男，35岁，腹痛、反酸10年。1周来症状加重，并出现夜间痛，进食能部分缓解。
最佳的治疗方案是
A．手术治疗
B．胃粘膜保护剂+抗生素
C．胃粘膜保护剂+铋剂
D．质子泵抑制剂+抗生素+铋剂
E．质子泵抑制剂
参考答案：D
解析：该病人腹痛、反酸10年，近期出现夜间痛，进食后能部分缓解，根据病史、临床表现首先考虑十二指肠球部溃疡。胃镜是确诊消化性溃疡首选的检查方法，不仅可以对胃、十二指肠粘膜直接观察、摄像，还可在直视下作病理学检查及幽门螺杆菌检测。确诊后，该病人治疗除应用抗酸药物质子泵抑制剂抗酸、保护胃粘膜的铋剂，还应加用抗生素，予以根除幽门螺杆菌治疗。
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| Mrs. White was very fat. She was over 100 kilos. 1 she went to see a doctor. The doctor said, "You need a balanced diet, Mrs. White, and I have a good 2 here." He gave Mrs. White a small book and said, "Read this carefully and eat the things on page 11 every day. Then come back and see 3 in four weeks." Mrs. White came again four weeks 4 , but she wasn't 5 . She was still very fat. The doctor was surprised and asked, "Are you eating the things on page 11 of the small 6 ?" "Yes, doctor." She answered. The next day the doctor visited Mrs. White during her 7 . He was very surprised. He said, "Mrs. White, 8 are you eating potatoes and bread? They 9 in your diet. ""But, doctor," Mrs. White answered, " I follow my diet 10 lunch time. This is my dinner. " | |||
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