Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada; Hospital for Sick Children, Toronto, Canada.
Neuromuscul Disord. 2012 Dec;22(12):1035-9. doi: 10.1016/j.nmd.2012.07.010. Epub 2012 Aug 21.
We describe five patients with Duchenne muscular dystrophy who presented with acute neurologic and respiratory symptoms following minor trauma. Four of the five deteriorated rapidly and died within 36 h after falling. X-rays for fractures were negative. Four of the five patients were taking corticosteroids daily. All five patients fulfilled the clinical criteria for Fat Embolism Syndrome. Autopsy findings were consistent with fat embolism in two cases. Fat Embolism Syndrome needs to be considered in patients with Duchenne muscular dystrophy following minor trauma even without fractures. Early recognition of Fat Embolism Syndrome and aggressive resuscitation are important to improve survival. This report serves as an important reminder that seatbelts need to be used at all times.
我们描述了 5 例杜氏肌营养不良症患者,他们在轻微创伤后出现急性神经和呼吸症状。这 5 例中的 4 例迅速恶化,并在摔倒后 36 小时内死亡。骨折的 X 射线检查为阴性。这 5 例患者中有 4 例每天服用皮质类固醇。这 5 例患者均符合脂肪栓塞综合征的临床标准。尸检结果在 2 例中与脂肪栓塞一致。即使没有骨折,在遭受轻微创伤后,杜氏肌营养不良症患者也需要考虑脂肪栓塞综合征。早期识别脂肪栓塞综合征并积极复苏对提高生存率很重要。本报告重要提醒大家,无论何时都需要系好安全带。