问题 多项选择题 案例分析题

患者女,32岁,“排便困难1年余”。大便4~5天一次,Bristol分型为Ⅰ型或Ⅱ型,无黏液脓血;排便费力,每次至少约10分钟,伴肛门坠胀感,无腹痛及腹部不适。食欲尚可,睡眠欠佳,体重无明显减轻。无结直肠息肉史和结直肠癌肿瘤家族史。间断自服“麻仁丸”,疗效欠佳。查体:神清,生命体征平稳,心肺(-),腹平软,无压痛及反跳痛,肝脾无肿大,腹水征(-)。

便秘的症状包括()。

A.每周排便次数小于3次

B.每周排便次数小于2次

C.粪便干结

D.排便费力,排出困难

E.排便不尽感

F.排便费时需手法辅助排便

答案

参考答案:A, C, D, E, F

解析:

3.便秘的定义主要是指排便次数减少、粪便量减少、粪便干结、排便费力等。对于便秘患者,应行大便常规检查和潜血检查以及直肠指检,初步排除肠道器质性疾病如直肠近肛门肿瘤等。

5.慢性便秘经验性治疗疗效不好时,根据最新的便秘指南,一定要进一步完善相关检查,排除器质性疾病,如果考虑功能性便秘则进一步行相关检查进行病理生理分型,以进一步指导治疗。

8.对于存在排便障碍性便秘的患者,目前明确有效的治疗是生物反馈治疗,大约70%左右的排便障碍性便秘患者,经正规足疗程生物反馈治疗后可以获得明显缓解。

单项选择题 A1/A2型题
阅读理解

阅读理解。

     Is it time to kick Russia out of the BRICs (金砖四国)? If so, it may end up sounding like a famous

ball-point pen maker-BIC. An argument is being made that Goldman Sach's famous marketing device

(策略), the BRICs, should really be the BICs.

     "Is Russia really worth the name BRICs?" asks Anders Aslund, senior fellow at the Peterson Institute

for International Economics, in an article for Foreign Policy. Aslund, who is also co-author with Andrew

Kuchins of  "The Russian Balance Sheet", thinks the Russia of Putin and Medvedev is just not worthy of

inclusion alongside Brazil, India and China in the list of future economic powerhouses. He writes:

     "The country's economic performance has fallen to such a weak level that one must ask whether it has

any say at all on the global economy, compared with the other members of its group. I have just returned

from Moscow, which is always dull around this season. For the last seven years, Russia has taken very

few measures to improve its economy. Instead, the state has been living on oil and gas."

     Economically, Aslund has the numbers on his side. The International Monetary Fund figures that the

Russian economy will fall by 6.7 percent in 2009, while China will grow 8.5 percent and India 5.4 percent.

There is less of a case for Brazil, with a fall of 0.7 percent, but it is still doing far better than Russia.

     But the BRICs are not just about economy. As is mentioned above, it is a marketing device to encourage

investors (投资者)to focus on the big promising players. From an investment standpoint, it could be argued

that Russia is leading the BRICs. Its stock (股票) market is up 128 percent this year while around 80 percent

is for the other three.

     At very least, however, Russia's economic underperformance and stock market outperformance does suggest it is indeed one of the group.

1. According to the passage, which country will enjoy the biggest increase in 2009?

A. China.

B. Russia.

C. Brazil.

D. India.

2. According to Aslund, Russia shouldn't be a BRIC partly because _____.

A. Russia's economic performance is far worse than the other three

B. Russia's leaders are not good at managing economy

C. Russia has taken effective measures to improve its economy

D. Russia will no longer attract investors from other countries

3. From the passage we know that _____.

A. Anders Aslund is working for the Russian government

B. Russia outperformed the other three countries in stock market

C. most people disagree Russia is included in BRICs

D. the BRICs would end up being the BICs sooner or later

4. The author seems to _____.

A. suggest it's time to kick Russia out of the BRICs?

B. feel worried about the economy of the BRICs

C. think Russia is worth being one of the group

D. show disappointment to Russia's economy