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例1,男42岁。干部,主因腰腿疼痛一个月,右下肢放射性疼痛伴麻木20天于1993年7月24日入院。患者发病前有下楼迈空楼梯腰部扭伤史。伤后腰部疼痛,在某单位按“腰扭伤”给予按摩治疗。症状无改善,入院前20天,腰疼加重,放射至右下肢,在咳嗽、排便腹压增加时诱发右小腿麻木。在某医院住院后行CT扫描,诊断为“腰椎间盘突出症”给予腰部封闭治疗。入院前5天,症状加重,腰骶部、颈部前胸均疼痛不适。影响夜间睡眠,伴低热(37.2～38℃)。入院前一天行脊髓造影检查未见异常,门诊以“腰腿疼痛待查”收住院。体检:T37℃,痛苦病容。胸腹检查未见异常,脊柱未见畸形,下颈部棘突压痛,颈部活动时有疼痛,但不向上肢放射,双手Hoffmann
In Example 1, the male is 42 years old. The cadres, mainly due to pain in the lower back and leg for one month, were admitted to the hospital on July 24, 1993 with radiological pain in the right lower limb and numbness for 20 days. Before the onset of illness, there was a history of waist sprains on the stairs down the stairs. After the injury to the waist, he was given massage treatment in a unit according to “lumbar sprain.” Symptoms did not improve. 20 days before admission, the back pain worsened and radiated to the right lower extremity. When the cough and abdominal pressure increased during defecation, the right calf was induced. After being hospitalized in a hospital, a CT scan was performed and a lumbar closure was diagnosed as “Lumbar Disc Herniation.” Five days before admission, the symptoms worsened, and the lumbosacral region and the neck region were painful and discomfortable. Affects sleep at night with low fever (37.2 to 38°C). One day before admission, myelogram examination showed no abnormalities. Outpatients were admitted to hospital with “low back pain”. Physical examination: T37 °C, painful disease. There was no abnormality in chest and abdomen examination. There was no deformity in the spine. There was tenderness in the spinous process in the lower neck. There was pain in the neck but not in the upper limb. Hoffmann