Shacklock Emma, Gemmell Andrew, Hollister Nigel
Department of Anaesthetics and Intensive Care, North Devon District Hospital, Barnstaple, UK.
Department of Radiology, North Devon District Hospital, Barnstaple, UK.
J Intensive Care Soc. 2017 Nov;18(4):339-341. doi: 10.1177/1751143717718664. Epub 2017 Jul 10.
Fat embolism syndrome is a serious multi-system pathology which classically affects the respiratory system, neurological system and causes a petechial rash. We present the case of a 20-year-old farmer who developed fat embolism syndrome following a traumatic femoral fracture. Features developed within 24 h of injury and necessitated a prolonged stay in Intensive Care. He exhibited significant signs of cerebral fat embolism syndrome including coma and seizures but went on to make full functional recovery. Magnetic resonance imaging is the recommended imaging modality for patients with suspected cerebral fat embolism. In this case, computerised tomography was inconclusive, but magnetic resonance imaging demonstrated the "starfield pattern" of multiple high signal foci on a dark background. Supportive treatment of fat embolism syndrome is required in an appropriate setting, such as High Dependency or Intensive Care, for patients at risk of hypoxia or neurological deterioration. Despite major neurological involvement of fat embolism syndrome, full recovery is described by several cases including ours.
脂肪栓塞综合征是一种严重的多系统疾病，典型表现为影响呼吸系统、神经系统，并出现瘀点样皮疹。我们报告一例20岁农民，在股骨创伤性骨折后发生脂肪栓塞综合征。相关症状在受伤后24小时内出现，需要在重症监护室长期住院治疗。他出现了脑脂肪栓塞综合征的显著症状，包括昏迷和癫痫发作，但最终实现了完全功能恢复。对于疑似脑脂肪栓塞的患者，磁共振成像（MRI）是推荐的影像学检查方式。在该病例中，计算机断层扫描（CT）结果不明确，但MRI显示在暗背景上有多个高信号灶的“星芒状图案”。对于有缺氧或神经功能恶化风险的患者，需要在适当的环境中，如高依赖病房或重症监护室，对脂肪栓塞综合征进行支持性治疗。尽管脂肪栓塞综合征主要累及神经系统，但包括我们的病例在内，已有多例报告实现了完全康复。
