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題 名 | 脂肪栓塞症候群--病例報告=Fat Embolism Syndrome--A Case Report |
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作 者 | 蔡子禾; 陽光耀; 秦凌霄; 蔡俊明; 彭瑞鵬; | 書刊名 | 胸腔醫學 |
卷 期 | 12:4 1997.12[民86.12] |
頁 次 | 頁167-173 |
分類號 | 415.38 |
關鍵詞 | 脂肪栓塞症候群; Fat embolism syndrome; |
語 文 | 中文(Chinese) |
中文摘要 | 脂肪栓塞症候群為一少見之骨折後的併發症;其常見的臨床表現為低血氧,意識不清及前胸壁紫斑;而病理發現則証實其為骨折後之骨髓脂肪顆粒經由體循環到達肺循環,腦部,腎臟以及心肌等處;進而造成組織損傷的疾病。本病例報告一位十六歲多發性骨折患者,在送醫十二小時後,突然產生呼吸困難及意識障礙的現象;經臨床症狀及頭部電腦斷層掃瞄,証實為脂肪栓塞症候群。於是接受靜脈內肝素注射及正壓呼吸器合併吐氣末期陽壓等支持性療法,之後病情明顯進步於入院後二十一天脫離呼吸器,並且意識逐漸恢復中,目前出院在門診追蹤治療。由過去的文獻報告,多發性骨折合併脂肪栓塞症候群時,死亡率可高達 5-10%;而本病例經由早期診斷,早期給予適切之治療,以致能避免其他併發症及死亡之威脅。故特別提出此一病例及回顧以往文獻研究以供大家參考。 |
英文摘要 | Fat embolism is an uncommon condition that often complicates a long bone fracture. The usual clinical manifestations are hypoxemia, neurologic dysfunction and cutaneous petechiae of anterior chest Wall. The pathologic basis is proven to be dislodgment of fat particles from bone marrow, mostly after fractue, which is carried by the systemic circulation to the pulmonary, cranial, renal and myocardial vascular beds where they cause tissue damage. We report a young female patient who incurred multiple bone fracture after a traffic accident. After 12 hours of hospitalization, acute respiratory insufficiency with conscious disturbance developed, accompanied by severe hypoxemia with petechiae of anterior chest wall. Under the diagnosis of fat embolism syndrome, supportive treatment with intravenous heparin and mechanical ventilation with PEEP were prescribed. Later, her condition improved and consciousness recovered. Review of medical literature reveal the mortality rate of multiple bone fracture with fat embolism to be around 5 to 10%. If early diagnosis could be made and immediately aggressive treatment given, severe complication, such as the acute respiratory distress syndrome, can be avoided and can lead to a better prognosis. |
本系統中英文摘要資訊取自各篇刊載內容。