最後更新:2026年10月1日
長骨骨折或骨科手術後脂肪微粒進入血流,栓塞肺臟及其他器官。引起呼吸窘迫及神經症狀。
Feline emergencies frequently include urethral obstruction (FIC/FLUTD in male cats), ATE, dyspnea (CHF, asthma, pleural effusion), and trauma (high-rise syndrome). Cats are adept at masking pain — subtle changes in behavior may indicate severe distress.
Common canine emergencies include GDV, urethral obstruction, anaphylaxis, heatstroke, and vehicular trauma. Triage using a modified Glasgow Coma Scale (for head trauma) or shock index guides initial stabilization. FAST ultrasound is rapid and non-invasive for detecting free fluid.
這頁有幾個欄位是同系統共用的模板,還沒針對本疾病單獨改寫過。請以臨床判斷為準,記得對照下方文獻。
脂肪栓塞症候群(FES)急救處置: 1. **快速識別**:Gurd's triad — 呼吸困難(hypoxemia + ARDS pattern)、神經學變化(意識、癲癇)、petechial rash(腋窩 / 軀幹 / 眼結膜);長骨骨折後 24-72 hr 為典型發生時窗 2. **建立 IV 通路**:14-18 gauge × 1-2 條;抽血(CBC / 血氣 / 凝血 / lipase / lactate) 3. **氧氣支持**:100% O2;SpO2 < 92% 或 PaO2 < 60 → intubation + PPV;考慮 PEEP 5-10 cmH2O 改善 ARDS 4. **晶體液維持**:避免過度復甦(增加肺水腫);目標 MAP > 65 + 尿量 > 1 mL/kg/h 5. **支持療法**(無特異解毒):類固醇 methylprednisolone 1-2 mg/kg IV q12h × 24-48h(爭議但部分研究支持);抗血小板(heparin 低劑量爭議性) 6. **持續監測 72-96h**:呼吸 / 神經學 / ECG(右心衰竭徵象)/ 凝血(DIC 風險) ⚠️ **禁忌**: - **過度晶體液復甦** — 加重肺水腫與 ARDS - **長骨手術延遲固定** — 超過 24-48 hr 顯著升高 FES 風險,應早期固定 - **單獨用 anticoagulant 治療** — 證據不足且出血風險
建議:Shock dose crystalloid 20-30 mL/kg IV bolus(犬),10-15 mL/kg(貓),評估反應後調整
速率:20-30 mL/kg
監測頻率:q2-4h
[1]Can IL-6 predict the development of fat embolism in polytrauma? A rabbit model pilot experimental study.
[2]Ursodeoxycholic acid protects against lung injury induced by fat embolism syndrome.
[3]The Protective Roles of Urinary Trypsin Inhibitor in Brain Injury Following Fat Embolism Syndrome in a Rat Model.
[4]Correlation between the time elapsed after liposuction and the risk of fat embolism: An animal model.
[5]Effects of the ALX/FPR2 receptors of lipoxin A4 on lung injury induced by fat embolism syndrome in rats.
可在數分鐘至數小時內致死,需立即穩定生命徵象 (life-threatening, requires immediate stabilization)
飼主衛教
用藥指引
⚠ 警訊症狀(立即回診)
環境調整
長期計畫:依根本病因制定長期計畫
限制活動
穩定後漸進恢復活動
期間:依病因
預後不良,死亡率可達10-20%。無特異性治療。
脂肪栓塞症候群 診斷流程
詳細問診包括發病經過、用藥史、飲食與環境
CBC、生化全套、尿液分析
來源:自動產生