Recently, District Hospital of Traditional Chinese Medicine A patient with multiple rib fractures due to trauma was admitted, with minor bleeding in the chest cavity on admission. During the hospitalization observation period, the patient developed chest tightness and shortness of breath, and after the re-examination of CT, it was considered that a large amount of blood in the pleural cavity may exist, and there may be acute bleeding due to vascular injury. During the operation, it was found that the patient’s fractured rib punctured the lungs, and also punctured the arteries between the ribs, resulting in acute bleeding. There was a large amount of blood accumulation and blood clots in the chest cavity. The total amount of bleeding reached about 2000ml, which has endangered to the patient’s life.
Liu Jin, director of cardiothoracic surgery in our hospital, and his team used minimally invasive treatment technology to perform surgery on the patient, repairing the punctured lung in time, ligating the bleeding artery, and connecting the displaced ribs. The rib was prevented from puncturing the important part again, and the patient finally turned the corner.
On the second day after the operation, the patient can basically Exercise on the ground. Director Liu Jin said that rib fractures like his are still very dangerous. I once diagnosed and treated a patient with a similar rib fracture. At that time, the broken rib pierced the aorta. Since the aorta is the largest artery in the human body, once a major hemorrhage occurs, it can take people’s lives within seconds. Fortunately, the operation was handled in time, otherwise The consequences could be disastrous.
< span>Don’t be careless about rib fractures!
A rib fracture is when the continuity of the human rib is damaged due to some reasons. The most common reason is the impact of external forces, such as car accidents, falls, direct violent blows, etc., which cause rib fractures caused by blows to the chest.
In the traditional view, it is generally believed that since the rib is not an important load-bearing structure of the human body, after a fracture, it can be cured by conservative treatment and gradual rest without causing too much impact on the body, so surgery is not required. It may be suitable for simple, relatively minor rib fractures. However, for rib fractures in some special cases, the traditional conservative treatment plan is not suitable. Although some patients can recover slowly, the required treatment cycle is long, which may cause a certain impact on the body or leave a certain disability in the later stage, such as Thoracic deformity, respiratory function limitation, scoliosis deformation, etc., may even be life-threatening in severe cases.
With the advancement of medical technology and the development of medical device manufacturing, the concept of treatment of rib fractures has gradually changed. For some patients with rib fractures, taking active surgical treatment measures can significantly reduce the occurrence of serious complications, mortality, and disability rates, while greatly shortening the length of hospitalization, saving hospitalization costs, and reducing the economic pressure of patients.
When does a fractured rib require surgery?
Active surgical treatment is recommended in the following situations:
1. Multiple, multi-segment rib fractures, that is, our Said “flail chest”.
2. Multiple rib fractures are obviously dislocated, which obviously affects the patient’s respiratory function, and the compression of the intercostal nerve causes severe pain intolerable.
3. Combined with vascular injury and important organ injury requiring emergency surgery.
4. The patient’s personal willingness for surgery is strong.
The injury condition of rib fracture in thoracic injury is often complicated, and the evolution of the condition is varied, which needs to be analyzed in detail. Generally, after chest injury, there is often a process of gradual aggravation and initial emergence of complications within 72 hours, which leads to some patients who are in good condition when they are first injured, and then become more and more serious. At this time, there is no need to be nervous and anxious. Actively communicate with the doctor and take reasonable treatment measures.
Review: Wang Huichao
< span>Edit: Hu Dan