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1病例患者老年女性,因“左手外伤10 d,张口困难、颈背部强直3 d”入院。入院查体:体温37℃,脉搏97次/min,呼吸23次/min,血压156/78 mm Hg,SPO2100%(鼻塞给氧5 L/min)。患者神志清楚,痛苦面容,双侧痛苦直径3 mm,对光反射存在,角弓反张,牙关紧闭,颈抵抗。两肺呼吸音清,未闻及明显干湿性啰音,心率97次/min,未闻及杂音。腹部平软,无压痛及反跳痛,双下肢无水肿,四肢肌力明显增高,腱反射亢进,肌力查体不合作,病理征未引出。辅助检查CT:头颅未见异
1 case of elderly patients, because of “left hand trauma 10 d, mouth opening difficulties, dorsal neck stiffness 3 d ” admission. Admission examination: body temperature 37 ℃, pulse 97 beats / min, breathing 23 beats / min, blood pressure 156/78 mm Hg, SPO2100% (nasal plug oxygen 5 L / min). Patients with clear, painful face, bilateral pain diameter of 3 mm, the presence of light reflex, angle arch anti-Zhang, teeth closed, neck resistance. Breath sounds clear lungs, no obvious and wet and dry rales, heart rate 97 beats / min, no smell and noise. Abdomen soft, no tenderness and rebound tenderness, no lower extremity edema, limb muscle strength was significantly higher, tendon hyperreflexia, muscle strength physical examination did not cooperate, the pathological sign did not lead. Auxiliary examination CT: no difference in the head