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桥脑中央髓鞘溶解(central portine myelinolysis简称CPM)于1959年由Adams等首先报导。临床上非常罕见,几乎所有病人都是尸检证实。最近我科遇到一例经剖检证实的CPM,现报告如下。病例摘要杨×,男,17岁,入院前三天无明显诱因出现头痛、恶心、呕吐。同时出现视物双影,特别是向左视明显。走路不稳,言语不清。饮水反呛,四肢无力于1991年11月17日入院。病人十年前曾因颜面浮肿,迅速发展到躯干及四肢,伴有肉眼血尿,少尿,每日尿量小于500ml,在当地医院诊断为肾小球肾炎。
Central pontine myelinolysis (CPM) was first reported by Adams et al in 1959. Clinically very rare, almost all patients are confirmed by autopsy. Recently, our department met a case of CPM confirmed by the autopsy, are as follows. Case summary Yang ×, male, 17 years old, three days before admission no obvious incentive to headache, nausea, vomiting. At the same time appear double shadow of the material, especially to the left obvious. Unsteady walking, unclear words. Anti-choke drinking water, limb weakness in November 17, 1991 admission. Ten years ago, the patient developed swollen face and swollen to the trunk and extremities with gross hematuria and oliguria. The daily urine output was less than 500ml and was diagnosed as glomerulonephritis in a local hospital.