Comparative Analysis Of Clinical Efficacy Between Conservative And Internal Fixation

Background and objective: The sacral chest is a serious chest trauma,which is difficult to treat and has a high risk of death.In recent years,its incidence has increased year by year,and its treatment problems have attracted much attention.How to improve the clinical treatment effect of patients and ensure the health of patients Become the focus of academic attention.Conservative treatments have been unable to meet the actual treatment needs,and internal fixation surgery has received attention as a new treatment.This study compared conservative treatment with internal fixation.The purpose of this study was to clarify the difference in efficacy between the two treatments and to provide scientific guidance for the development of clinical treatments for the treatment of sputum.Methods: A total of 317 cases of hospitalized thoracic surgery from September2009 to September 2017 were enrolled in the study.Among them,303 patients were eligible for inclusion and exclusion criteria,and were classified according to treatment methods.Conservative group(161 cases)and internal fixation group(142 cases),the difference of baseline data between the two groups was small(P>0.05),and the study was comparable.By comparing the hospitalization indicators(mechanical ventilation time,ICU treatment time,hospitalization time,hospitalization cost,pain relief time,fracture healing time),blood gas index before treatment and treatment for 24 hours(oxygen partial pressure PaO2,blood carbon dioxide partial pressure)PaCO2,blood oxygen saturation SaO2,pH pH),tracheotomy rate,complication rate(thoracic deformity,pulmonary infection,acute respiratory distress syndrome ARDS,atelectasis),pre-treatment and 6 months of treatment of lung Functional indicators(forced vital capacity FVC,one second FEV1,highest expiratory flow rate PEF,total lung TLC),follow-up outcome(6 months post-treatment mortality,readmission rate,return to work rate)comprehensive evaluation of two treatment methods The difference in effect.Results:(1)The mechanical ventilation time,ICU treatment time,hospitalization time,hospitalization cost,pain relief time,and fracture healing time were lower in the internal fixation group than in the conservative group,and the difference was statistically significant(P<0.05).(2)Before treatment,the blood gas indexes of PaO2,PaCO2,SaO2 and pH were similar in the two groups,and the difference was not statistically significant(P>0.05).After treatment for 24 hours,the internal fixation group PaO2,SaO2,pH was higher than the conservative group.PaCO2 was lower than the conservative group,and the difference was statistically significant(P<0.05).(3)The tracheotomy rate(14.79%)in the internal fixation group was lower than that in the conservative group(58.39%),and the difference was statistically significant(P<0.05).The internal fixation group had thoracic deformity,pulmonary infection,ARDS,and lung.The incidence of Zhang was lower than that of the conservative group,and the difference was statistically significant(P<0.05).(4)Before treatment,there was no significant difference in lung function indexes between the two groups(P>0.05).After 6 months of treatment,the lung function of FVC,FEV1,PEF and TLC in the internal fixation group was higher than that in the internal fixation group.In the conservative group,the difference was statistically significant(P<0.05).(5)Within 6 months of follow-up,there was no significant difference in mortality between the internal fixation group and the conservative group(1.41%,2.48%)(P>0.05).The readmission rate(1.41%)in the internal fixation group was lower than conservative.In the group(9.94%),the return-to-work rate(73.24%)was higher than that in the conservative group(50.93%),and the difference was statistically significant(P<0.05).Conclusion: The effect of internal fixation for patients with sacral thoracicsurgery is better than conservative treatment.It can further optimize the hospitalization index,improve the blood gas status and lung function,reduce the tracheotomy rate and complication rate,and have good clinical outcomes.Should be promoted and applied in the clinic.