การตรวจวินิจฉัย1,การซักประวัติ ผู้ป

การตรวจวินิจฉัย
1,การซักประวัติ
ผู้ป่วยรายนี้เป็นโรคมะเร็งเม็ดเลือดขาวกลุ่ม Lymphoblastic ชนิดเฉียบพลัน (Acute Lymphoblastic Leukemia) ทำให้มีภาวะภูมิคุ้มกันต่ำ (Low Immune) และได้รับการรักษาโดยได้รับยาเคมีบำบัด(Combination Chemotherapy) ซึ่งการได้รับยาเคมีบำบัดส่งผลให้ระดับภูมิคุ้มกันต่ำลงไปอีกทำให้มีการติดเชื้อได้ง่ายจากผลตรวจ วันที่11/11/2015

ชนิดของLaboratory Sputum Aerobic culture Sputum Gram stain Urine
Culture
ผลตรวจ Pseudo
monas aeruginosa
Gram Negative Bacilli Acineto
bacter-Baumannii

การติดเชื้อครั้งแรกต่อมาผู้ป่วยภาวะหัวใจหยุดเต้น (Cardiac arrest) 5 ครั้ง จึงได้มีการทำ CPR 3 ครั้ง ซึ่งในครั้งแรกหลังทำ CPR ไปแพทย์มีการตรวจดู Motor power ก็พบว่าผู้ป่วยมีภาวะกล้ามเนื้ออ่อนแรงของแขนและขาทั้ง 2 ข้าง(Paraplegia) ต่อมาแพทย์ส่งผู้ป่วยทำ MRI ผลเป็น MRI OF THE BRAIN AND CERVICAL SPINE วันที่27/04/2559 Impression: Incomplete study is noted. -Diffuse brain atrophy ( มีภาวะสมองฝ่อ) - Multiple hyperintensity T2W fool could be non-specific gliosis, previos brain injury or ischemic change (เกิดแรงกดทับขึ้นที่ T2 ,ไม่พบการบาดเจ็บที่สมอง หรือภาวะการขาดเลือดไปเลี้ยงสมอง) - Extramedullary CSF intensity lesion along anterior central spinal canal of lower cervical to upper thoracic keveks. Ddx arachnoid cyst or prominent CSF space (มีการ leak ของน้ำไขสันหลัง อาจมีการเคลื่นของกระดูกทำให้มีการ leak , พบ Cyst ที่บริเวณ Arachnoid หรือ CSF space) - Spinal cord atophy/ chronic myelopathy or evidence of previous spinal cord injury ( ไขสันหลังฝ่อ หรือ มีการกดทับมานานทำให้เกิดการบาดเจ็บที่ไขสันหลัง)จนถึงปัจจุบันจากตรวจผล UA ก็พบว่าผู้ป่วยไม่หายจากการติดเชื้อแบคทีเรียที่ปอดระหว่างการรักษาตั้งแต่แรกรับมาจนถึงปัจจุบัน (ตามเอกสารแนบ

ผลลัพธ์ (อังกฤษ) 1:

And diagnosis.1, history This patient is a blood cancer Acute Lymphoblastic khaoklum types (Acute Lymphoblastic Leukemia), have a weak immune system (Immune Low) and treated by receiving chemotherapy (Combination Chemotherapy). Where to get chemotherapy resulted in a lower level of immunity to another cause is infection from a test. 11/11/2015Types of Laboratory Sputum Sputum Gram stain culture Aerobic Urine. CultureThe results make Pseudo.monas aeruginosa Gram Negative Bacilli Acinetobacter-Baumannii The first infection later, patients with cardiac arrest (Cardiac arrest) 5 times, have done CPR 3 times, which for the first time after doing CPR to have doctors check Motor power, it was found that patients with muscle weakness in the arms and legs of both sides (Paraplegia). Later, the doctors send patients to do the MRI AND MRI OF THE BRAIN results in a CERVICAL SPINE date 27/04/2559 (2016) Impression: Incomplete study is Diffuse brain atrophy (noted. Depression, brain atrophy)-fool could be Multiple hyperintensity T2W non-specific ischemic brain injury, or gliosis previos change (pressure up at T2, found no injury to the brain or to ischemic stroke)-Extramedullary spinal CSF along central canal lesion intensity of lower cervical anterior to upper thoracic keveks. arachnoid cyst Ddx or prominent CSF space (there is a. Leak of CSF might have to move your bones cause a leak, Arachnoid Cyst was found nearby, or Spinal cord CSF) space-or evidence of atophy/chronic spinal cord myelopathy previous injury (spinal cord atrophy or have a long history of causing injury to the spinal cord) until now, the result of UA finds patients do not recover from bacterial infections that the lungs during the first treatment received up until now (as an attachment.

ผลลัพธ์ (อังกฤษ) 2:

Diagnosis of
one, the history of
this patient's leukemia cluster. Lymphoblastic Acute (Acute Lymphoblastic Leukemia) has a low immune system (Low Immune) and was treated with chemotherapy (Combination. Chemotherapy), which received chemotherapy resulted in a lower level of immunity to infection, making it easy to monitor. 11.11.2015 Date

of Aerobic Laboratory Sputum Culture Sputum Gram stain Urine
Culture
monitor Pseudo
Monas aeruginosa
Gram Negative bacilli Acineto
bacter-Baumannii

the first infection following cardiac arrest patients (Cardiac arrest) 5 times so. it has to do CPR 3 times in the first after CPR, the doctor has to examine motor power was found that patients suffer muscle weakness of the arms and legs two sides (Paraplegia) later, doctors send patients to MRI. the result is an MRI oF tHE BRAIN AND CERVICAL SPINE date 27/04/2559 Impression: Incomplete study is noted. -Diffuse brain atrophy (a condition vCJD) - Multiple hyperintensity T2W fool could be non-specific gliosis, previos brain injury or ischemic change. (resulting pressure at T2, no brain injury. Or a lack of blood to the brain) - Extramedullary CSF intensity lesion along anterior central spinal canal of lower cervical to upper thoracic keveks. Ddx arachnoid cyst or prominent CSF space (a leak of spinal fluid. Subject to K-slip bone cause a leak, find Cyst area Arachnoid or CSF space) - Spinal cord atophy / chronic myelopathy or evidence of previous spinal cord injury (spinal cord atrophy or are pressed for causing injuries. CSF) examination results to date from the UA, it was found that patients recovering from a bacterial infection of the lungs during treatment first received to date. (according to attachment

ผลลัพธ์ (อังกฤษ) 3:

Diagnosis,, 1 HistoryThis patient with acute leukemia group Lymphoblastic (Acute Lymphoblastic Leukemia) the immune status is low. (Low Immune) and were treated by chemotherapy (Combination Chemotherapy) which received chemotherapy result in immunity levels down again make infection easily from the test results. The 11 / 11 / 2015.The type of Laboratory Sputum Aerobic culture Sputum Gram stain Urine.Culture.The test results Pseudo.Monas aeruginosa.Gram Negative Bacilli Acineto.Bacter-Baumannii.Initial infection later patients cardiac arrest (Cardiac arrest) 5 times has made CPR 3 times, as in the first house. CPR go to a doctor is checking Motor power found that patients with severe muscle weakness of the legs and arms, both 2 side (Paraplegia) later, doctors send a patient. MRI effect is MRI OF THE BRAIN AND CERVICAL SPINE date 27 / 04 / 2559 Impression: Incomplete study is noted. - Diffuse brain atrophy. (of house) - Multiple hyperintensity T2W fool could be, non-specific gliosis previos brain injury or ischemic change. (born pressure up at T2, not found brain injuries or conditions, lack of blood flow to the brain) - Extramedullary CSF intensity lesion along. Anterior central spinal canal of lower cervical to upper thoracic keveks. Ddx arachnoid cyst or prominent CSF space (. Leak of cerebrospinal fluid, may move of the bone to leak, found Cyst the Arachnoid or CSF space) - Spinal cord. Atophy / chronic myelopathy or evidence of previous spinal cord injury (spinal cord atrophy or are pressing for injury at the spinal) to the present from the test results. UA found patients recovering from bacterial infections of lung during treatment from the beginning till now (according to the attachments.