Bouaggad A, Harti A, Barrou H, Zryouil B, Benaguida M
Service d'Anesthésie, CHU Ibnou Rochd, Casablanca, Maroc.
Ann Fr Anesth Reanim. 1994;13(5):730-3. doi: 10.1016/s0750-7658(05)80731-2.
This is a report of two cases of tetraplegia complicating fat embolism after fracture of long bones. In the first case, a 26 year-old male sustained fractures of femur and tibia. One day after admission, the patient became comatose (Glasgow coma score = 6) with dyspnaea and petechiae present on the anterior chest wall. In second case, a 22 year-old man with a fracture of tibia and humerus, suffered two days after admission from similar signs of fat embolism (dyspnaea, Glasgow score coma = 6, petechiae). A tetraplegia occurred after 7 days in the first patient and 6 days in the second. No lesions were visible on brain CT scan. Magnetic resonance imaging showed relative high-intensity areas on T2 weighted views. The outcome at three weeks was favourable, without neurologic sequelae.
本文报告两例长骨骨折后并发脂肪栓塞导致四肢瘫痪的病例。第一例，一名26岁男性，股骨和胫骨骨折。入院一天后，患者昏迷（格拉斯哥昏迷评分=6），伴有呼吸困难，前胸壁出现瘀点。第二例，一名22岁男性，胫骨和肱骨骨折，入院两天后出现类似脂肪栓塞症状（呼吸困难、格拉斯哥昏迷评分=6、瘀点）。第一例患者在7天后出现四肢瘫痪，第二例在6天后出现。脑部CT扫描未见病变。磁共振成像在T2加权像上显示相对高强度区域。三周时预后良好，无神经后遗症。
