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患者男,37岁。于1991年9月17日入院,4月前因剧烈腹痛在某院以“胃溃疡穿孔”行胃大部切除术。术后腹痛仍有发作。术后40天出现发热,体温达39℃。并出现面部及四肢肿胀脱屑,渐面部发僵、咀嚼吞咽困难.四肢远端麻木、力弱。转外地某院按“营养不良性神经炎”治疗,症状无缓解。家族史无特殊记载。查体:BP15/10kPa,P82次/分,T37℃,皮肤无肿胀,心肺未见异常。腹部无压痛。神经系统:构音不良,双咀嚼肌萎缩、力弱、双侧周围性面瘫,双手骨间肌萎缩。四肢肌力5~-,腱反射弱,病理征(—),四肢末端呈“手套、袜套”样痛觉减低。血色素136g/L,血沉53mm/h,CPT95,TTT10,TFT++,A/G=37/
Male patient, 37 years old. In September 17, 1991 admitted to hospital, 4 months ago due to severe abdominal pain in a hospital with “gastric ulcer perforation” gastrectomy. Postoperative abdominal pain still seizures. 40 days after fever, body temperature of 39 ℃. And facial and limb swelling and scaling, facial gradually stiff, chewing swallowing .Letal distal numbness, weak. Transferred to a foreign hospital according to “malnutrition neuritis” treatment, no relief of symptoms. Family history no special records. Examination: BP15 / 10kPa, P82 times / min, T37 ℃, no swelling of the skin, no abnormal heart and lung. Abdominal tenderness. Nervous system: dysarthria, double masticatory muscle atrophy, weak, bilateral peripheral facial paralysis, his hands between the atrophy of the interosseous muscle. Limb muscle strength 5 ~ -, tendon reflex weak, pathological signs (-), extremities were “gloves, socks,” like reduced pain. Hemoglobin 136g / L, ESR 53mm / h, CPT95, TTT10, TFT ++, A / G = 37 /