论文部分内容阅读
患者男,73岁。因糖尿病7年、右上眼睑下垂伴复视16天,于1987年7月18日入院。体检:血压190/90mmHg。神志清楚,右上眼睑下垂,右眼球内收,上下视,外上下视及外展受限。双侧瞳孔等圆等大,光反射存在。心肺(-),肝脾未触及。神经反射正常。实验室检查;尿糖+++,尿酮体弱阳性,血糖17.47mmol/L。肝、肾功能正常。心电图示左前半分支阻滞,偶发房早。脑电图正常,头颅X线平片正常。拟诊为糖尿病Ⅱ型并动眼、滑车神经麻痹。入院后在应用胰岛素、降糖药控制血搪的同时,使用654-2 40mg加生理盐水300ml静滴,每日1次;口服654-2 10mg,每日2次,并用心痛定10mg,每日3次,疗程20天。治疗1周后眼睑下垂改善,但眼球活动仍受限。第20天眼睑,眼球活动均恢复正常。血糖降至
Male patient, 73 years old. 7 years due to diabetes, right upper eyelid ptosis with coping for 16 days, on July 18, 1987 admission. Physical examination: blood pressure 190 / 90mmHg. Consciousness, right upper eyelid ptosis, right eye ball adduction, up and down, outside the upper and lower as and abduction limited. Bilateral pupil circle and other large, light reflection exists. Cardiopulmonary (-), liver and spleen not touched. Reflex normal. Laboratory tests; urine sugar +++, urine ketone body weak positive, blood glucose 17.47mmol / L. Liver, kidney function is normal. Left half of the ECG branch block, sporadic room early. EEG normal skull X-ray film normal. To be diagnosed with type Ⅱ diabetes and eye movement, block motor nerve paralysis. After admission in the application of insulin, hypoglycemic agents to control blood borne at the same time, the use of 654-2 40mg intravenous infusion of 300ml saline once daily; oral 654-2 10mg, 2 times a day, and heartburn set 10mg, daily 3 times, treatment for 20 days. Eyelid ptosis improved after 1 week of treatment but eye movement was still limited. On day 20, the eyelids and eyeball movements returned to normal. Blood sugar dropped to