股骨干骨折并发脂肪栓塞综合征的诊断与治疗

Diagnosis and treatment of fat embolism syndrome caused by femoral shaft fracture

目的 探讨股骨干骨折后脂肪栓塞综合征（ＦＥＳ）的诊断与治疗方法。方法１９８９～１９９８年收治的股骨干骨折病人２１２例，对并发ＦＥＳ的８例病人的临床表现、治疗方法与结果进行描述。结果１８４例单股骨骨折病人发生ＦＥＳ４例，２８例双股骨骨折病人发生ＦＥＳ４例，发生率分别为２．２％和１６．７％，Ｐ＜０．０５。结论ＦＥＳ更好发于双股骨骨折病人；骨折的早期开放复位固定可降低ＦＥＳ的发生率，而骨折髓内针固定有增加ＦＥＳ发生的危险；呼吸支持和循环维持是治疗ＦＥＳ的关键，早期大剂量激素应用有肯定的治疗效果。

Objective To discuss diagnosis and treatment methods of the fat embolism syndrome(FES)after the femur fractures. Methods From 1989 to 1998,212 cases of the patients with femur fractures were divided into two groups(the group of single femur fracture and double femur fractures) .The clinical manifestation,treatment methods and results of 8 cases with FES were described. Results The incidence of FES in two groups was 2.2% and 16.7% respectively(P < 0.05). Conclusion The incidence of FES in patients with double femur fractures is higher. It may decrease when early open reduction and fixation of femur fractures are performed, but it may raise when an intramedullary nailing technique is used. The crux of treatment is to support the pulmonary and cardiac function. Early large dosage of steroids is effective.