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。

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

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.