汶川地震伤致脂肪栓塞综合征的早期诊断和治疗分析

The early diagnosis and treatment of fat embolism syndrome caused by the injuries in Wenchuan earthquake

目的探讨分析汶川地震伤致脂肪栓塞综合征（FES）的早期诊断标准和治疗措施。方法对在2008年5月12日发生的汶川大地震期间收治的13例脂肪栓塞综合征患者，行动态血气分析及血常规检查，结合临床表现，早期诊断，并使用氢化可的松、低分子右旋糖酐、丹参，同时强调支持呼吸功能，纠正低氧血症等进行早期治疗。结果13例患者之中12例抢救成功（92．30％）；1例爆发性FES死于继发出血性肺炎及呼吸衰竭。结论早期诊断及快速准确的处理是治疗FES的关键。呼吸功能支持，纠正低氧血症和早期大剂量激素等综合疗法是治疗FES的有效措施。

Objective To analysis and discuss the early diagnosis and treatment of fat embolism syndrome caused by the injuries in Wenchuan earthquake happened in May 12th,2008. Methods To carry out dynamic blood and oxygen analysis and blood routine examination for the 13 fat embolism syndrome patients wounded in the earthquake, and combine with clinical features and early diagnosis, inject hydrocortisone injection, dextran 40 glucose injection and Dan Shen Root injection. Meanwhile, pay attention to supporting the respiratory function and correcting hypoxemia. Results Of 13 patients, 12 cases were rescued successfully, and the successful rate was 92. 3% , while one cases died from respirometric failure with fat embolism syndrome and secondary hemorrhagic pneumonia. Conclusions The key to treating fat embolism syndrome is the early diagnosis and timely and accurate treatment. Supporting the respiratory function, correcting hypoxemia and early high-dose combination of hormone treatment are the effective treatment methods.