问题 单项选择题 共用题干题

患者男,34岁。盖房子时因土墙垮塌砸伤左小腿。伤后35分钟被送往当地卫生院行清创缝合术。第2天夜间,患者感伤肢沉重感,行走困难,疼痛逐渐加剧,自觉发热,全身无力。次日,病情加重,急来院就诊。查体:T40℃,P130次/分,R20次/分,BP100/60mmHg。痛苦面容,贫血貌,表情淡漠,烦躁,呼吸急促。整个左小腿延至大腿肿胀明显,左小腿下1/3外侧有一4cm长而不规则缝合伤口,周围皮肤苍白、紧张发亮,伤口中有恶臭味的血性液体和气泡溢出。触诊肢体有捻发音。实验室检查:RBC2.0×1012/L,Hb40%,WBC12×109/L,N90%。尿常规:血红蛋白尿。左小腿X线平片检查:肌群内有积气阴影。

首先应采取的紧急治疗措施是()。

A.拆除缝线,彻底清创引流,最大限度地切除坏死组织和切开筋膜减压

B.拆除缝线,敞开伤口,用大量过氧化氢反复冲洗

C.拆除缝线,敞开伤口,每日换药

D.拆除缝线,敞开伤口,高压氧治疗

E.拆除缝线,敞开伤口,并作多个小切口引流

F.拆除缝线,敞开伤口,用大量1:4000的高锰酸钾溶液反复冲洗

答案

参考答案:A

选择题
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A strange thing happens to nearly everybody at night. They turn off the lights, put up the covers and close their eyes. Six or seven hours later, they wake up again. Strange, isn’t it?

Sleep puzzles science. Scientists and doctors would rather talk about why one can’t fall asleep. They are not so sure what causes sleep.

The best conditions for sleep, they say, are good health and meal neither too big nor too small. No worries and a comfortable place to sleep in are important, too. They advise against two in one bed.

Strange things happen during sleep. For example, you move often. You would feel tired if you didn’t. You also dream. Part of your brain is still awake when you dream. Dreaming happens when the memory and imagination parts of your brain are still awake. Experiments have shown that bad dreams may be caused by a stomachache.

Don’t worry if you dream. Some great stories and poems were begun while the writers slept.

41. Sleep puzzles scientists because they are not certain _______. 

why one can’t fall asleep

why one wakes up six or seven sleeping hours later

both A and B

D. what causes sleep

42. You would feel tired during sleep if you ________.

A. move often           B. sleep on your back     C. didn’t move    D. went back too later

43. Dreaming happens when _______.

A. you are in a deep sleep                           B. you are not comfortable

C. part of our brain is still awake               D. there’s too much noise  in the room

44. The best title for this passage is ________.

A. Why You Dream                              B. The Strangeness of Sleep

C. What Happens During Sleep            D. The Cause of Sleep