低温治疗急性脑梗死-第三军医大学学报.DOCVIP

四肢骨折并发脂肪栓塞综合征病人的早期临床诊治 马威 刘军 黄雪莲 黄涛 【摘要】 目的 探讨四肢骨折并发病人的早期临床诊治策略 方法 回顾性分析我科2005年3月至2010年9月收治的7例经确诊为四肢骨骨折并发病例的临床资料，对之早期诊断及治疗措施进行归纳、总结。 结果 本组7例病例中有4例为双侧股骨骨折，1例为股骨骨折并骨盘骨折，2例为单纯股骨骨折，5例为闭合性骨折，病程中合并休克4例。经治疗后7例患者中死亡1例，余6例患者临床症状体征均得到改善，骨折按期愈合，功能恢复满，生活可自理，随访3年无死亡病例。 结论 早期诊断治疗可降低四肢骨折并发病人的病死率和致残率，改善患者预后，其中，筛选高危患者（包括双侧长骨骨折、病程中合并休克、闭合性骨折等）并随之加强病情观察，及早诊断并采取早期综合治疗是四肢骨折并发病人的合理临床救治策略。 【关键词】四肢骨折，诊断，治疗，早期 The early diagnosis and treatment for patients with limb fracture complicating with fat embolism syndrome 【Abstract】 Objective To discuss the early diagnosis and treatment for patients with limb fracture complicating with fat embolism syndrome. Methods Retrospectively reviewed clinical data of 7 patients with limb fracture complicating with fat embolism syndrome in our departments from 2005-3~2010-9. The early diagnosis and therapeutic measure were induced and summarized in this study. Result In this Investigate，4 cases went with bilateral femoral fractures, 1 case with femoral fractures coupling with pelvis fractures, and 2 cases with pure femoral fractures. Among those patients, 5 cases encountered closed fractures and 4 cases incured shock in the pathogenesis. After treatement , 1 patient was dead, and the other patients’ clinical symptoms and signs were improved with fracture healing on time and satisfied unctional rehabilitation After following up for 3 years, the 6 cases were self-supporting and with no dead case. Conclusion Early diagnosis and treatment could reduce the morbidity and mortality of patients with limb fracture complicating with fat embolism syndrome, among which, high risk patients’screening(bilateral femoral fractures, incuring shock in the pathogenesis, closed fractures, ect.), intensive ob servation of patients condition and early diagnosis together with combined modality therapy was the reasonable policy for the clinical remedy for patients with limb fracture complicating with fat embolism syndrome. 【Keyword】 limb fracture, fat embolism sy