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患者男性,60岁.因双侧上睑下垂,吞咽困难逐渐加重21个月,颈部肿物伴左耳鸣、耳聋3个月于1991年11月6日住院。查体:肌病面容,面部呆板,笑时呈苦笑貌,声嘶。双上颈部均可触及肿大淋巴结,左右侧各1个,大小分别为5cm×4cm和3.5cm×2cm.质硬半固定。双侧上睑下垂,上午眼裂宽为0.3cm,傍晚缩为0.1cm。张闭目疲劳试验和新斯的明试验均阳性。双眼球无下陷,各方向运动均受限,以外展为甚;咀嚼有力,闭嘴完全,吹气无漏气,舌肌无萎缩,咽反射存在,吞咽缓慢易呛咳,四
The patient was male, 60 years old. Due to bilateral ptosis, dysphagia gradually worsened for 21 months. The neck mass with left ear ringing and deafness was hospitalized for 3 months on November 6, 1991. Physical examination: Myositis face, dull face, smile and smile, shouting. Both upper necks can reach enlarged lymph nodes, one on the left and right side, and the size is 5cm×4cm and 3.5cm×2cm respectively. The bilateral palatal sagging, the amputation width of the eye in the morning was 0.3 cm, and the reduction in the evening was 0.1 cm. Both the closed eye fatigue test and the neostigmine test were positive. Eyeballs without sagging, movement in all directions are limited, outside the show is very good; chewing is powerful, shut up completely, no air leakage leak, tongue muscle without atrophy, pharyngeal reflex, slow swallowing easy cough, four