Kroupa J, Kusák I
Czech Med. 1983;6(2):65-79.
The body's response to the effects of mechanical injury, taking the form of shock during the first hours and the onset of fat embolism in the subsequent period, is substantially higher in patients with multiple or associated injuries, both as regards the severity of manifestations and prognostic risk. Also the death rate due to this sort of complication is seen rising. Two groups of injured persons with isolated (n = 33) and multiple fractures (n = 33) were used to show that dynamic follow-up of PaO2 in the blood could serve as a criterion of the risk of fat embolism development in the body and, in particular, as a prognostic criterion for the progress of fat embolism. Special point was made of findings demonstrating a time relationship between PaO2 deterioration in the early post-injury period (up to 24-36 hours) as compared with the period of 48-72 hours after the injury. PaO2 is seen dropping rapidly in injured persons showing signs of fat embolism syndrome development. The decrease can be recorded as early as the free interval phase, i.e. prior to the manifestation of the clinical signs of fat embolism. The findings of low PaO2 levels in the blood are in accordance with respiratory ventilation disturbances and impaired diffusion documented in our investigation.
身体对机械损伤影响的反应，在最初几个小时表现为休克，在随后阶段会出现脂肪栓塞，对于多处损伤或合并损伤的患者，无论在表现的严重程度还是预后风险方面，这种反应都要高得多。而且，这类并发症导致的死亡率也在上升。两组受伤人员，分别为单纯骨折（n = 33）和多处骨折（n = 33），用于表明动态监测血液中的PaO₂可作为体内脂肪栓塞发生风险的一个标准，特别是作为脂肪栓塞进展的预后标准。特别指出的是，研究结果表明，与受伤后48 - 72小时相比，受伤后早期（长达24 - 36小时）PaO₂恶化存在时间关系。在出现脂肪栓塞综合征迹象的受伤人员中，PaO₂迅速下降。这种下降最早可在无临床表现期记录到，即在脂肪栓塞临床症状出现之前。血液中PaO₂水平低的结果与我们调查中记录的呼吸通气障碍和弥散受损一致。
