Hsu D T, Chao E K, Shih C H
Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
Changgeng Yi Xue Za Zhi. 1990 Jun 20;13(2):86-95.
Forty patients with post-traumatic fat embolism syndrome (FES) from January 1977 through December 1986 were retrospectively analyzed. Diagnosis was made according to the criteria modified by Guard. All 40 patients had at least two major criteria, namely change in consciousness and hypoxia. Twenty patients (50%) presented with full-blown clinical features. Prompt respiratory support with oxygen mask or nasal prongs was the first line of treatment. Forty per cent of patients responded well, whereas the others had to be advanced to endotracheal intubation and mechanical ventilation with positive end expiratory pressure. Steroids were given to 80% of patients and better results were achieved than in the group not treated with steroids. The mortality rate was low (2.5%) and only four patients suffered prolonged cerebral sequelae. The clinical course and prognosis cannot be predicted from the severity of the fracture.
对1977年1月至1986年12月期间40例创伤后脂肪栓塞综合征（FES）患者进行回顾性分析。诊断依据Guard修改的标准进行。所有40例患者至少有两项主要标准，即意识改变和缺氧。20例（50%）患者表现出典型的临床特征。首先采用氧气面罩或鼻导管进行快速呼吸支持治疗。40%的患者反应良好，而其他患者则需进展为气管插管及呼气末正压机械通气。80%的患者接受了类固醇治疗，其效果优于未接受类固醇治疗的组。死亡率较低（2.5%），仅有4例患者出现长期脑后遗症。骨折的严重程度无法预测临床病程及预后。
