术中暴发型脂肪栓塞综合征三例（Fulminant fat embolism syndrome in three cases）.doc

术中暴发型脂肪栓塞综合征三例（Fulminant fat embolism syndrome in three cases） Fulminant fat embolism syndrome in three cases Update Date: 2010-10-08, Zhou Dongsheng, Wang Bomin, Liu Shiming Fat embolism syndrome (FES) is rarely seen in operation, but it often results in rapid death of the patient and serious consequences. Our department has had 3 cases since 1970~1997, and now the possible predisposing factors, prevention and treatment methods and rescue experience are analyzed as follows. clinical data Case 1, male, 18. The middle part of right femoral shaft fracture was treated with open reduction and intramedullary nail fixation under epidural anesthesia 3 days after injury. Preoperative examination and examination showed no abnormalities, to the femoral bone marrow cavity into the intramedullary needle during operation, patients suddenly felt chest tightness, shortness of breath, and respiratory distress to stop breathing, consciousness is not clear. Then stop the operation, the ventilator support emergency tracheotomy, open chest cardiac massage, but in the end because of rapid progression, died. In the thoracotomy, the double lung syndrome showed red and white, and the pathological diagnosis was fulminant fat embolism syndrome. Case 2, male, 57. Right femoral neck fracture, down head type. Artificial femoral head replacement under epidural anesthesia 5 days after injury. Preoperative routine examination and examination showed no abnormality, the prosthesis was struck after bone cement, the patient suddenly felt chest tightness, shortness of breath, dyspnea, irritability, twitching limbs, stopped breathing, soon unconscious. Immediately supine patients, tracheal intubation assisted artificial respiration and chest massage, died after the rescue treatment. The clinical diagnosis of fulminant fat embolism syndrome. Case 3, female, 61. Left femoral neck fracture. Artificial femoral head replacement under epidural anesthesia 10 days after injury. Preoperative examinations were wi