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熊×,男,3(6/12)岁,住院号120230,因左耳下方及右侧舌根部包块逐渐增大2年余,于1992年9月23日入院.体检:体温36.8℃,脉搏86次/分,呼吸22次/分.全身正常,双眼正常,左腮腺区及右舌背粘膜下分别可见1个4×5cm和2×3cm大的包块,其边界清楚,质地中等,可活动,无压痛.无血管性博动及杂音.血尿粪化验及心电图、胸透等检查正常.考虑为:1.左腮腺血管瘤.2.左腮腺囊肿.3.舌部淋巴管瘤.于10月5日在氯胺酮复合麻醉(给氧,呼吸机助呼吸)下行手术摘除,术中患儿突然心跳骤停,经心外按摩及心内三联注射处理,3分钟后心跳恢复正常.术后5小时清醒,诉双眼看不见东西,检查见病孩意志清晰,问答切题,颈软,心肺及肌力正常,膝腱反射无亢进或减弱,双侧Brudzinski征(十);双眼无光感,惊恐反射消失.瞳孔圆形,直径3mm,光反射存在.眼底检查无异常发现.视诱发电位:双眼闪光刺激呈N—P波,各波潜伏期延长,P波后平坦,N_2波消失.诊断为脑缺氧后皮质盲.经高压氧治疗,
Bear ×, male, 3 (6/12) years old, hospital 120230, due to the left ear and right tongue base mass gradually increased more than 2 years, admitted to hospital on September 23, 1992. Physical examination: body temperature 36.8 ℃, Pulse 86 beats / min, breathing 22 beats / min. The body is normal, his eyes are normal, left parotid gland area and the right lingual mucosa were seen a 4 × 5cm and 2 × 3cm large mass, the border is clear, medium texture, Can be activity, no tenderness .Vascular motility and murmur.Surgery and urinary tests and ECG, thoracic and other tests were normal.Considerated as: 1. Left parotid gland tumor .2. Left parotid cyst .3. Tongue lymphangioma. On October 5, ketamine combined anesthesia (oxygen, ventilator-assisted breathing) surgical excision, intraoperative sudden cardiac arrest, external massage and intracardiac triple injection, 3 minutes after the heartbeat returned to normal. 5 hours after awake, v. Eyes can not see things, the examination see the patient will clear, Q & A, neck soft, cardiopulmonary and muscular strength, knee tendon reflexes hyperthyroidism or weakened, bilateral Brudzinski sign , Panic reflex disappeared pupil circular, diameter 3mm, light reflex exists. Fundus examination no abnormalities. Visual evoked potentials: eyes flash stimulation was N-P wave, the latency of the wave latency , The P-wave flat, N_2 wave disappears. Cortical blindness after diagnosis of cerebral hypoxia. Hyperbaric oxygen therapy by,