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病历摘要男患,52岁。因左手不灵,左半身无力数小时入院。既往有高血压病史20余年,否认胃病史。入院在体:体温、脉搏、血压正常。神清,瞳孔同圆等大,左面神经核上瘫,左上,下肢肌力Ⅲ级,无明显感觉异常,左巴氏征(+),眼底检查符合动脉硬化改变。入院后按脑血栓形成治疗,静滴低分子右旋糖酐并支持疗法。入院第5天进食后呕吐咖啡色物250ml,次日再次呕吐红褐色血液约300ml,以应激性溃疡并上消化道出血治疗,用冰盐水加肾上腺素、甲氰咪胍通过胃管灌注后症状缓解。于入院第9天又呕血200ml。转上级医院,CT 扫描4～5层双侧基底节见斑点状密度减低影,提示双侧基底节梗塞,诊断为脑血栓形成、应
Medical history male suffering, 52 years old. Due to the left hand is not working, the left half of weakness hospitalized. Past history of hypertension more than 20 years, denied stomach history. Admission in the body: body temperature, pulse, normal blood pressure. Shen Qing, the same pupil with the circle, the left paralysis of the nucleus, the left upper and lower limb muscle strength Ⅲ, no significant sensory abnormalities, left Pakistan’s sign (+), fundus examination consistent with arteriosclerosis change. After admission, patients were treated with cerebral thrombosis, infusion of low molecular weight dextran and supportive therapy. On the 5th day after admission, vomit coffee 250ml, vomit red-brown blood about 300ml again to stress ulcer and upper gastrointestinal bleeding treatment, with ice saline and adrenaline, cimetidine through gastric tube perfusion symptoms ease. 9 days on admission and hematemesis 200ml. Go to the higher hospital, CT scan 4-5 layers of bilateral basal ganglia seen spot density reduction, suggesting bilateral basal ganglia infarction, diagnosis of cerebral thrombosis should be