胸骨骨折治疗方法的临床研究
The Clinical Study of Treatment for Sternal Fracture

目的：探讨胸骨骨折的外科治疗方法。方法：回顾分析我院于2000年1月至2014年4月收治的35例胸骨骨折，将33例手术治疗的胸骨骨折分为3组：钢丝固定组(包括钢子加钢丝固定)、钢板固定组和记忆合金固定组(镍钛记忆合金胸骨环抱固定)，比较其手术时间、术中出血、术后疼痛时间，并比较其术后并发症。结果：记忆合金固定组手术时间为31 ± 7.6 min，明显少于钢丝固定组(52 ± 5.4 min)和钢板固定组(74 ± 5.1 min)，P < 0.05；记忆合金固定组术中出血为7.0 ± 4.6 ml，明显少于钢丝固定组(11.0 ± 3.4 ml)和钢板固定组(16.0 ± 4.1 ml)，P < 0.05；记忆合金固定组术后疼痛时间为1.0 ± 0.5 d，明显少于钢丝固定组(3.5 ± 0.5 d)和钢板固定组(3.0 ± 1.0 d)，P < 0.05；记忆合金固定组术后并发症发生率明显低于钢丝固定组和钢板固定组，P < 0.05。结论：镍钛记忆合金胸骨环抱固定是目前治疗胸骨骨折的最佳方法。
Objective: To compare the efficacies of treatment for sternal fracture with steel wire, steel plate, and memory alloy. Methods: 35 cases with sternal fracture surgical treated from Jan. 2000 to April 2014 were followed up. Among them, 15 cases were surgical treated with memory alloy, 8 cases were surgical treated with steel plate, 10 cases were surgical treated with steel wire. The condi- tions before, during and after operation and complications were compared. Result: The operation time of memory alloy group was 31 ± 7.6 min, less than steel plate group (74 ± 5.1 min) and steel wire group (52 ± 5.4 min), P < 0.05; the blood loss of memory alloy group was 7.0 ± 4.6 ml, less than steel plate group (16.0 ± 4.1 ml) and steel wire group (11.0 ± 3.4 ml), P < 0.05; the duration of pain of memory alloy group was 1.0 ± 0.5 d, less than steel plate group (3.0 ± 1.0 d) and steel wire group (3.5 ± 0.5 d), P < 0.05. The postoperative complication incidence rate of memory alloy group was less than steel plate group and steel wire group, P < 0.05. Conclusion: The best way of treat- ment for sternal fracture is to fasten with Ni-Ti memory alloy surrounding.