Husebye Elisabeth Ellingsen, Lyberg Torstein, Røise Olav
Orthopedic Center, Ullevaal University Hospital, Oslo, Norway.
Injury. 2006 Oct;37 Suppl 4:S8-18. doi: 10.1016/j.injury.2006.08.036.
Fat embolism (FE) and fat embolism syndrome (FES) are controversial topics, particularly regarding their clinical relevance and their independency as a clinical syndrome. FE describes the presence of fat globules within the microcirculation. FES on the other hand, is a clinical syndrome characterized by the presence of FE with the manifestation of an identifiable clinical pattern of signs and symptoms. Both experimental and clinical studies have demonstrated the occurrence and the possible harmful effects of FE. For instance, FE involving the lungs can result in adult respiratory distress syndrome (ARDS). The effects of FE are certainly mechanical, leading to capillary congestion, but are also highly likely to be of a proinflammatory and prothrombotic nature. The demarcation of FES against ARDS is mainly demonstrated by the single organ involvement of ARDS, exclusively influencing the lungs, whereas FES has a multiorgan effect with pulmonary, skin and, neurological manifestations. This article is a review of the pathophysiological mechanisms of FE and the clinical occurrence and influence of FE and FES.
脂肪栓塞（FE）和脂肪栓塞综合征（FES）是颇具争议的话题，尤其是在它们的临床相关性以及作为一种临床综合征的独立性方面。FE指的是微循环中存在脂肪球。另一方面，FES是一种临床综合征，其特征是存在FE，并伴有可识别的体征和症状的临床模式表现。实验研究和临床研究均已证实FE的发生及其可能的有害影响。例如，累及肺部的FE可导致成人呼吸窘迫综合征（ARDS）。FE的影响肯定有机械性的，会导致毛细血管充血，但也极有可能具有促炎和促血栓形成的性质。ARDS与FES的区别主要体现在ARDS仅累及单一器官，即只影响肺部，而FES具有多器官效应，会出现肺部、皮肤及神经方面的表现。本文是对FE的病理生理机制以及FE和FES的临床发生情况与影响的综述。
