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例1,男,59岁。病人于24天前,因患慢性胆囊炎在当地医院住院治疗,静点庆大霉素(剂量不详)4天后,自觉走路不稳,行走时步距宽,易倾倒,发病中无眩晕、耳鸣、耳聋及听力减退。查体:神志清楚,言语流利,颅神经检查未见异常,四肢肌张力较低,肌力Ⅴ级,腱反射正常,未引出病理反射。蹒跚步态,双侧指指试验,指鼻试验,跟膝胫试验均不稳准,反击试验阳性,Romberg试验睁闭眼均不稳。头颅CT及头颅MRI检查未见异常。前庭功能检查正常。临床诊断庆大霉素中毒,给予营养神经及对症治疗2周后,好转出院。
Example 1, male, 59 years old. Patients 24 days ago, suffering from chronic cholecystitis hospitalized in the local hospital, gentamicin point (unknown dose) 4 days after conscious walking unsteadily, walk walking step wide, easy to dump, no onset of vertigo, tinnitus , Deafness and hearing loss. Examination: Consciousness, fluent speech, cranial nerve examination showed no abnormalities, lower extremity muscle tone, muscle grade Ⅴ, tendon reflexes normal, did not lead to pathological reflex. Toddler gait, bilateral finger test, finger nasal test, knee and shin test are not accurate, back test was positive, Romberg test eyes open and closed are unstable. Head CT and cranial MRI examination showed no abnormalities. Vestibular function test is normal. Clinical diagnosis of gentamicin poisoning, given neurotrophic and symptomatic treatment after 2 weeks, improved discharged.