Comprehensive approach to the management of the patient with multiple rib fractures: a review and introduction of a bundled rib fracture management protocol.
Comprehensive approach to the management of the patient with multiple rib fractures: a review and introduction of a bundled rib fracture management protocol.
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DOI：
10.1136/tsaco-2016-000064
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发表时间：
2017-01-01
影响因子：
2
通讯作者：
Bulger, Eileen M
中科院分区：
文献类型：
--
作者：
Witt, Cordelie E;Bulger, Eileen M
肋骨骨折在遭受钝性创伤的患者中很常见，是严重身体和实体器官损伤的标志。它们与高发病率和高死亡率有关，包括多种肺部并发症，并可导致慢性疼痛和残疾。几个机构已经开发了临床和放射学评分系统来预测并发症的风险。减少发病率的临床策略已被研究，包括多模式疼痛管理、基于导管的止痛、肺部卫生和手术稳定性。在这篇文章中，我们回顾了发病率和并发症的危险因素，干预策略，并讨论了肋骨骨折捆绑临床路径的经验。此外，我们还介绍了我们I级创伤中心使用的多学科肋骨骨折治疗方案。
Rib fractures are common among patients sustaining blunt trauma, and are markers of severe bodily and solid organ injury. They are associated with high morbidity and mortality, including multiple pulmonary complications, and can lead to chronic pain and disability. Clinical and radiographic scoring systems have been developed at several institutions to predict risk of complications. Clinical strategies to reduce morbidity have been studied, including multimodal pain management, catheter-based analgesia, pulmonary hygiene, and operative stabilization. In this article, we review risk factors for morbidity and complications, intervention strategies, and discuss experience with bundled clinical pathways for rib fractures. In addition, we introduce the multidisciplinary rib fracture management protocol used at our level I trauma center.