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患者,男,18岁。因被尖刀刺伤左背部和头,失血较多,后出现胸闷、心悸、面色苍白、寒颤1小时入院。当时患者头部又受棒击,但无昏迷、呕吐、肢体抽搐及二便失禁。查体:体温36℃,脉搏96次/分,呼吸28次/分,血压10.7/5.3 kPa。面色及球结膜苍白,神志清楚,精神萎靡。左头顶有3cm 长的头皮裂口,左背部肩胛骨下方有3cm 长的裂口并有活动性出血。急查血 Hb50g/L,诊断为“多发性刺伤,早期失血性休克”。给予清创、输血、抗休克、抗感染等治疗。但次日晨起患者突然右下肢不能活动。检查:右下肢肌力0级,肌张力高,
Patient, male, 18 years old. Stabbed by a sharp knife left back and head, blood loss, chest tightness, palpitations, pale, chills 1 hour admission. At that time, the patient’s head was again hit by a stick but no coma, vomiting, limb twitching and incontinence. Physical examination: body temperature 36 ℃, pulse 96 beats / min, breathing 28 beats / min, blood pressure 10.7 / 5.3 kPa. Complexion and ball conjunctiva pale, conscious, apathetic. The left head has a 3cm long scalp, a 3cm long split beneath the left back scapula and active bleeding. Urgent blood Hb50g / L, diagnosed as “multiple stab wounds, early hemorrhagic shock ”. Give debridement, blood transfusion, anti-shock, anti-infection treatment. However, the patient suddenly could not move his right leg the next morning. Check: right lower extremity muscle 0, high muscle tension,