男性，38岁。阑尾切除术后5天。体温38.5℃，伤口疼痛，无红肿，压痛明显，轻度水肿。根据患者情况，应采取的措施是（）。
A.更换广谱抗生素
B.拆除切口缝线，敞开伤口
C.切口诊断性穿刺
D.理疗
E.继续观察
参考答案：B
解析：阑尾穿孔后脓液沿右结肠旁沟到右膈下形成脓肿，脓肿刺激膈中心，通过膈神经反射引起右肩部疼痛，并通过刺激胸膜引起反应性胸腔积液。
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| "It's my own fault."Carl Fenter pulled his jacket closer against the abnormal bite of cold morning wind.“The rest of the family is home , where it's __1__." Just another one of his__2__ideas-a big tamale(玉米粉蒸肉)feast after tonight's Christmas Eve service at the church-and look where it landed him：waiting in a line 50 people deep. Who would have guessed that the tamale in every shop in the city would be sold out the day before Christmas?But they __3__, as Carl knew.He had been driving all over El Paso that morning. __4__ to bring home tamales.Carl tried one last shop, an old favorite one in Canutillo. When he arrived, a fresh batch(一炉)was __5__off the steamer in 45 minutes.__6__ at the end of the snaking line of tamaleseekers, he watched the woman in front of him__7__her jacket to cover her shivering youngster.It wasn't long before she, too， __8__ in the biting wind.After only a moment's __9__, Carl took off his own jacket and offered it to the __10__mother. Together, they__11__when the line slowly moved forward at last, and smiling people exited the shop carrying steamy bags.__12__, Carl got inside the door and__13__ closer to the counter, the woman now first in line."Sorry folks， "the clerk announced， “that's the last of the tamales.""__14__!"Carl groaned(抱怨)with everyone else__15__behind him. "16__",， stressed the man at the counter， “We'll have a final batch ready__17__, oh, about two hours.” Defeated, Carl backed away, but the young mother grabbed his arm. "You're leaving?" "I__18__,"Carl glanced at his watch."I promised to put up luminarias(传统圣诞灯)at my churh." "I'll get your order of tamales and bring them to your house." Carl's brow furrowed “I couldn't ask you to do that.” "But it's__19__I can do.You lent me your coat."Her smile overrode(推翻)his objections."Just give me your address."She and her little girl settled in for the long wait. And at__20__noon on Christmas Eve, they delivered four dozen fragrant tamales-along with Carl's brown jacket-to his home. |
| ( )1．A.harmonious ( )2．A.brilliant ( )3．A.were ( )4．A.Decided ( )5．A.ready ( )6．A.Finding his way ( )7．A.move ( )8．A.waved ( )9．A.assumption ( )10．A.grateful ( )11．A.cheered ( )12．A.Immediately ( )13．A.shouldered his way ( )14．A.No problem ( )15．A.lined up ( )16．A.So ( )17．A.before ( )18．A.plan to ( )19．A.the least ( )20．A.just | B．warm B．bad B．did B．Determined B．prepared B．Taking his road B．reject B．froze B．appreciation B．respectful B．congratulated B．Hopefully B．forced his way B．No way B．held up B．But B．for B．intend to B．the most B．exactly | C．happy C．stupid C．could C．Wanted C．soon C．Taking his place C．abandon C．shook C．hesitation C．hopeless C．shouted C．Lastly C．felt his way C．No doubt C．looked up C．Then C．in C．have to C．the last C．accurately | D．pleasant D．common D．had D．Expected D．due D．Finding his place D．remove D．shocked D．attention D．shameful D．screamed D．Finally D．inched his way D．No wonder D．waited up D．Besides D．after D．ought to D．the best D．right |