Kroupa J
Urazová nemocnice, Brno.
Acta Chir Orthop Traumatol Cech. 1993;60(2):114-22.
Immediate high-standard provisions implemented as soon as possible after serious injuries with the aim to prevent the development of shock or to treat incipient and developing shock is one of the most important aspects of prophylaxis of the syndrome of traumatic fat embolism (FE). An important place is held by the rostoration of normal microcirculation, replacement of blood losses and the control of hypoxia, in particular by artificial pulmonary ventilation. A high caloric intake both by the parenteral and enteral route has among others the objective to prevent excessive development of lipolysis. Surgical operations with the exception of urgent ones which must not be delayed should be postponed till complete regression of clinical manifestations of traumatic shock. The group of comprehensive provisions comprises pharmacological provisions against traumatic shock and pharmacological participation in the prophylaxis of the FE syndrome: Lipostabil; Trasylol; heparin and other anticoagulants in small doses; hydrocortisone; dextrans, CaCl2 and possibly other effective substances or drugs in rational individually recommended doses and expedient combinations.
重伤后尽快实施立即高标准的措施,旨在预防休克的发展或治疗初期和发展中的休克,这是创伤性脂肪栓塞综合征(FE)预防的最重要方面之一。恢复正常微循环、补充失血以及控制缺氧(特别是通过人工肺通气)具有重要地位。通过肠外和肠内途径摄入高热量食物等目的之一是防止脂解过度发展。除了不能延迟的紧急手术外,其他手术应推迟到创伤性休克临床表现完全消退后进行。综合措施组包括抗创伤性休克的药理学措施以及药理学参与FE综合征的预防:力保肪宁;抑肽酶;小剂量肝素和其他抗凝剂;氢化可的松;右旋糖酐、氯化钙以及可能其他有效物质或药物,以合理的个体化推荐剂量和适宜组合使用。