临床复杂性脊柱结核一例
Chinese Journal of New Clinical Medicine(2018)
Abstract
1 病例介绍
患者,女,62岁,因“腰痛伴双下肢疼痛、麻木1月,行走困难1周”入院.患者1个月前因搬重物突发腰痛,伴双下肢疼痛、麻木,无低热、盗汗,无咳嗽等症状,对症治疗疼痛减轻,但麻木未缓解,1周前腰痛逐渐加重,行走困难,为进一步诊治收住院.既往高血压、糖尿病病史10余年,否认肝炎、结核等传染病史.查体:体温36.5℃,腰椎活动受限,第五腰椎左侧压痛并向下肢放射,双侧直腿抬高试验(-),双侧“4”字试验(+),左足背外侧痛觉减退,双下肢肌力减弱,双侧膝腱、跟腱反射减退,病理反射未引出.行化验检查,血常规:白细胞计数24.52×109/L,中性粒细胞百分比91.30%,单核细胞绝对值0.98×109/L;生化球蛋白45.3 g/L,α-羟丁酸脱氢酶213 U/L,乳酸脱氢酶277 U/L;肿瘤标志物:糖类抗原125为52.1 U/ml,癌胚抗原6.99 ng/ml,细胞角质素抗原21-1为2.32 ng/ml,降钙素原定量(-),CRP 212.1 mg/L.
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