摘要
目的：探讨氢化可的松对脂肪栓塞综合征（ＦＥＳ）血液流变学、氧分压（ＰａＯ２）以及预后的影响。方法：实验动物随机分成对照、治疗和未治疗三组。治疗和未治疗组采用油酸静脉注射诱发ＦＥＳ，治疗组接受氢化可的松治疗。观察三组动物死亡率、病理改变、ＰａＯ２、血小板、纤维蛋白原及血液流变学等指标。结果：未治疗组血粘因素明显升高，伴血小板计数下降和纤维蛋白原含量增高；治疗组死亡率（６．６％）明显低于未治疗组（４０％），治疗组ＰａＯ２明显升高但未恢复至正常水平，病理改变明显减轻，血粘因素、血小板计数和纤维蛋白原含量均恢复正常。结论：ＦＥＳ血液多呈高粘滞状态，氢化可的松降低其血液粘滞度的作用机理与其降低纤维蛋白原含量和阻止血小板聚集有关；氢化可的松可提高ＦＥＳ的ＰａＯ２，并明显改善ＦＥＳ预后。
Objective: To study the effect of hydrocortisone on hemorheology, PaO 2 and prognosis of fat embolism syndrome (FES) . Methods:The experimental rabbits were divided into 3 groups: normal control,treated and untreated. FES in the treated and untreated groups was induced by intravenous oleic acid and the treated group received hydrocortisone therapy .Mortality rate, PaO 2 ,platelet counts, fibrinogen concentration and hemorheology index were observed in the 3 groups.Results: It was found that blood viscosity, fibrinogen concentration increased and platelet counts decreased significantly in the untreated.The mortality rate(6.6% ) in the treated group was lower than that(40% ) in the untreated. PaO 2 in the treated increased, but it didn't reach normal level. Blood viscosity, fibrinogen concentration and platelet counts were kept normal in the treated. Conclusion: Hyperviscosity was of ten observed in FES. The mechanism of hydrocortisone reducing blood viscosity in FES was relative to both the decrease of fibrinogen concentration and the prevention of platelet from aggregation. Hydrocortison can obviously raise PaO 2 and improve the prognosis of FES, but it must be used early with effective respiratory supporting measures .
出处
《中华骨科杂志》
CAS
CSCD
北大核心
1998年第9期551-554,I004,共5页
Chinese Journal of Orthopaedics
