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患者,杨某,男21岁。入院前11天开始发热,体温38度,并出现胸憋、咳嗽、气短。随后出现头疼、呕吐、颈部发僵,双下肢无力。7天后全身出现紫癜。当地医院疑为“白血病”转入我院。入院后查:体温39度,血压120/80毫米汞柱。意识清楚、精神不振,极度衰竭。双手苍白,可见大片脱皮。皮下可见散在出血点。双肺底可闻细小泡音,左肺呼吸音低。心率96次/分,心律规整、各瓣膜区无杂音。肝脾未触及。颅神经无异常。会阴及双臀部呈“马鞍形”痛触觉迟钝,肛门反射消失,双下肢不完全性瘫痪,肌力Ⅱ级,肌张力低,双侧腓肠肌、胫骨前肌萎缩,双足骨间背侧肌萎缩。双膝腱、跟腱反射消失,病理反射未引出。双下肢痛温觉对称存在,双髂前上嵴以下音叉震动觉减弱。颈部抵抗,克氏
Patient, Yang, male 21 years old. 11 days before admission fever, body temperature 38 degrees, and appear chest choke, cough, shortness of breath. Then headache, vomiting, neck stiff, weakness of both lower extremities. 7 days after the body purpura. Local hospital suspected “leukemia” into our hospital. After admission check: temperature 39 degrees, blood pressure 120/80 mm Hg. Consciousness, lack of energy, extreme exhaustion. Pale hands, visible large peeling. Scattered subcutaneous bleeding point. Double bottom lungs can smell small bubbles, left lung breath sounds low. Heart rate 96 beats / min, regular heart rhythm, the valve area without noise. Liver and spleen not touched. No abnormal cranial nerve. Perineal and double buttocks were “saddle-shaped” pain tactile, anal reflex disappeared, incomplete paralysis of both lower extremities, muscle strength class Ⅱ, low muscle tone, bilateral gastrocnemius, anterior tibial muscle atrophy, dorsal anterior muscle atrophy . Double knee tendon, Achilles tendon reflex, pathological reflex did not lead. Symptoms of bilateral lower extremity pain exist symmetrically, and the ankle anterior superior iliac crest weakens. Neck resistance, Kirschner