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患者,女,72岁。因心窝部持续性疼痛伴阵发性加剧3天入院。该患3天前乘汽车,因途中在一凹陷处,汽车剧烈巅簸一次,当时感觉腰部瞬间针刺样疼痛,持续闷胀不适,近3天无何诱因心窝部持续性疼痛伴阵发加剧,来院就诊。既往无腹痛及腰痛史。检查:T36.8℃,P80次/分,BP160/90mmHg,皮肤及巩膜无黄染,心肺无异常,腹平软,剑下有轻度压痛,无抵抗及反跳痛。肝脾未扪及,移动性浊音阴性,肠音正常,脊柱四肢未查。病理反射未引出。化验:血、尿、便、肝功正常,出凝血时及凝血酶原时间正常,X线腹部透视未见异常,临床诊断:胆道蛔虫症。入院后禁食、补液,预防感染及对症治疗未缓解,第4天由家人扶起下床,但站立不起瘫倒在地,经检查,双下肢已不能自主运动,足及小腿感觉明显迟钝,双侧巴彬斯基征阳性,双侧霍夫
Patient, female, 72 years old. Due to continuous pain in the fossa with intermittent paroxysmal exacerbation 3 days admission. The suffering three days ago by car, on the way in a depression, the car thunderstorm once, felt the acupuncture instant waist ache-like pain, continuous boring discomfort, no inducement for nearly 3 days heart socket continuous pain with the array exacerbated , To hospital for treatment. No previous history of abdominal pain and back pain. Check: T36.8 ℃, P80 beats / min, BP160 / 90mmHg, skin and sclera no yellow dye, no abnormal heart and lungs, abdominal soft, mild tenderness under the sword, no resistance and rebound tenderness. Not palpable liver and spleen, mobility dullness negative, normal bowel, spine limbs not checked. Pathological reflex did not lead. Laboratory tests: blood, urine, stool, normal liver function, normal clotting time and prothrombin time, X-ray abdominal fluoroscopy no abnormalities, clinical diagnosis: biliary ascariasis. After admission, fasting, fluid replacement, prevention of infection and symptomatic treatment were not alleviated. On the 4th day, the family members helped to get out of bed, but they could not stand paralyzed to the ground. After examination, the lower extremities were unable to exercise autonomously. , Both sides Babinski sign positive, bilateral Huff