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[药理学在创伤后脂肪栓塞综合预防中的作用]

[The role of pharmacology in the comprehensive prophylaxis of post-traumatic fat embolism].

作者信息

Kroupa J

机构信息

Urazová nemocnice, Brno.

出版信息

Acta Chir Orthop Traumatol Cech. 1993;60(2):114-22.

PMID:8342376
Abstract

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.

摘要

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。

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1
[The role of pharmacology in the comprehensive prophylaxis of post-traumatic fat embolism].[药理学在创伤后脂肪栓塞综合预防中的作用]
Acta Chir Orthop Traumatol Cech. 1993;60(2):114-22.
2
[Fundamentals of comprehensive prevention of the post-traumatic fat embolism syndrome].[创伤后脂肪栓塞综合征的综合预防基础]
Acta Chir Orthop Traumatol Cech. 1993;60(1):11-8.
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[Syndrome of post-traumatic fat embolism. Clinical study and presentation of 7 cases].[创伤后脂肪栓塞综合征。7例临床研究与报告]
Minerva Anestesiol. 1976 Oct;42(10):713-9.
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[Fat embolism in severe multiple injuries].[严重多发伤中的脂肪栓塞]
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[Fat embolism and proteinase inhibitors].[脂肪栓塞与蛋白酶抑制剂]
Med Welt. 1967 Sep 2;35:1997-2000.
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[Posttraumatic fat embolism. Clinical case contribution].[创伤后脂肪栓塞。临床病例报告]
Minerva Med. 1981 Jul 7;72(27):1799-816.
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[New aspects regarding prophylaxis and treatment of post-traumatic fat embolism. Part 2: Outline of guiding principles for the complex prophylaxis and treatment of fat embolism, based on the literature and personal empirical and experimental facts (author's transl)].创伤后脂肪栓塞预防与治疗的新进展。第2部分:基于文献以及个人经验和实验事实的脂肪栓塞综合预防与治疗指导原则概述(作者译)
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Sb Ved Pr Lek Fak Karlovy Univerzity Hradci Kralove. 1988;31(3):199-258.