特重型破伤风1例

A case of extremely severe tetanus

1例58岁男性因出现双侧颌下肿痛,张口受限,体格检查:开口度约1横指,口腔黏膜见多处溃疡,双侧颌下未触及明显肿胀,稍压痛,全身未寻及伤口。治疗期间出现突发牙关紧闭,呼吸困难,四肢强直,临床诊断破伤风感染,治疗上予开放气道、机械通气、抗感染、中和毒素、解除痉挛、营养支持、纠正自主神经功能紊乱等,患者好转出院。本文总结1例特重型全身性破伤风感染的临床表现及治疗方案,以提高临床医师对该病的诊治水平。

A 58-year-old man suffered from bilateral submaxillary swelling and pain with limited mouth opening.Physical examination showed that the opening degree was about a cross finger,and multiple ulcers were found in the oral mucosa,with no obvious swelling and slight tenderness in the bilateral submaxillary area,and no wounds were found in the whole body.During the treatment,the patient developed sudden lockjaw,dyspnea,stiffness of limbs,clinical diagnosis of tetanus infection,treatment of open airway,mechanical ventilation,anti-infection,neutralization of toxins,relief of spasm,nutritional support,correction of autonomic nervous disorders,etc.,the patient improved and was discharged.This paper summarizes the clinical manifestations and treatment of severe systemic tetanus infection in order to improve the level of diagnosis and treatment of this disease.