论文部分内容阅读
流行性腮腺炎并发Ｂｅｌｌ麻痹一例中国人民解放军５１７医院（０３６３０１）马桂兰，武留信患者男，１３岁。因发热，两腮肿痛３天于１９９１年５月１２日入院。体检：Ｔ３８℃，Ｐ８８次，Ｒ１６次，神志清双腮腺及颌下腺肿大，右侧重，有触痛，表面不红，无波动感，右侧腮腺导管口红肿，挤压无脓性分泌物，心肺检查正常，腹平软，无压痛，肝脾未及。外周血白细胞６．７×１０９／Ｌ中性３９％，淋巴５９％，单核２％，血色素１２０ｇ／Ｌ血小板１２０×１０９／Ｌ尿淀粉酶６４ｕ，有腮腺炎病人的密切接触史。诊断：流行性腮腺炎。入院后给予病毒唑，转移因子，板兰根冲剂治疗，病情好转，于入院第３天患者右眼闭合不全，流涎。查体，右侧额纹消失不能皱额，右限裂扩大，眼睑闭合不全，试闭眼露白，右侧鼻唇沟变浅，口角下垂，露齿时口角向左侧偏斜，查血白细胞８．２×１０９／Ｌ，Ｎ８５％Ｌ１５％，给予青霉素３２０万ｕ／日，氨苄青霉素３ｇ／日静脉滴注及对症治疗，病程第９大双侧腮腺消退，一日后随访已痊愈。讨论：流行性腮腺炎可引起全身各系统损害，但并发Ｂｅｌｌ麻痹临床上少见，本例依据接触史，腮腺炎的临床表现及右侧额纹消失，不能皱额，右眼裂扩大，眼睑闭合不全，鼻唇沟变浅，露齿
Mumps complicated by Bell paralysis A case of Chinese People’s Liberation Army 517 Hospital (036301) Ma Guilan, Wu left letter patients male, 13 years old. Due to fever, two cheeks sore three days in May 12, 1991 admission. Physical examination: T38 ℃, P88 times, R16 times, conscious parotid gland and submandibular gland enlargement, right heavy, tenderness, the surface is not red, no fluctuations in the right parotid duct mouth swollen, squeezing no purulent secretions , Normal cardiopulmonary examination, abdominal soft, no tenderness, liver and spleen not yet. Peripheral blood leukocytes 6.7 × 109 / L neutral 39%, lymphatic 59%, mononuclear 2%, hemoglobin 120g / L platelet 120 × 109 / L urinary amylase 64u, there is a close history of mumps patients. Diagnosis: Mumps. After admission to give ribavirin, transfer factor, Ban Langen granules treatment, the condition improved, on the 3rd day of admission patients with right eye closure insufficiency, salivation. Check the body, right forehead wrinkles can not be disappeared, the right crack to expand, the eyelid closed incomplete, try to close the eyes white, right nasolabial fissure shallow, mouth drooping, tooth mouth skewed to the left skew, check white blood cells 8.2 × 109 / L, N85% L15%, given penicillin 3.2 million u / day, ampicillin 3g / day intravenous drip and symptomatic treatment, the duration of the first two large parotid gland regression, after a day follow-up has been cured. Discussion: Mumps can cause systemic systemic damage, but complicated with Bell’s palsy clinically rare, this case based on contact history, mumps clinical manifestations and right frontal pattern disappeared, can not wrinkle, right eye cracked, closed eyelid Incomplete, shallow nasolabial fold, toothy