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桥脑中央髓鞘溶解(CPM)在临床上较少见,而在垂体前叶功能减退的基础上发生者尚未见报道,现报道1例。患者女,30岁,农民。因精神异常伴呕吐52天,加重21天伴大小便失禁入院。于1992年5月30日分娩时出血较多(24小时内约500ml),并出现“昏迷”约20分钟,1个月后逐渐出现无乳、闭经、皮肤苍白、畏寒,腋毛、眉毛及阴毛逐渐脱落,出现表情淡漠。1996年2月21日因胃肠型感冒出现上腹部疼痛及呕吐,并出现精神异常,继之出现意识不清。当地医院曾以“垂体前叶功能减退危象”给予氢化考的松治疗。4天后意识恢复,但仍缄默少动,不进饮食,双上肢及头部不自主抖动及大小便失禁,在当地医院做头颅CT检查未发现明显异常。
Central pontine myelinolysis (CPM) is clinically rare, and in the anterior pituitary dysfunction based on the occurrence of those who have not been reported, is reported in 1 case. Female patient, 30 years old, farmer. Due to mental abnormalities with vomiting 52 days, increased 21 days with incontinence admission. Hemorrhage occurred during childbirth on May 30, 1992 (about 500 ml in 24 hours) and appeared “coma” for about 20 minutes. After 1 month, there was no milk, amenorrhea, pale skin, chills, armpit hair, eyebrows and Pubic hair gradually shedding, appear indifferent expression. February 21, 1996 due to gastrointestinal influenza appeared upper abdominal pain and vomiting, and mental disorders, followed by the emergence of confusion. The local hospital had to “hydrocephalus cortisol treatment of crisis” anterior pituitary dysfunction. Four days after the recovery, but still silent, not into the diet, upper limbs and head involuntary jitter and incontinence, skull CT examination at the local hospital did not find significant abnormalities.