中华神经医学杂志
中華神經醫學雜誌
중화신경의학잡지
Chinese Journal of Neuromedicine
2015年
8期
843-845
,共3页
金涌%彭秋菊%高想杰%杨琴
金湧%彭鞦菊%高想傑%楊琴
금용%팽추국%고상걸%양금
脂肪栓塞综合征%临床特征%骨折
脂肪栓塞綜閤徵%臨床特徵%骨摺
지방전새종합정%림상특정%골절
Fat embolism syndrome%Clinical characteristic%Fracture
目的 探讨脂肪栓塞综合征(FES)的临床特征及诊治效果. 方法 回顾性分析自2004年至2014年重庆医科大学附属第一医院神经内科收治的11例FES患者的病因、临床表现、实验室检查和影像学特点、诊断、治疗及预后. 结果 11例患者病因为创伤后长骨骨折9例,膝关节人工置换术后2例;首发意识障碍10例,呼吸困难1例;胸片示“爆风雪”征2例,肺CT异常8例,MRI显示多发脑梗死3例;72 h内确诊率为63.63％,误诊率为36.36％;经综合治疗,7例治愈,1例植物状态,3例死亡,死亡率为27.2％. 结论 FES的病因多为创伤性长骨骨折或关节手术,临床表现形式复杂,早期极易误诊.治疗成功的关键是早期确诊并给予有效的综合治疗.
目的 探討脂肪栓塞綜閤徵(FES)的臨床特徵及診治效果. 方法 迴顧性分析自2004年至2014年重慶醫科大學附屬第一醫院神經內科收治的11例FES患者的病因、臨床錶現、實驗室檢查和影像學特點、診斷、治療及預後. 結果 11例患者病因為創傷後長骨骨摺9例,膝關節人工置換術後2例;首髮意識障礙10例,呼吸睏難1例;胸片示“爆風雪”徵2例,肺CT異常8例,MRI顯示多髮腦梗死3例;72 h內確診率為63.63％,誤診率為36.36％;經綜閤治療,7例治愈,1例植物狀態,3例死亡,死亡率為27.2％. 結論 FES的病因多為創傷性長骨骨摺或關節手術,臨床錶現形式複雜,早期極易誤診.治療成功的關鍵是早期確診併給予有效的綜閤治療.
목적 탐토지방전새종합정(FES)적림상특정급진치효과. 방법 회고성분석자2004년지2014년중경의과대학부속제일의원신경내과수치적11례FES환자적병인、림상표현、실험실검사화영상학특점、진단、치료급예후. 결과 11례환자병인위창상후장골골절9례,슬관절인공치환술후2례;수발의식장애10례,호흡곤난1례;흉편시“폭풍설”정2례,폐CT이상8례,MRI현시다발뇌경사3례;72 h내학진솔위63.63％,오진솔위36.36％;경종합치료,7례치유,1례식물상태,3례사망,사망솔위27.2％. 결론 FES적병인다위창상성장골골절혹관절수술,림상표현형식복잡,조기겁역오진.치료성공적관건시조기학진병급여유효적종합치료.
Objective To investigate the clinical characteristics of fat embolism syndrome (FES) and explore the diagnosis and therapy efficacy.Methods The etiology,clinical manifestations,laboratory and radiological characteristics,diagnosis,treatments and outcomes of 11 patients with FES,admitted to our hospital from 2004 to 2014,were retrospectively analyzed.Results There were 9 patients with traumatic long bone fracture,2 with artificial knee joint replacement in 11 patients.Disturbance of consciousness was noted in 10 patients,dyspnea in one in the first onset.There were 2 with "snow storm appearance" in chest X-ray,8 with abnormality in pulmonary CT and 3 with multiple cerebral infarction in MRI.The rates of final diagnosis and misdiagnosis within 72 h were 63.63％ and 36.36％,respectively.After comprehensive treatment,7 patients were cured,one was at vegetative state and 3 died,with a mortality rate of 27.2％.Conclusions The main causes of FES include traumatic long bone fracture and operation of joint.Early definite diagnosis and effective combined modality therapy are key points of successful treatment.
