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脑脂肪栓塞的跨多普勒检测和与矛盾栓塞的关系:一个试点研究
Alejandro M Forteza1, Sebastian Koch, Iszet Campo-Bustillo
1Cardiac and Stroke Institute, Jackson Memorial Hospital, University of Miami Miller School of Medicine, FL, USA. aforteza@med.miami.edu
Circulation
|April 27, 2011
概括
脂肪栓塞综合征,长骨折后的神经问题是特征,与右向左的分流 (RLS) 有关. 跨骨多普勒检测微栓塞信号,预测RSS骨折患者的神经症状.
科学领域:
- 神经学 神经学
- 血管外科 血管外科
- 创伤外科 手术 创伤外科
背景情况:
- 脂肪栓塞综合征 (FES) 呈现出呼吸障碍,肺和神经功能障碍.
- FES主要与长骨折和骨髓脂肪的全身循环有关.
- 心脏内右向左的分流 (RLS) 可以促进更大的脂肪颗粒进入全身循环.
研究的目的:
- 调查骨骨架骨折患者中通过跨多普勒 (TCD) 检测到的RLS和微栓塞信号之间的关系.
- 评估RLS和微栓塞信号对FES神经症状发展的预测价值.
主要方法:
- 对42名骨骨折的患者进行前性研究.
- 使用心声回声和每日TCD与栓塞检测对RLS的评估.
- 神经学检查以评估FES症状.
主要成果:
- 在42名患者中,有14名患有检测到的RLS.
- 七名患者出现神经症状,所有患者的RLS阳性 (P<0.001).
- 患有RLS的患者显示显著更高的微血栓信号数量和强度 (P<0.05,P<0.01).
- 在RLS+患者中,高微血栓信号计数/强度强烈预测神经症状 (OR 204,P<0.001).
结论:
- 在长骨折患者中,RLS的存在与大脑微栓塞信号的增加和扩大有关.
- 在RLS+患者中检测微栓塞信号的跨骨多普勒检测可以预测神经症状的发展.
- 在长骨骨折后的神经性FES的发病过程中,RLS是关键因素.
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