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題 名 | Fat Embolism Syndrome: A Case Report and Review of Literature=脂肪栓塞症候群--病例報告及文獻回顧 |
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作 者 | 林重光; 楊世平; 李錫詢; | 書刊名 | Acta Cardiologica Sinica |
卷 期 | 15:1 1999.01[民88.01] |
頁 次 | 頁33-38 |
分類號 | 415.38 |
關鍵詞 | 脂肪栓塞; 脂肪栓塞症候群; 骨折; 三酸甘油; 類固醇; Fat embolism; Fat embolism syndrome; Fracture; Lipids; Corticosteroid; |
語 文 | 英文(English) |
中文摘要 | 我們提出一個因多處長骨骨折而產生脂肪栓塞症候群的案例並做文獻回顧。一名19歲正常年輕女性,因車禍造成多處長骨骨折而住院。起初,病人除骨折外無其他傷害。但12小時後,低血氧,肺浸潤,意識狀態改變,及休克等快速進展。心電圖,心臟超音波檢查,以及肺動脈順流導管的血行動力學結果均顯示急性肺栓塞的表象。基於病人的臨床表現和從發生車禍到產生這些臨床表現之間的時間差,我們診斷病人發生了脂肪栓塞症候群。第三天時,病人的前胸及腋下出現了出血點。不幸地,雖經積極處置,病人仍因綠膿桿菌肺炎而過世。要即時正確地診斷脂肪栓塞症候群,必須對主要三病徵(肺,腦,出血點)及從受傷到出現症狀的約12到24小時時間差有所瞭解,並對長骨骨折的病人保持高度的警覺心。以藉由現代的加護病房照顧,使病人得以存活而無後遺症。 |
英文摘要 | Here we presented a case of long bone fractures who developed fat embolism syndrome shortly after hospitalization with fatal outcome. A literature review about fat embolism syndrome was summarized. A 19-year-old girl was admitted due to uncomplicated multiple long bone fractures suffered in a car accident. She shortly developed hypoxemia, consciousness change and shock 12 hours after hospitalization. Her serial electrocardiograhic and echocardiographic findings as well as hemodynamic profiles obtained from right heart catheterization were all consistent with a diagnosis of acute pulmonary embolism. The cause of pulmonary embolism was attributed to fat after considering her underlying disease, clinical course, response to treatment, cutaneous and urinary findings, and neurologic and pulmonary disorders. However, the patient expired on a account of pseudomonas pneumonia after a two-week hospitalization. Prompt diagnosis of fat embolism syndrome is dependent on clinician's alertness to this potential complication in patients with bone fracture who presented with unexplained dyspnea and hypoxemia. With current intensive care unit facilities as well as the full understanding of the disease pathophysiology, most patients may survive without sequelae. |
本系統中英文摘要資訊取自各篇刊載內容。