延髓麻痹是延髓和脑桥脑神经运动核变化疾病,呈进行性吞咽、构音困难及面肌和咀嚼肌无力。此病患者多发生窒息或吸入性肺炎而死亡,本院收治的患者中有2例因心搏骤停死亡,现报告如下。 1 病例介绍 例1,患者男性,68岁,饮酒后恶心、呕吐、吞咽困难10d,全身乏力,难以行走,说话声音嘶哑,饮水呛咳5d而收入院。查体:咽反射迟钝,右肺可闻及湿罗音,四肢肌力Ⅴ级,血糖32mmol/L,经头颅CT检查未见异常。诊断为糖尿病合并球麻痹。应用胰岛素、消栓灵、青霉素治疗,并给予鼻饲,4d后患者自行拔除胃管,此时可饮少许水。行胃镜检查发现十二指肠球部溃疡并出血。因患者病情无明显变化,仍存在吞咽 Bulbar palsy is a medullary and pontine neurological movement of the nuclear disease, was progressive swallowing, dysarthria and facial and masticatory muscle weakness. The patient died of asphyxia or aspiration pneumonia, admitted to our hospital in 2 patients died of cardiac arrest, are as follows. 1 case description Example 1, male patient, 68 years old, drinking nausea, vomiting, difficulty swallowing 10d, malaise, difficult to walk, hoarse voice, drinking cough 5d and hospital admission. Physical examination: slow pharyngeal reflex, right lung can smell and wet rales, limb muscle strength Ⅴ level, blood glucose 32mmol / L, no abnormalities after head CT examination. Diagnosis of diabetes complicated with ball paralysis. Application of insulin, suppositories Ling, penicillin treatment, and given nasal feeding, 4d after the removal of patients with gastric tube, then drink a little water. Gastroscopy found duodenal ulcer and bleeding. Due to the patient’s condition no significant change, there is still swallowing