多发性骨折早期预防脂肪栓塞综合征的体会

摘要

Objective To evaluate early prevention of fat embolism syndrome(FES)in patients with multiple fractures. Methods The clinical data of 125 patients with multiple fractures were collected. Based on the damage control strategy, limited fixation of multiple fractures were used combined with dex-tran 40 and dexamethasone to prevent FES. Results There were 7 patients with FES altogether. After symptomatic treatment,6 patients were stable and underwent decisive surgery 10 ~ 15d after injury;1 case died due to fat embolism,which was confirmed by autopsy. Conclusion For multiple fractures patients,it is effective to apply limited fixation combined with dextran 40 and dexamethasone treatment for early FES prevention under the damage control strategy.%目的 探讨早期预防多发性骨折患者发生脂肪栓塞综合征的方法.方法 遵循损伤控制理论,对125例多发性骨折患者早期有限固定多发骨折,应用低分子右旋糖酐加地塞米松预防脂肪栓塞综合征.结果 本组共发生7例脂肪栓塞综合征,经对症处理后,6例患者全身情况稳定,伤后10～15 d行确定性手术治疗,l例患者死亡,尸检证实为脂肪栓塞.结论 对于多发性骨折患者,运用损伤控制理论,有限固定骨折,应用低右联合地塞米松是有效预防脂肪栓塞综合征的方法.