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创伤手术中患者体位对脂肪栓塞综合征的影响:一项实验研究。

The effect of patient position during trauma surgery on fat embolism syndrome: An experimental study.

作者信息

Syed Khalid A, Blankstein Michael, Bhandari Mohit, Nakane Masaki, Zdero Radovan, Schemitsch Emil H

机构信息

Division of Orthopaedic Surgery, Musculoskeletal Health and Arthritis Program, Toronto Western Hospital, Toronto, Canada.

Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Canada.

出版信息

Indian J Orthop. 2014 Mar;48(2):203-10. doi: 10.4103/0019-5413.128769.

Abstract

BACKGROUND

The aim of this study was to compare the effect of supine versus lateral position on clinical signs of fat embolism during orthopedic trauma surgery. Dogs served as the current study model, which could be extended and/or serve as a basis for future in vivo studies on humans. It was hypothesized that there would be an effect of position on clinical signs of fat embolism syndrome in a dog model.

MATERIALS AND METHODS

12 dogs were assigned to supine (n = 6) and lateral (n = 6) position groups. Airway pressures, heart rate, blood pressure, cardiac output, pulmonary artery pressure, pulmonary artery wedge pressure, right atrial pressure, arterial and venous blood gases, white blood count, platelet count and neutrophil count were obtained. Dogs were then subjected to pulmonary contusion in three areas of one lung. Fat embolism was generated by reaming one femur and tibia, followed by pressurization of the canal.

RESULTS

No difference was found in any parameters measured between supine and lateral positions at any time (0.126 < P < 0.856).

CONCLUSIONS

The position of trauma patients undergoing reamed intramedullary nailing did not alter the presentation of the features of the lung secondary to fat embolism.

摘要

背景

本研究旨在比较仰卧位与侧卧位对骨科创伤手术期间脂肪栓塞临床体征的影响。犬作为当前的研究模型,该模型可扩展和/或作为未来人体体内研究的基础。研究假设在犬模型中,体位对脂肪栓塞综合征的临床体征有影响。

材料与方法

将12只犬分为仰卧位组(n = 6)和侧卧位组(n = 6)。记录气道压力、心率、血压、心输出量、肺动脉压、肺动脉楔压、右心房压、动脉和静脉血气、白细胞计数、血小板计数及中性粒细胞计数。然后对犬一侧肺的三个区域造成肺挫伤。通过扩髓一根股骨和胫骨,随后对髓腔加压来产生脂肪栓塞。

结果

在任何时间点,仰卧位和侧卧位之间测量的任何参数均未发现差异(0.126 < P < 0.856)。

结论

接受扩髓髓内钉固定的创伤患者的体位不会改变继发于脂肪栓塞的肺部特征表现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7dde/3977378/77acc6604c33/IJOrtho-48-203-g001.jpg

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