胃癌手术中并发肺脂肪栓塞综合征死亡1例并文献复习

Stomach cancer surgery died of pulmonary fat embolism syndrome,one case report and literature review

目的探讨脂肪栓塞综合征(FES)患者临床表现及原因。方法报道胃癌手术中并发肺脂肪栓塞综合征死亡病例,阅读国内外已发表的文章,并进行归纳整理。结果 1例胃癌患者在手术中发生死亡,尸检发现散在肺泡壁毛细血管内可见脂肪空泡。苏丹Ⅲ染色,毛细血管内可见染成桔红色脂滴。结论 FES主要发生在骨折及创伤患者,腹部手术中发生少见,手术中轻柔操作可能是预防的关键。

Objective To explore the clinical manifestations and reasons of the fat embolism syndrome patients.Methods Report one case which died of stomach cancer surgery with fat embolism syndrome.Review the published articles and synthesize them.Results 1 case of stomach cancer patient died during the operation.autopsy found diffuse fat empty bubble in the liver cells,Empty bubble dyed orange with Sudan Ⅲ dyeing.Fat empty bubble scattered in the lung cell walls capillary,and dyed orange lipid drops with Sudan Ⅲ dyeing.Conclusion The fat embolism syndrome occurs mainly in the fractures and trauma patients,abdominal surgery occurs rare,soft operation is the key to prevent this occurence.