论文部分内容阅读
患者男性,15岁。以高烧10d,截瘫4d 主诉于1989年6月16日入院。10d 前因咽痛、咳嗽、发热等在当地注射青霉素,症状有好转。但4d 后体温再度升高,双下肢不能活动,小便潴留,否认外伤史。查体:T39℃、皮肤苍白,散在出血点,静脉穿刺部位见瘀斑。瞳孔等大等圆,对光反射存在,视物模糊。颈微抵抗,胸骨压痛(+)、心肺无特殊发现。肝、脾未扪及。上肢肌力正常,下肢自主活动消失,肌力0级,感觉正常,直腿抬高试验(+),膝反射,跟腱反射消失,病理反射未引出。脊柱无明显压痛点。实验室检查:外周血Hb40g/L、
Male patient, 15 years old. To high fever 10d, paraplegia 4d chief complaint on June 16, 1989 admission. 10d ago due to sore throat, cough, fever and other injection of penicillin in the local, the symptoms have improved. But after 4d the body temperature rose again, both lower extremities could not move, urinate retention, denied the history of trauma. Examination: T39 ℃, pale skin, scattered bleeding point, venous puncture site see ecchymosis. Pupil and other large circle, the presence of light reflections, blurred vision. Neck micro-resistance, sternal tenderness (+), no special discovery of cardiopulmonary. Liver, spleen not palpable. Normal upper limb muscle strength, lower extremity autonomic activity disappeared, muscle strength 0, normal feeling, straight leg raising test (+), knee reflex, Achilles tendon reflex, pathological reflex did not lead. Spine no tenderness point. Laboratory tests: peripheral blood Hb40g / L,