论文部分内容阅读
重症肌无力的典型病例不难诊断,但症状不典型或询问病史不详时出现危象常有误诊。现将重症肌无力危象误诊为肺炎并呼吸衰竭1例报告如下。患者男,56岁,农民。因咳喘呼吸困难10余天于1986年2月7日入院。病人10天前因“感冒”轻咳、气喘,有时发热畏寒及胸痛,且咀嚼困难,咳少量白痰,伴乏力,食欲减退。给肌注抗生素及口服止咳平喘药治疗无效,近日来渐加重,咳嗽无力,呼吸困难,既往有慢性咳嗽病史和“胆石症”手术史。查体:体温36.4℃,脉搏108次/分,呼吸30次/分,血压100/70mmHg。精神萎糜,端坐位,呼吸困难,无力。口唇轻度紫绀,双肺满布干湿罗音,心脏及腹部检查未见异常。四肢及神经系统均正常。实
A typical case of myasthenia gravis is not difficult to diagnose, but the symptoms are not typical or when the history is unknown, there is a risk of misdiagnosis. Myasthenia gravis crisis is now misdiagnosed as pneumonia and respiratory failure in 1 case report below. Male patient, 56 years old, farmer. Dyspnea due to cough and more than 10 days in February 7, 1986 admission. The patient 10 days ago because of “cold” Cough, asthma, fever and sometimes chills and chest pain, and chewing difficulties, cough, a small amount of sputum with sputum, with fatigue, loss of appetite. To intramuscular antibiotics and oral cough and antiasthmatic drugs ineffective treatment, has gradually increased in recent days, cough, weakness, difficulty breathing, a history of chronic cough and “cholelithiasis” history of surgery. Physical examination: body temperature 36.4 ℃, pulse 108 beats / min, breathing 30 beats / min, blood pressure 100 / 70mmHg. Spirit wilting, sitting, breathing difficulties, weakness. Mild cyanosis lips, lungs covered with wet and dry rales, heart and abdominal examination showed no abnormalities. Limbs and nervous system are normal. real