- 期刊
股骨骨折造成肺部脂肪栓塞－病例報告
Pulmonary Fat Embolism Syndrome after Femoral Fracture: A Case Report
摘要
脂肪栓塞症候群（Fat embolism syndrome）是一種罕見且困難診斷的病症，最常出現在長骨骨折的病人，可侵犯身體多處器官造成傷害，尤其是肺部。致病機轉目前認為主要包括機械理論與生化理論，造成發炎反應，容易出現成人呼吸窘迫症（adult respiratory distress syndrome: ARDS）。臨床表現有意識紊亂、瞻妄、嗜睡、頭暈、疲累、呼吸困難、喘息、心搏過速，皮膚則是出現紫斑，也會有發燒，視力模糊等症狀。儘早固定骨折處可降低脂肪栓塞發生的機會，減少脂肪從骨髓腔釋出進入微血管系統。類固醇的使用被認為可能有所幫助，可降低游離脂肪酸，穩定細胞膜，抑制發炎反應。最終被證實有效的治療方式是支持療法，尤其是氧氣的供給及體液的補充。必須提高警覺，防止延遲治療造成器官的永久損壞。
並列摘要
Frequently occurs after a long bone fracture and affects multiple organs, fat embolism syndrome (FES) is rare and difficult to diagnose. The primary pathophysiology of FES includes the mechanical and biochemical actions that cause inflammation and the susceptibility of adult respiratory distress syndrome. The FES clinical presentations include confusion, delirium, drowsiness, dizziness, tiredness, breathing difficulty, breather, tachycardia, cutaneous purpura, fever, and blurred vision. Early fixation of the fractured bone can reduce the FES incidence and release of fat from the bone marrow cavity to microcirculation. Corticosteroid is thought to help reduce the free fatty acids, stabilize the cell membrane, and inhibit the inflammation response. Supportive treatment is currently proven effective, especially the oxygen and fluid supplements. Alerts are advised to prevent permanent organ damages caused by delayed treatments.