Bouffard Y, Guillaume C, Perrot D, Delafosse B, Motin J
Ann Fr Anesth Reanim. 1984;3(5):335-8. doi: 10.1016/S0750-7658(84)80068-4.
Between 1977 and 1982, fifty cases of post-traumatic fat embolism were treated in a general intensive care unit. Average age of patients was 25.5 +/- 13 years; there was no male majority. Mean free interval was 39 +/- 27 h. 12 cases (24%) had single fractures and 38 (76%) multiple fractures. Forty-four patients had a fractured femur. Thirty-two patients presented the complete clinical syndrome with general, respiratory, neurological and cutaneous signs. Thrombocytopaenia and hypocholesterolaemia were the biological signs most often seen. In forty-four patients, orthopaedic treatment consisted of immediate immobilization, usually with traction. Twenty-six patients were reoperated on: intramedullary nail for twenty patients, plate for the other six. Fat embolism appeared in spite of surgery in six cases; it worsened after surgery in six others. Seven patients had per- or postanaesthetic problems. Fourteen per cent of patients died. The decrease in mortality was mainly due to an improvement in mechanical ventilation techniques. Early surgical fixation remained the rule if there was no serious respiratory distress or haemodynamic instability, although it did not seem to change the mortality rate in this group of patients.
1977年至1982年间，一家综合重症监护病房共治疗了50例创伤后脂肪栓塞患者。患者的平均年龄为25.5±13岁；男性并不占多数。平均自由间隔时间为39±27小时。12例（24%）为单处骨折，38例（76%）为多处骨折。44例患者有股骨骨折。32例患者出现了包括全身、呼吸、神经和皮肤症状在内的完整临床综合征。血小板减少症和低胆固醇血症是最常见的生物学体征。44例患者接受了骨科治疗，通常采用牵引立即固定。26例患者接受了再次手术：20例采用髓内钉，另外6例采用钢板。6例患者尽管接受了手术仍出现脂肪栓塞；另外6例患者术后病情恶化。7例患者有麻醉期间或麻醉后的问题。14%的患者死亡。死亡率的降低主要归因于机械通气技术的改进。如果没有严重的呼吸窘迫或血流动力学不稳定，早期手术固定仍是常规做法，尽管这似乎并未改变该组患者的死亡率。
