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患者,女,24岁,初产妇。因分娩突发四肢麻木,不能活动3天入院。患者3天前足月分娩,第2产程延长,静滴催产素至胎头拨露时突感背部剧烈疼痛,随之双上肢无力,双下肢不能活动,躯干及双下肢感觉消失,以胎吸术结束分娩。半天后出现高热、尿潴留。查体:神志清楚,左上肢肌力Ⅱ～Ⅲ级,右上肢肌力Ⅲ级,双下肢肌力0级,四肢肌张力减低,双侧 Babinski、Chaddock 征阳性,胸2以下痛温觉消失,鞍区浅感觉保留。脑脊液压力1.52 kPa,Queckested 试验示椎管不通畅,呈黄红色,白细胞420×10~6/L,红细胞3.4×10~(12)/L,呈皱缩形态,蛋白0.76 g/L,颈椎 CT 示颈6-胸1脊髓增粗,中央有不规则高密度影。经脱水、应用糖皮质激素治疗,于入院第7天出现呼吸肌麻痹,呼吸衰竭死亡。
Patient, female, 24 years old, primipara. Burst of limb numbness due to childbirth, can not be active 3 days admission. Patients with full-term delivery 3 days ago, the second stage of labor to extend the infusion of oxytocin sudden headache when exposed to the back of severe pain, followed by weak upper extremity, both lower extremities can not move, torso and lower extremity feeling disappeared to fetal suction End childbirth. High fever after half a day, urinary retention. Physical examination: Consciousness, left upper limb muscle strength Ⅱ ~ Ⅲ grade, right upper limb muscle strength Ⅲ grade, lower limb muscle strength 0, lower extremity muscle tone, bilateral Babinski, Chaddock sign positive chest 2 pain pain disappeared, Saddle area light feeling reserved. The cerebrospinal fluid pressure was 1.52 kPa. The Queckested test showed that the spinal canal was unobstructed with a yellowish red color. White blood cells (420 × 10 ~ 6 / L) and red blood cells (3.4 × 10 ~ (12) / L) Show neck 6 thoracic 1 spinal thickening, the central irregular high-density shadow. After dehydration, the application of glucocorticoid treatment, paralysis of respiratory muscles appeared on the seventh day of admission, respiratory failure and death.