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病例 例1,患者,男,60岁,农民。主因发热10天,头晕、呕吐3天,四肢活动不利1天入院。既往无高血压病史,患者于入院10天前因受凉后咽痛、流涕、发热,体温在38℃左右,3天前出现头晕、恶心呕吐,当时四肢无活动不利。查CT未见著变。在家静脉点入甘露醇、青霉素,于入院一天前病情加重,四肢活动不利。入院查体:体温39℃,双肺呼吸音粗,右面舌瘫,右眼球不能外展、内收,左眼不能内收,但能外展,有水平震颤,左上下肢肌力Ⅲ~+,右上下肢肌力Ⅳ级,按“脑炎”对症处理,于入院第二天,病人不能张口、吞咽、言语,双眼水平活动不能,但能上下运动,四肢瘫,肌力0级,发热,体温持
Case 1, patient, male, 60 years old, farmer. Mainly due to fever 10 days, dizziness, vomiting for 3 days, adverse physical activity in one limb admission. No previous history of hypertension, patients admitted to hospital 10 days ago due to cold sore throat, runny nose, fever, body temperature around 38 ℃, 3 days ago, dizziness, nausea and vomiting, limbs were not adversely affected. Check CT has seen no change. Point mannitol intravenous injection, penicillin, admitted to hospital one day prior to exacerbations, limb activity adversely. Admission examination: body temperature 39 ℃, lung breath sounds thick, right lingual paralysis, right eye can not be abducted, adduction, the left eye can not adduction, but can be abducted, with tremor level, left upper limb muscle strength Ⅲ ~ +, Right upper extremity muscle strength Ⅳ, according to “encephalitis” symptomatic treatment, the day after admission, the patient can not mouth, swallowing, speech, binocular level activity can not, but can move up and down, quadriplegia, muscle strength 0, fever, body temperature hold