Gossling H R, Donohue T A
JAMA. 1979 Jun 22;241(25):2740-2.
The fat embolism syndrome is a symptom complex of acute respiratory failure after long-bone fractures. It is thought to be caused by deposition of embolic fat within the pulmonary capillaries, resulting in a capillary leak within the lung. The source of the embolic fat appears to be marrow fat. Alterations in circulating free fatty acids, increases in fibrin split products, and increases in platelet adhesiveness have been observed to occur in this syndrome and probably play an important part in the production of the pulmonary lesion. The signs and symptoms of the syndrome are hypoxemia, tachypnea, petechiae, fever, altered sensorium, and chest roentgenograms similar to signs of the adult respiratory distress syndrome (ARDS). Early recognition is facilitated by monitoring of arterial blood gas levels for hypoxemia. Treatment is directed at ARDS using graduated oxygen therapy and steroids.
脂肪栓塞综合征是长骨骨折后急性呼吸衰竭的一组症状群。它被认为是由于栓塞性脂肪在肺毛细血管内沉积，导致肺内毛细血管渗漏所致。栓塞性脂肪的来源似乎是骨髓脂肪。在该综合征中已观察到循环游离脂肪酸的改变、纤维蛋白裂解产物的增加以及血小板黏附性的增加，它们可能在肺部病变的发生中起重要作用。该综合征的体征和症状包括低氧血症、呼吸急促、瘀点、发热、意识改变以及类似于成人呼吸窘迫综合征（ARDS）体征的胸部X线表现。通过监测动脉血气水平以检测低氧血症有助于早期识别。治疗针对ARDS，采用逐步增加的氧疗和类固醇药物。
