低分子右旋糖酐加地塞米松预防脂肪栓塞综合征的临床研究

Clinical Study of Prevention of Fat Embolism Syndrome with Dextran 40 and Dexamethasone in Patients with Fractures

目的:探讨在伴骨折的高危病人中药物预防脂肪栓塞综合征(FES)的疗效。方法:采取回顾性分析的方法,根据预防方法的不同,将损伤严重度评分(ISS)>16的1481例骨折病人分为四组:低分子右旋糖酐加地塞米松组、低分子右旋糖酐组、地塞米松组及空白组,观察ISS、FES发病率及死亡例数,然后进行两两对比分析。结果:共发生13例FES,死亡2例,各组ISS差异无显著性(P>0.05);联用组FES发病率仅0.30％,明显低于其它各组,且其差异均具显著性意义(P<0.05);而其它各组问差异无显著性(P>0.05)。结论:低分子右旋糖酐加地塞米松能有效地预防高危病人FES发生。

Objective To evaluate the preventive effect of medication on fat embolism syndrome(FES) in high-risk patients with fractures. Methods The clinical data were analysed retrospectively. One thousand four hundred and eighty-one patients with fractures,whose injury severity score (ISS) was more than 16, were divided into four groups, i. e. combination of dextran 40 and dexamethasone,dextran 40,dexamethasone,and blank (no special measure was taken)groups. FES incidence and mortality in all the groups were observed and compaired with each ather. Results There were 13 patients with FES altogether, in whom 2 cases died. There was insignificant difference in the ISS among the four groups(P>0. 05). FES incidence in the combination group, which was lower significantly than those in the other groups (P<0.05), was 0.30 % . There was insignificant difference in FES incidence amoug the other groups(P >0.05). Conclusion There is prophylactic value of dextran 40 treatment combining with dexamethasone to FES in the high梤isk patients with fratures.