12例脂肪栓塞综合征的临床诊疗分析
Clinical analysis of 12 cases fat embolism syndrome diagnosis and treatment
投稿时间:2018-11-19  
DOI:10.11724/jdmu.2019.01.11
中文关键词:  脂肪栓塞综合征  临床特点  诊断  疗效
英文关键词:pancreatic fistula  risk factors  clinical observation  nomogram
基金项目:
作者单位
隋 怡 大连医科大学附属第二医院 重症医学科辽宁 大连 116027 
王晓曼 大连医科大学附属第二医院 重症医学科辽宁 大连 116028 
于 健 大连医科大学附属第二医院 重症医学科辽宁 大连 116029 
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中文摘要:
      探讨脂肪栓塞综合征(FES)的临床特点、诊断、治疗方法及疗效。 方法 回顾性分析2007年1月至2017年12月大连医科大学附属第二医院诊治的12例脂肪栓塞综合征患者临床资料。其中骨折10例,高处坠落伤1例,挤压伤1例。3例患者首发症状为呼吸困难,1例为意识障碍,8例同时出现呼吸困难及意识障碍。12例患者均经实验室和影像学检查确诊,并给予综合治疗。 结果 12例中7例症状较轻,对症处理后缓解。5例重症患者中4例予气管插管,1例予无创机械通气治疗,且5例均给予甲泼尼龙及白蛋白静点。经综合治疗后,11例治愈,1例死亡,治愈率91.7%。 结论 FES的病因多为创伤或骨折,临床表现形式复杂,早期易被误诊,严密监测患者临床症状,早期诊断并给予有效的综合治疗,对于重症患者可予糖皮质激素及白蛋白治疗。
英文摘要:
      To develop a nomogram predicting the risk of pancreatic fistula (PF) in individual cases and to facilitate clinical frontline staff to predict risk of PF. Methods This study was based on the statistical analysis of the patients who were diagnosed as pancreatic diseases and underwent pancreatic resection in our hospital between 2000 and 2018.Patients were divided into two groups including PF group or non-PF (NPF) group. Risk factors of PF were determined by Logistic regression analysis. A PF risk nomogram was built by R soft.Results Age, gender, malignancy, operation time, method of surgical anastomosis, amylase level of the first day drainage after surgery were independent risk factors. The OR values were 3.8878,3.277,12.822,7.900,0.034 and 0.346, respectively (P<0.05). The C-index of nomogram was 0.758. Conclusion We have developed a nomogram to predict the risk of PF with high consistency, which could be used in disease diagnosis.
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