| 脂肪栓塞综合征的临床表现及影像诊断分析 |
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投稿时间：2023-04-10
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| 作者 | Author | 单位 | Address | E-Mail |
| 但倩 |
DAN Qian |
四川省骨科医院医学影像科, 四川 成都 610041 |
Department of Medical Imaging, Sichuan Orthopaedics Hospital, Chengdu 610041, Sichuan, China |
8687919@qq.com |
| 吴海燕 |
WU Hai-yan |
四川省骨科医院医学影像科, 四川 成都 610041 |
Department of Medical Imaging, Sichuan Orthopaedics Hospital, Chengdu 610041, Sichuan, China |
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| 黄昀桀 |
HUANG Yun-jie |
四川省骨科医院医学影像科, 四川 成都 610041 |
Department of Medical Imaging, Sichuan Orthopaedics Hospital, Chengdu 610041, Sichuan, China |
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| 罗飞 |
LUO Fei |
四川省骨科医院医学影像科, 四川 成都 610041 |
Department of Medical Imaging, Sichuan Orthopaedics Hospital, Chengdu 610041, Sichuan, China |
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| 李旭雪 |
LI Xu-xue |
四川省骨科医院医学影像科, 四川 成都 610041 |
Department of Medical Imaging, Sichuan Orthopaedics Hospital, Chengdu 610041, Sichuan, China |
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| 期刊信息：《中国骨伤》2024年，第37卷，第3期，第306-310页 |
| DOI：10.12200/j.issn.1003-0034.20221304 |
| 基金项目:四川省干部保健科科研课题项目(编号:川干研2021-608) |
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中文摘要:
目的:探讨脂肪栓塞综合征患者的临床及影像学表现特点。
方法:自2021年1月至2022年10月回顾性分析13例因骨折或骨科手术发生脂肪栓塞患者的临床表现,其中男11例,女2例;年龄17~60岁。入院后或术后发生精神及呼吸异常、生命体征改变,患者胸部、颅脑影像检查结果异常,对患者的精神及呼吸异常、生命体征、胸部及颅脑影像结果进行连续监测。
结果:主要临床表现肺呼吸异常13例、中枢神经功能异常7例、斑点皮疹2例,胸部CT结果表现为弥漫性分布的磨玻璃影13例,严重时表现为"暴风雪"征;9例磨玻璃样融合实变;5例可见多发结节影;4例伴有双侧胸腔积液。5例头颅CT表现为阴性,1例头颅MRI表现为基底节区、放射冠、半卵圆中心、丘脑及额顶叶皮层及皮层下多发T1WI低信号,T2WI高信号影,DWI高信号影,表现为"星空征"。
结论:脂肪栓塞综合征致死率高,呼吸系统及神经系统的临床表现没有特异性,皮肤斑点皮疹具有特征性表现;"暴风雪"征是脂肪栓塞胸部X线及CT检查的特异性表现,"星空征"是脂肪栓塞颅脑MRI检查弥散加权序列的典型表现。 |
| 【关键词】脂肪栓塞综合征 临床表现 影像学 |
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| Clinical manifestation and imaging diagnostic analysis of fat embolism syndrome |
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ABSTRACT
Objective To explore characteristics of clinical and imaging findings in patients with fat embolism syndrome.
Methods From January 2021 to October 2022,clinical manifestations of 13 patients with fat embolism due to fracture or orthopaedic surgery were retrospectively analyzed,including 11 males and 2 females,aged from 17 to 60 years old. Mental and respiratory abnormalities and changes in vital signs occurred after admission or after surgery,and patient's chest and brain imaging results were abnormal. The patient's mental and respiratory abnormalities,vital signs,chest and brain imaging results were continuously monitored.
Results The main clinical manifestations of fat embolism syndrome were abnormal pulmonary respiration in 13 patients,abnormal central nervous function in 7 patients,and spotted rash in 2 patients. Chest CT showed diffuse distribution of ground glass shadows in 13 patients,and severe symptoms were "snowstorm". Nine patients with ground glass fusion consolidation,5 patients with multiple nodules and 4 patients accompanied by bilateral pleural effusion. Head CT findings of 5 patients were negative,and head MRI findings of 1 patient showed multiple T1WI low signal,T2WI high signal shadow,DWI high signal shadow,and "starry sky sign" in basal ganglia,radiative crown,hemioval center,thalamus,frontal parietal cortex and subcortex.
Conclusion Fat embolism syndrome has a high mortality rate. Clinical manifestations of respiratory system and nervous system are not specific,and the skin spot rash has a characteristic manifestation. The "blizzard" sign is the specific manifestation of chest X-ray and CT examination of fat embolism,and the "starry sky" sign is the typical manifestation of diffusion-weighted sequence of brain MRI examination of fat embolism. |
| KEY WORDS Fat embolism syndrome Clinical manifestation Imaging |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 但倩,吴海燕,黄昀桀,罗飞,李旭雪.脂肪栓塞综合征的临床表现及影像诊断分析[J].中国骨伤,2024,37(3):306~310 |
| 英文格式: | DAN Qian,WU Hai-yan,HUANG Yun-jie,LUO Fei,LI Xu-xue.Clinical manifestation and imaging diagnostic analysis of fat embolism syndrome[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(3):306~310 |
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