after fracture, although the statistical results showed that the pain degree of patients in the non-operation group was lower than that in the operation group, the central tendency of pain degree in the two groups during this period had reached a negligible level (close to 0 score). Conclusion: For patients with comminuted or segmental rib fractures, the intervention effect of operative treatment is better than that of non-operation treatment in the early stage after fracture, but pain is not an independent indication in rib fracture surgery, and its pain management plan should be determined by the overall condition of the patient.The sixth month after fracture may be an important watershed for rib fracture pain.
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