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例1:患者女性,31岁。因反复咯血8年,咯血量增多4天,诊为支气管扩张咯血于1989年10月2日入院。否认结核、癫痫病史。体检:T36℃,P80次/分,R16次/分,BP13/8kPa。神志清,两肺呼吸音粗,左肺背部闻及少量湿罗音,心率80次/分,律齐,未闻杂音。腹平软,肝脾肋下未及,全腹无压痛。实验室检查:血Hb104g/L,WBC4.0×10~9/L,N0.74,L0.26,血小板数89×10~9/L,ESR17mm/h,肝功能、肾功能均在正常范围,胸片示两肺纹理增粗,心影无扩大,心电图示窦性心律。入院后经抗感染及止血治疗。用垂体后叶素15u加入5％葡萄糖500ml静滴,每分15滴,疗程1周。10月9日患者突然精神异常,哭闹不停,反应迟钝,继而神志不清,大小便失禁。两瞳孔对称等大0.25cm,两眼凝视,颈软,两上肢肌力V级,左下肢肌力Ⅲ级,右下肢肌力Ⅱ级,右侧巴彬斯基征阳性,脑电图示轻度异常;脑脊液检查:压力200mmH_2O,色清,潘氏试验阴性,蛋白0.32g/L,红细胞1×10~6/L,白细胞2×10~6/L,氯化物102mmol/L,糖4.2mmol/L。停用垂体后叶素,经用肾上腺皮质激素、甘露醇、胞二磷胆碱治疗,15天后神志转清,但仍失语,四肢肌力恢复至Ⅲ级,住院35天出院。
Example 1: Female patient, 31 years old. Because of repeated hemoptysis for 8 years, increased hemoptysis volume 4 days, diagnosed with bronchiectasis hemoptysis admitted on October 2, 1989. Denied tuberculosis, history of epilepsy. Physical examination: T36 ℃, P80 beats / min, R16 beats / min, BP13 / 8kPa. Consciousness, coarse breath sounds of both lungs, the back of the left lung smell and a small amount of wet rales, heart rate 80 beats / min, Law Qi, no unheard noise. Abdomen soft, liver and spleen ribs, the whole abdomen without tenderness. Laboratory tests: blood Hb104g / L, WBC4.0 × 10 ~ 9 / L, N0.74, L0.26, platelet count 89 × 10 ~ 9 / L, ESR17mm / h, liver function, renal function were in the normal range , Chest X-ray showed thickening of the lungs, no expansion of heart shadow, ECG showed sinus rhythm. After admission by anti-infection and hemostasis. Pituitrin 15u added 5% glucose 500ml intravenous infusion, 15 drops per minute, treatment for 1 week. October 9 sudden mental abnormalities, crying non-stop, unresponsive, and then unconscious, incontinence. Two pupil symmetry and other large 0.25cm, two staring, neck soft, two upper limb muscle strength V grade, left lower limb muscle strength Ⅲ grade, right lower extremity muscle strength Ⅱ grade, positive right Babinski sign positive, EEG light Degree of abnormalities; cerebrospinal fluid examination: pressure 200mmH_2O, color, Pan negative, protein 0.32g / L, red blood cells 1 × 10 ~ 6 / L, leukocytes 2 × 10 ~ 6 / L, chloride 102mmol / L, sugar 4.2mmol / L. Pituitrin was discontinued. After treatment with adrenocorticotropic hormone, mannitol and citicoline, consciousness was cleared after 15 days, but still aphasia. The muscle strength of the four limbs recovered to grade III, and was discharged 35 days after hospitalization.