股骨干骨折并发脂肪栓塞综合征的诊断与治疗

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。     

脂肪栓塞综合征早期诊断与治疗(附10例临床报告)

目的　总结脂肪栓塞综合征 (FES)早期诊断及治疗经验。方法　根据 1 0例 FES患者早期体征、临床表现及实验室检查改变 ,进行有效的治疗 ,并对结果进行评价。结果　 1 0例 FES均痊愈。结论　早期识别 FES是治疗的关键 ,对于 FES,防重于治     

脂肪栓塞综合征的预防与诊治

目的减少脂肪栓塞综合征（FES）的发生和提高其治愈率。方法对近10年来救治的28例FES进行回顾性分析。结果除2例暴发型患者病情凶险且未早期行高压氧治疗抢救无效死亡外，26例患者均临床治愈。结论只要在创伤救治中高度重视，注重预防，及时发现，早期综合治疗，尽早进行高压氧疗法，FES一般是可以治愈的。     

连续性静-静脉血液滤过在脂肪栓塞综合征治疗中的应用

到目前为止，对脂肪栓塞综合征（FES）所采取的各种治疗措施均为对症处理和支持疗法。我科自2002年2月-2005年3月应用连续性静-静脉血液滤过治疗FES患者8例，取得了满意疗效。现报告如下。     

大量成分输血抢救地震致多发伤1例

地震灾害中，许多伤员由于骨折和挤压引起大出血和休克，迅速及时的大量补液和输血治疗是维持生命的重要手段。但大量成分血液制品输注常会导致凝血功能紊乱，死亡率高达40％～75％。因此，应对拟进行大量成分输血治疗的伤员凝血功能进行及时、准确的评价。现将我院抢救1例地震多发伤伤员的情况报道如下。     

多发伤合并脂肪栓塞综合征的临床特点和诊治分析

目的分析多发伤患者脂肪栓塞综合征(FES)的临床特点,总结其诊治经验。方法收集2007年1月～2012年6月我科收治多发伤5 074例患者临床资料,有25例在创伤后继发FES。结合本组患者临床资料,分析其发病特点、诊断和治疗方法。结果 25例均为多发伤,损伤严重程度(ISS)≥16,FES发生率0.49%,脂肪栓塞症状伤后平均43.68h。所有患者给与积极有效的治疗措施,其中治愈12例,明显好转后转当地医院治疗7例,植物状态1例,放弃治疗1例,死亡4例,死亡率为16%。结论在多发伤中,FES发生率低但死亡率高,关键是对FES的早期诊断和及时处理创伤后长骨骨折。选择积极有效的综合治疗,改善创伤后FES患者的预后。     

脂肪栓塞综合征(综述)

脂肪栓塞综合征(Fat EmbolismSyndrome,简称FES)是以急性呼吸功能紊乱为特征的、伴有脑部或全身症状的临床综合病征,常发生于严重创伤病人,导致病     

和创伤有关的凝血问题

创伤和手术后凝血功能呈亢进状态，有利于局部的止血，这也是机体凝血系统对创伤和手术的应激反应．创伤和手术引起的凝血功能障碍，不外乎有两大类原因，一类是由于在治疗低容量性休克过程中，大量快速输液（包括晶体和胶体溶液），或输入大量的库存血或自体血，使凝血因子发生稀释性减少，造成所谓的稀释性凝血病（dilutional coagulopathy）。     

多发伤并脂肪栓塞综合征中长骨干骨折的手术方法与时机

脂肪栓塞综合征(fat embolism syndmme，FES)是创伤及长骨干骨折的严重并发症，也常并发于长骨干内固定术后。对多发伤伴长骨干骨折患者是否早期采取确定性治疗报道较多，而对已发生FES且长骨干骨折仅得到暂时固定治疗的多发伤患者，采取何种内固定方法、何时进行手术，尚未引起足够的重视。笔者自1990年1月至2003年1月以来，     

脂肪栓塞综合征诊治的临床研究进展

脂肪栓塞综合征(FES)多发生在创伤后和矫形手术过程中,典型特征为呼吸窘迫、神经系统改变和淤点皮疹.目前FES还没有统一的诊断标准和临床标准,诊断常基于症状和体征进行排除诊断,早期预防和早期诊断可能是FES的最佳治疗方法 .本文对FES发生率、发生机制、流行病学特点、临床表现、临床诊断、辅助检查和治疗及预防方面进行总结与探讨.     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.