论文部分内容阅读
病历摘要患者侯××,女,22岁,1981年12月28日入院。该患为初产妇,孕足月,入院前三天午后十三时出现宫缩,凌晨三时出现头痛,发烧(体温38℃),伴有呕吐。次日九时出现癫痫发作,发作时意识不清,牙关紧闭,面色发绀,双上肢屈曲,双下肢伸直,十分钟内发作两次,第二次发作后病人意识不清陷入昏迷状态。住院后给予甘露醇,高渗糖静注,于当晚五时许经吸引器助产,娩出一男性畸形儿(脑积水)产后血量不多,当夜未发生抽搐,第三天又抽搐两次,体温高达40℃,并出现右侧肢体瘫痪,尿潴留。体格检查:昏迷状态,T39℃,R24次/分,BP130/90mmHg。右膝关节处、左足背部可见0.7×1.0cm三块瘀斑,球结合膜高度水肿,右眼球结合膜充血,额部皮肤浮肿有指压痕,右上肺呼吸音粗糙,脾可能及边缘,质软,双下肢无浮肿。神经系
Patient summary Hou × ×, female, 22 years old, December 28, 1981 admission. The suffering of primipara, full term pregnancy, three days before admission at noon on the thirteen contractions, three at midnight headache, fever (body temperature 38 ℃), accompanied by vomiting. The next day at nine o’clock there seizures, seizures unconscious, teeth closed, looking cyanotic, upper limb flexion, lower extremity straight, attack within 10 minutes, the second episode after the patient unconsciously fell into a coma. Mannitol was given after hospitalization, hypertonic glucose intravenous injection at midnight 5:00 by aspirator midwifery, giving birth to a male malformation (hydrocephalus) postpartum blood volume is not much, did not convulsions that night, the third day convulsions two Times, body temperature up to 40 ℃, and paralysis of the right limb, urinary retention. Physical examination: coma, T39 ℃, R24 times / min, BP130 / 90mmHg. Right knee joint, left foot and back visible three 0.7 × 1.0cm ecchymosis, ball conjunctiva highly edema, right eye conjunctiva hyperemia, forehead skin edema finger indentation, right upper respiratory tract sound rough, the spleen may be edge and quality Soft, no swelling of both lower extremities. Nervous system