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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Is Serum Lactic Acid a Reliable Indicator for Diagnosing Fat Embolism Syndrome?
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Is Serum Lactic Acid a Reliable Indicator for Diagnosing Fat Embolism Syndrome?

机译：血清乳酸是否是诊断脂肪栓塞综合症的可靠指标？

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The incidence of Fat Embolism Syndrome (FES) has been reported to occur in 0.5 to 3% of patients with isolated long bone fracture. FES is most commonly associated with long bone fractures, if associated with polytrauma then the chance of manifestation increases by 11%. Fat embolism is a clinical entity diagnosed mainly by Gurd?s criteria which includes clinical signs and blood parameters. There is no single blood parameter to detect FES at earliest. A high lactate level is an early sign of tissue hypoxia. In patients with femur shaft fracture tissue hypoxia is the most important cause of increased lactate levels. Increased blood lactate level is related to increased mortality.Aim: To establish the relationship between serum lactic acid and fat embolism in patients with fracture shaft of the femur.Materials and Methods: The present was a prospective study done at Kasturba Medical College Hospitals, Mangalore, Karnataka, India, on 40 patients with femur shaft fracture. Statistical analysis was done using SPSS (version 17.0).Results: In the present study, four patients out of 40 had FES (Gurd?s criteria), whose serum lactic acid was high (>25) within 72 hours of injury. Fourteen patients had elevated lactic acid (>20) but did not develop FES. All patients with FES had elevated serum lactic acid which was statistically significant (p-value 0.003), yet serum lactic acid estimation was less sensitive 28.7%.Conclusion: In conclusion serum lactic acid is specific (100%) for fat embolism but not sensitive (28.7%). By using serum lactic acid level, development of fat embolism can?t be predicted however, elevated lactic acid level will help us in risk stratification.
机译：据报道，脂肪栓塞综合症（FES）的发生率在0.5％至3％的孤立性长骨骨折患者中。 FES最常与长骨骨折相关，如果与多发性创伤相关，则表现机会增加11％。脂肪栓塞是主要由葛德（Gurd）标准诊断的临床实体，其中包括临床体征和血液参数。没有最早可以检测FES的单一血液参数。高乳酸水平是组织缺氧的早期迹象。在股骨干骨折患者中，组织缺氧是乳酸水平升高的最重要原因。血液中乳酸水平的升高与死亡率的升高有关。目的：建立股骨干骨折患者血清乳酸与脂肪栓塞的关系。材料与方法：目前是一项前瞻性研究印度卡纳塔克邦芒格洛的Kasturba医学院医院治疗40例股骨干骨折患者。使用SPSS（版本17.0）进行统计分析。结果：在本研究中，40名患者中有4名患有FES（葛氏标准），受伤72小时内血清乳酸含量高（> 25） 。 14名患者的乳酸升高（> 20），但未发展为FES。所有FES患者的血清乳酸升高均具有统计学意义（p值0.003），但血清乳酸评估的敏感性较低，为28.7％。结论：结论血清乳酸对脂肪栓塞具有特异性（100％）。但不敏感（28.7％）。通过使用血清乳酸水平，无法预测脂肪栓塞的发生，但是，升高的乳酸水平将有助于我们进行风险分层。

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