论文部分内容阅读
祁某,男,17岁。1988年3月2日为预防流脑,口服复方新诺明2片。次日,左口角出现水泡,其痒难忍。同时觉双眼前有黑点漂动。4日黑点增多伴闪光,视物模糊并变形,来我院急诊。自述既往对复方新诺明无过敏史。体查:左口角皮肤有1.5×1.0cm水泡,其余正常。眼部:视力:右0.07,J_4;左0.06,J_4;戴镜不能矫正。(病前双眼视力0.5,J_1。戴—1.25DS镜片达1.5)眼睑无红肿结膜不充血,角膜清亮,晶体、玻璃体正常。眼底,双视乳头色红,生理凹陷存在,颞侧边界稍模糊。黄斑视网膜灰白隆起,范围1.5PD大小,中心窝光反射消失,周围静脉充盈盂曲,动脉稍细;视网膜赤道部,周边部正常,无渗出及出血。治疗:5％葡萄糖液500ml加氟美松8.0mg、维生素C、肌苷静脉注射,配合维生素B_(12)、呋喃硫胺肌注。两天后,眼前闪
Qi, male, 17 years old. March 2, 1988 for the prevention of meningitis, oral cotrimoxazole 2 tablets. The next day, the left mouth blisters, itch unbearable. At the same time, there are black spots floating in front of both eyes. 4 black spots increase with flash, blurred vision and deformation, to our hospital emergency room. Self-reported no symptoms of cotrimoxazole. Physical examination: left angle 1.5 × 1.0cm skin blisters, the rest of normal. Eye: visual acuity: right 0.07, J_4; left 0.06, J_4; wearing glasses can not be corrected. (Pre-binocular vision 0.5, J_1 wearing -1.25DS lens up to 1.5) eyelid without swelling and no conjunctival congestion, corneal clear, crystal, vitreous normal. Fundus, binocular nipple color, the existence of physiological depression, the temporal border slightly blurred. Macular retinal gray uplift, the size of 1.5PD size, central reflex disappeared, peripheral venous filling of the canton, arterioles slightly thinner; retinal equator, peripheral normal, no exudation and bleeding. Treatment: 5% dextrose 500ml plus dexamethasone 8.0mg, vitamin C, inosine intravenous injection, with vitamin B_ (12), intramuscular injection of thiamine. Two days later, eyes flash