Alho A, Saikku K, Eerola P, Koskinen M, Hämäläinen M
Surg Gynecol Obstet. 1978 Sep;147(3):358-62.
The effects of methylprednisolone on the clinical fat embolism syndrome were studied in a series of 60 patients who had at least two fractures of the pelvis, femur and tibia and who did not have any other important injuries. This series was dichotomized at random, and 29 patients were given 10 milligrams per kilogram of methylprednisolone three times, once upon admission and, then, at eight and 16 hours post-traumatically. Thirty-one patients served as controls. Fat embolism syndrome was defined as a combination of hypoxemia, bilateral "snow storm" infiltrations of the lungs, petechial rash, mental disturbances, pyrexia, anemia and thrombocytopenia. Varying degrees of the syndrome were observed in two patients given methylprednisolone and in 15 patients in the control group. Methylprednisolone reduced all individual signs. There were no fatalities in this series of fracturers. No complications were observed from the use of methylprednisolone. Methylprednisolone in an early pharmacologic dosage is effective in fulminant instances of fat embolism that occur in spite of adequate respiratory care and the proper treatment of fractures.
在60例至少有两处骨盆、股骨和胫骨骨折且无其他严重损伤的患者中，研究了甲基强的松龙对临床脂肪栓塞综合征的影响。该组患者被随机分为两组，29例患者接受每千克10毫克甲基强的松龙治疗，共给药三次，入院时一次，创伤后8小时和16小时各一次。31例患者作为对照组。脂肪栓塞综合征定义为低氧血症、肺部双侧“暴风雪”样浸润、瘀点皮疹、精神障碍、发热、贫血和血小板减少的组合。接受甲基强的松龙治疗的2例患者和对照组的15例患者出现了不同程度的该综合征。甲基强的松龙减轻了所有个体症状。该系列骨折患者中无死亡病例。未观察到使用甲基强的松龙引起的并发症。早期药理剂量的甲基强的松龙对尽管进行了充分的呼吸护理和正确的骨折治疗仍发生的暴发性脂肪栓塞有效。
