问题 单项选择题

患者女性,62岁,农民。因上腹突发剧痛8小时急诊入院,患者有多年“胃病”史,经服药后好转。患者近来感上腹隐痛,乏力,易疲倦,体重减轻约10kg。近1个月来进食后上腹部胀闷不适,时有呕吐和黑便,呕吐物多为胃液及宿食,无胆汁,呕吐后腹部闷胀感减轻,曾在当地卫生院对症处理,疗效欠佳。8小时前进食后突然出现上腹剧痛,如刀割样,为持续性腹痛,曾呕吐一次,量约200ml。体检发现,患者消瘦,贫血貌,大汗淋漓,痛苦面容。心肺正常,腹式呼吸消失,板状腹。

提示:为病人实施了手术,术中检查发现腹腔内有含食物残;查的混浊样液体共吸出约300ml,胃窦部近幽门处可扪及-4cm×3cm的肿块,浆膜面灰白色,胃壁稍水肿。幽门上下淋巴结肿大,幽门下淋巴结融合成团并与胰头浸润或粘连,不易推动。术中诊断:胃窦癌。对本病例,应选择的手术方式是()。

A.胃癌穿孔修补+腹腔引流术

B.胃癌联合胰十二指肠切除术

C.胃癌穿孔修补+胃空肠吻合术

D.胃癌切除,胃、肠Roux-Y吻合术

E.胃癌切除,毕Ⅱ式吻合术

F.胃癌切除,毕Ⅰ式吻合术

答案

参考答案:C

完形填空
Mr Guppy was a very large man. Life was not easy for him. He could not find clothes big enough. His         were too large for most shoes. In buses, trains and planes, he could not stand up straight. The roofs were too        . In fact, wherever he went and whatever he did, Mr Guppy had         because of his size.
These problems were so bad that Mr Guppy         at home most of time. Life was easier at home.Then one day, a friend said, “You spend too much time at home. You          go out more. There’s a good movie at the theatre.”
“I can’t sit in any seat there,” Mr Guppy said. “I’m         big.”
“That is no problem,” his friend said. “I’ll buy you two tickets. You can         them at the theatre when you get there.”
The friend sent money to the theatre for two tickets. When the day came, Mr Guppy        his best clothes and went to the theatre.
“You have two tickets for me,” he said to the       in the ticket office. “My name is Guppy.”
“Oh, yes, Mr. Guppy,” the woman said. “Here you are. Seats G4 and P12. I’m sorry, you and your friend can’t sit together          too many people have come to see the film this evening.”
Poor Mr Guppy! He smiled sadly, walked out of the theatre and went home.
小题1:
A.handsB.feet C.earsD.eyes
小题2:
A.lowB.highC.large D.small
小题3:
A.experienceB.problemsC.relationsD.practice
小题4:
A.left B.keptC.stayedD.lived
小题5:
A.mustB.wouldC.shouldD.need
小题6:
A.fewB.littleC.someD.too
小题7:
A.buyB.sell C.give D.get
小题8:
A.picked upB.asked forC.put onD.saved up
小题9:
A.womanB.manC.girlD.boy
小题10:
A.untilB.becauseC.beforeD.whether
名词解释