骨创伤并发脂肪栓塞综合征损伤严重度预警参数探讨

目的：探讨骨创伤并发脂肪栓塞综合征（ FES）损伤严重度预警参数。方法采取回顾性分析方法，应用损伤严重度改良评分法（ RISS）对1993年1月～2009年11月收治的47例骨创伤并发FES患者进行定量评估，探讨其损伤严重度值域范围。结果全部病例RISS评分均在11分以上：单纯多发性骨创伤6例，RISS值位于11～18；伴有颅脑或胸腹腔内脏器损伤的多发性骨折患者有38例，RISS分值在18～25，3例分值＞25分。 FES发生与RISS分值呈正相关（P＜0.05）。结论骨创伤损伤严重度与FES发生之间具有相关性，当单纯多发性骨创伤患者RISS值≥11、伴有颅脑或胸腹腔内脏器损伤的多发性骨折RISS值≥18时，易发生骨创伤并发FES，应采取预防措施。

Prewarning parameters of injury severity score in fat embolism syndrome after bone trauma

Objective To explore the prewarning parameters of injury severity score in fat embolism syn-drome(FES) after bone trauma.Methods Quantitation study was employed to evaluate 47 cases of FES after bone trauma admitted in our hospital from Jan .1993 to Nov.2009 retrospectively with revised injury severity score ( RISS) and to explore the range of RISS .Results The RISS was over 11 in all cases .Of them,the RISS of 6 cases of sim-ple multiple fractures ranged from 11 to 18.Thirty-eight cases were from 18 to 25 and 3 cases were higher than 25 in patients with multiple fractures associated with craniocerebral or splanchnocoele injury .FES occurrence was positively correlated with the RISS(P<0.05).Conclusion An correlation exists between injury severity score of bone trauma and the development of FES .FES is likely to happen and precautions should be taken when the value of RISS is high-er than 11 in patients with simple multiple fractures ,or RISS value≥18 in patients with multiple fractures accompa-nied by traumatic brain injury or abdominal cavity organ damage .