问题 单项选择题 案例分析题

患者男,18岁。右下肢软组织挫裂伤3小时,急诊科施行清创术后,给予静脉滴注头孢噻吩。输液约5分钟时,患者出现胸闷、气急、烦躁不安和头晕,面色苍白。检查患者脉速而弱,在测血压时患者心搏骤停。

患者最可能的是发生了()

A.失血性休克

B.心源性休克

C.过敏性休克

D.神经性休克

E.反射性休克

答案

参考答案:C

解析:切口感染是术后常见并发症之一,是指清洁和可能污染的切口并发感染,发生率约3%~4%。血肿、异物和局部组织或全身抵抗力削弱等因素均与感染有关。一般表现为手术后3~4天,切口疼痛加重,或减轻后又加重,并有体温升高,白细胞计数增高,即提示切口可能感染。检查可发现切口局部有红、肿、热和压痛的典型体征。有疑问时,可分开切口进行观察并取切口分泌物培养。切口有早期发炎现象时,应使用有效的抗菌药物或理疗等;如已形成脓肿,应予敞开切口,通畅引流。但不可滥用抗生素,否则会产生耐药菌株。故答案应选E。

单项选择题
单项选择题

On cold days in Delhi, the poor light bonfires (篝火) of tyres, trees and rags whose fumes mix with the exhaust from the city’s 2 million vehicles to form a thick smog. On most days in Mexico City, a blanket of pollution cuts off views of the surrounding mountains. On one famous occasion it got so bad that birds fell dead out of the sky on to the Zocalo, the city’s main square. Throughout the developing world, smogs in many big cities are getting worse as more people use cars and more manufacturing firms are belching out (喷出) pollution. Congestion is on the rise. too: according to one estimate, a car in Bangkok now spends the equivalent of 40 days a year stuck in traffic. The air in Asia’s cities, like the water in its rivers, is particularly unhealthy, containing levels of dust and smoke several times higher than in the rich countries’ cities.

Environmentalists in the developed world also worry about air pollution in poorer countries. not just out of the goodness of their hearts but because they fear it may affect their own backyard. Carbon-dioxide emissions, thought to be the cause of global warming, are growing particularly fast in developing countries. So are emissions of sulphur dioxide, blamed for acid rain. which sometimes falls hundreds of miles from the source of the pollution.

But the harm that air pollution causes in the developing countries themselves is much more serious and immediate. The biggest concern are indoor air pollution, lead emissions and small particles. Indoor pollution in poor countries is not much talked about, but it is often as damaging to health as smoking cigarettes. Around a third of all energy consumed in developing countries comes from wood, crop residues and dung, which are often burnt in poorly designed stoves within ill-ventilated (通风很差的) huts. Studies of women in India and Nepal exposed to smoke from such fuels show that their death rates from chronic respiratory disease are similar to those of heavy smokers.

Lead has long been known to be dangerous in large doses. But only since the 1970s have scientists been aware that relatively small quantities of lead in the bloodstream can be harmful to humans. In particular, many studies show a correlation between levels of lead in children’s blood and lower IQ scores, hearing loss and hyperactivity (活动过度).

But the kind of air pollution thought to cause the most damage to human health in developing countries is that from small particles. Caused by vehicle exhausts, coal-burning smoke from factories and dust stirred up by vehicles, these particles easily find their way into people’s lungs. Studies the world over have shown a p positive correlation between small particles in the air and death rates.

Small particles mainly damage ().

A. lungs

B. eyes

C. bloodstream

D. heart