Without effective treatment, multiple fractures of multiple ribs can cause the partial chest wall lose the ribs to support, and also causes paradoxical breathing, the softening area of chest wall invagination when inhaling, and outer protrusion when exhaling, it is called the flail chest ( 5), can cause long-term disability, chest wall pain, and the paradoxical motion of the chest wall inducing respiratory distress ( 6). However, some cases are complicated by serial rib fractures ( 4). Most patients with thoracic trauma do not undergo surgical treatment. Thoracic trauma is often associated with significant morbidity and mortality ( 2, 3). Thoracic trauma is a major traumatic injury throughout the world, and it has very high incidence in developing countries ( 1). Delayed hemopneumothorax occurred in 7 cases in the surgical group and in 16 cases in the conservative group (P=0.012). Atelectasis occurred in 10 cases in the surgical group and in 17 cases in the conservative group (P=0.046). The number of rib displacement cases after treatment was 1 case in the surgical group and 2 cases in the conservative group (P=0.475). The hospitalization cost was 6,206.44☓71.42 USD for the surgical group and 4,544.61±524.79 USD for the conservative group (P<0.001). The index of partial pressure of carbon dioxide (PaCO 2) was 37.80☒.86 mmHg 24 h after surgery and it was 39.08☒.46 mmHg 24 h after conservative treatment. The index of partial pressure of arterial oxygen (PaO 2) was 91.05☑0.88 mmHg 24 h after surgery whereas 86.49☑1.69 mmHg 24 h after conservative treatment (P=0.036). The indwelling thoracic drainage tube time was 5.85☑.52 days in the surgical group and 8.26☑.96 days in the conservative group (P<0.001). The duration of the thoracic intensive care unit (ICU) stay was 4.02☑.41 days in the surgical group and 5.06☑.80 days in the conservative group (P=0.001).
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