中英译文126主动脉夹层脊髓梗死脊髓前动脉综合征--余求龙
运动后吃什么好
Ca Description 病例介绍
A 63-year-old man with a history of hypertension, paroxysmal atrial fibrillation, and dyslipidemia had a sudden inten chest pain radiating to his left arm, and he lost control of his legs. He was not on anticoagulant therapy and had no history of back trauma. During transport, he was hypotensive (blood pressure 88/51), his right arm was pale, and he was not able to move his legs. ECG showed inferolateral ST-gment depressions. He was given 250 mg aspirin and morphine for pain. With intravenous fluid-replacement therapy, his blood pressure ro and the activity of his legs improved. Aortic disction was suspected, and the patient was urgently admitted to the surgical emergency room within the university hospital. In the emergency room, his blood pressure was 108/62. Cardiac and pulmonary auscultation and abdominal palpation were normal, and peripheral puls were symmetrical. Computed tomography of the aorta revealed a hematoma next to the ascending aorta, raising a suspicion of type A aortic disction reaching from the ascending aorta to the beginning of the left renal artery. The aortic valve was intact.外语程度
愚人买鞋
一位63岁男性患者，既往有高血压病、阵发性房颤、高脂血症史，突然出现剧烈胸痛并放射至左侧上肢，伴双下肢无力。未曾接受抗凝治疗，否认背部外伤史。往医院转送过程中，患者出现低血压（血压88/51mmHg），右侧上肢苍白，双下肢不能平移。心电图显示下侧壁ST段压低，给予口服阿司匹林肠溶片250mg和吗啡止痛。给予静脉补液后，患者血压逐渐上升，双下肢运动障碍改善。怀疑主动脉夹层，患者被紧急送往大学医院的外科急诊室。在急诊室，患者血压108/62mmHg。心肺听诊及腹部触诊正常，外周动脉搏动对称。主动脉CT显示升主动脉旁有一血肿，高度怀疑从升主动脉到左侧肾动脉起始段的A型主动脉夹层，主动脉瓣完整。
During an emergency operation, the ascending aorta and a part of the aortic arch were replaced with a prosthetic graft. The arrest time was 24 minutes, and closure of the aorta took 112 minutes. In the beginning, the patient needed vasoactive support becau of hypotension but later on his hemodynamic was stable. However, the next day, the patient had to undergo a resternotomy becau of postoperative bleeding. After the operation, he was hypertensive and was treated with antihypertensive medication.
外国情诗
急诊手术中，升主动脉和部分主动脉弓用人工移植物代替。停搏时间为24分钟，主动脉夹闭时间为112分钟。因为血压过低，患者一开始需要血管活性药物维持血压，但后来血流动力学平稳。然而第2天，患者因为术后出血，不得不行开胸手术治疗。术后血压高，给予降压药物治疗。
米戈
The patient was extubated on the cond postoperative day and mobilization was started the next day, when it was noticed that the patient could not stand on his feet and coordination of his lower limbs was impaired. On the fourth postoperative day, a neurologist was consulted. The patient was somnolent but oriented, and denied any back or limb pain. His cranial nerves were intact, and his upper limbs had normal strength and nsation. He could hold his left leg up for 5 and his right leg for 3 s in a prone position. He could not press/push against resistance neither distally nor proximally, the right leg being somewhat weaker, and tonus of his lower limbs was weak-ened. The patient reported impaired nsation for pain and light touch on his feet. Reflexes were normal, and Babinski sign was negative. There was no impaired nsation in upper body. Diuresis was monitored by means of urinary catheter.
术后第2天拔除气管插管，第3天患者下床活动时发现双下肢站立不能，伴共济失调。术后第4天请神经科医生会诊。患者呈嗜睡状态，但定向力正常，否认背部或者四肢痛。颅神经检查正常，双上肢运动及感觉未见异常。患者仰卧位时，左下肢抬起能坚持5秒，右下肢3秒，肢体近端及远端均不能抵抗阻力，右侧下肢比左侧肌力更差，肌张力低。双下肢痛觉和轻触觉减退，腱反射正常存在，巴宾斯基征阴性。上半身感觉正常。通过留置导尿管监测到多尿。
Next, Magnetic Resonance Imaging of the Spinal Cord Was Performed. What Would You Expect to Find?
下一步行脊髓MRI检查，你希望能发现什么呢？活动策划流程
Magnetic resonance imaging showed incread signal intensity of the anterior spinal cord between T11 and conus in T2-weighted images with edema and restricted diffusion in diffusion-weighted images. The finding suggested an ischemic lesion.让子弹飞经典台词
磁共振显示胸11至脊髓圆锥段脊髓前部T2加权像高信号，伴有水肿，弥散加权像受限，结果提示脊髓缺血性病变。
On the 19th postoperative day, nsory deficits were no longer found. The patient was able to walk with assistance of a walker, but distal and motor weakness was still detected, the right side being weaker. Proprioceptive and temperature n was normal. Vibration n was impaired in both upper and lower limbs, probably unrelated to the acute situation. Bowel function was normal but the patient was still catheter-bound, partially becau of the postoperative complication (bleeding in the groin area).
