脂肪栓塞症候群之診斷與護理

Fat Embolism Syndrome: Diagnosis and Nursing Care

脂肪栓塞症候群常見於骨科手術病患及創傷骨折病患，另外，非創傷性因素包括急性胰臟炎、嚴重燒傷、糖尿病等也會造成脂肪栓塞症候群的發生。脂肪栓塞症候群典型症狀會出現低血氧、呼吸窘迫甚至衰竭、大腦意識程度改變及皮下瘀斑，雖然罕見卻嚴重威脅到病患生命。對於發生脂肪栓塞症候群病患，目前診斷此症候群大多依據Gurd所提出之診斷要件標準，應立即給予積極治療，加強評估病患心肺功能和意識變化，及早給予骨折部位固定及手術、投予皮質類固醇藥物、維持病患良好呼吸功能，以期降低因脂肪栓塞症候群引發之死亡率。

Fat embolism syndrome occurred in patients receiving orthopaedics surgery and patients with traumatic fracture. Some non-traumatic conditions such as acute pancreatitis, severe burns, and diabetes mellitus, are also the factors for fat embolism syndrome. Fat embolism syndrome is rare but serious and could be fatal. The classical signs of fat embolism syndrome include hypoxemia, respiratory distress, neurological dysfunction and petechial rash. The diagnosis of fat embolism is mainly based on the Gurd’s criteria. Treatments of these patients included closely monitoring and maintaining the patients’ cardiovascular and respiratory function, early fixation and operation of fracture, and corticosteroids given to decrease the mortality rate.