Vedrinne J M, Guillaume C, Gagnieu M C, Gratadour P, Fleuret C, Motin J
Service d'Anesthesie-Reanimation, Hopital Edouard Herriot, Lyon, France.
Chest. 1992 Nov;102(5):1323-7. doi: 10.1378/chest.102.5.1323.
Fat embolism syndrome (FES) is a rare but serious complication occurring after long bone fractures. Presence of fat droplets in cells obtained by bronchoalveolar lavage has been proposed as a specific tool for FES diagnosis in trauma patients. We evaluated this technique over a 15-month period in 85 patients. Twenty-eight patients were excluded. The remaining 57 patients were divided into three groups: group 1, 26 patients without trauma as control; group 2, 22 patients with trauma but without evidence of FES; and group 3, nine patients with trauma and evidence of FES. Six of 26 patients in group 1 and nine of 22 patients in group 2 exhibited fat droplets in alveolar macrophages, whereas three of nine patients of group 3 had not. This study suggests that (1) presence of fat droplets in alveolar macrophages is not a reliable method for diagnosis of FES after long bone trauma, and (2) many conditions are associated with fat droplets in alveolar macrophages.
脂肪栓塞综合征（FES）是长骨骨折后发生的一种罕见但严重的并发症。通过支气管肺泡灌洗获得的细胞中存在脂肪滴，已被提议作为创伤患者FES诊断的一种特异性工具。我们在15个月的时间里对85例患者评估了这项技术。28例患者被排除。其余57例患者分为三组：第1组，26例无创伤的患者作为对照；第2组，22例有创伤但无FES证据的患者；第3组，9例有创伤且有FES证据的患者。第1组26例患者中有6例、第2组22例患者中有9例在肺泡巨噬细胞中出现脂肪滴，而第3组9例患者中有3例未出现。本研究表明：（1）肺泡巨噬细胞中存在脂肪滴并非长骨创伤后FES诊断的可靠方法；（2）许多情况与肺泡巨噬细胞中的脂肪滴有关。
