关节置换术后精神及意识异常与不完全性脑型脂肪栓塞防治

摘要

Objective To investigate the spirit of joint replacement surgery in patients with abnormal contact between consciousness incomplete cerebral fat embolism, and analyzes its control measures.Methods A retrospective approach to the hospital from January 2010 to January 2013 20 cases of joint replacement surgery after incomplete cerebral fat embolism clinical data analysis, analysis of joint replacement surgery patients with abnormal mental awareness incomplete contact between cerebral fat embolisms.Results 20 patients in this group have to undergo a targeted therapy in the treatment of 24-72h after regaining consciousness of its symptoms , was discharged one year follow-up study , patients with neurological defects were normal , and NIHSS score was 0 , and treatment of pre- comparison with a signiifcant difference.Conclusion The clinical arthroplasty insecure cerebral fat embolism is one of the major causes of mental disorders of consciousness, in the clinic because it does not have the typical clinical presentation, it is prone to misdiagnosis. Strengthen postoperative MRI examination of the head; Thereby further clarify its inlfuencing factors, giving better targeted treatment.%目的：探讨关节置换手术后患者精神意识异常与不完全性脑型脂肪栓塞之间的联系,并分析其防治措施。方法采取回顾性的方法对广州市正骨医院2010年1月～2013年1月间20例关节置换手术后出现不完全性脑型脂肪栓塞的临床资料进行分析，分析关节置换手术后患者精神意识异常与不完全性脑型脂肪栓塞之间的联系。结果本组的20例患者均经过针对性的治疗，在治疗24～72h之后其意识恢复症状，出院随访观察1年，患者缺损神经功能均恢复正常，且NIHSS评分均为0，与治疗前比较具有明显的差异。结论临床中关节置换术后不安全型脑型脂肪栓塞是造成患者精神意识障碍的重要原因之一，在临床中由于其临床表现不具典型性，很容易出现漏诊和误诊。加强患者术后头部MRI的检查，从而进一步的明确其影响因素，更好的给予针对性的治疗。