问题 多项选择题

[案例] 患儿,男,4个月大,因“上唇部裂开与生俱来,要求手术整复”入院。入院时T:36.8℃,P:120次/分。专科检查见左侧上唇裂开,鼻底尚完整,左侧鼻翼略塌陷。牙齿未萌,左侧前牙区牙槽突可见“V”字形切迹,黏膜完整。硬腭、软腭黏膜完整。完善相关检查后行“左侧唇裂修复术”。

若行单侧唇裂修复术,适合的麻醉方式是

A.眶下神经阻滞麻醉

B.气管内插管全麻

C.γ-羟丁酸钠基础麻醉+眶下神经阻滞麻醉

D.硫喷妥钠基础麻醉+眶下神经阻滞麻醉 E.氯胺酮基础麻醉+眶下神经阻滞麻醉 F.若患者为成人,可单独进行眶下神经阻滞麻醉

答案

参考答案:B,F

解析: 唇裂修复手术,为保证呼吸道通畅,保障安全,除成人可在局麻下进行手术以外,幼儿都应在气管内插管全麻下进行手术。

选择题
单项选择题

Henry Kissinger may be the most successful, certainly the most flamboyant, Secretary of State to hold that office in modern times. When he was appointed in the late 1960’s, there were no American ties with Communist China, Vietnam and Berlin seemed ready to draw the United States into a third world war, and Russia was seen as "the enemy".
But all this has changed, and Henry Kissinger caused much of the change; in 1971, he made his first trip to China, a trip that was the beginning of the current ties between the United States and China. He brought the United States and Russia closer together on major issues by the policy he called "detente", literally meaning a relaxation. His philosophy was always to talk and to bring together. With these two policies, Kissinger did much to draw attention away from any possible Russia-American friction.
In 1973 he made his first visit to Egypt. Here he was able to begin U.S. relations with Egypt. He used his contact later to begin the sort of talks that the American press called "shuttle diplomacy". For ninety-nine days, he "shuttled" back and forth on flights between Cairo and Jerusalem to work out a step-by-step withdrawal of Israeli troops from the Sinai desert. His wit, his careful approach to detail, and his presence made "shuttle diplomacy" work. It was the only successful approach to Mid-east peace in the thirty years since the state of Israel was founded.

The text does not directly say, but implies that Kissinger
[A] suffered a series of defeats while being in office.
[B] significantly altered the direction of international relationships.
[C] was unsuccessful in bringing about peace in the Middle East.
[D] played a more important role than the president during the Nixon administration.


Another major work was the Strategic Arms Limitation Talk. Though his term in office passed with the treaty unsigned, Kissinger left a draft of the treaty to which the Russians had already agreed. The SALT treaty spelled out a one-tenth reduction in nuclear arms, a major accomplishment by any standard, even if one does not consider all the other conditions and limitations included in the treaty.
Even though he successfully helped bring an end to the Vietnam War, Kissinger’s final days in office were affected, as was the entire executive branch in one way or another, by the scandals of the Nixon White House. Kissinger’s critics point to his role in placing wiretaps on the phones of reporters and officials and to what they consider his "high-handed" approach to setting foreign policy. But Kissinger, during the last few months of the Nixon presidency, limited the effects of American domestic problems on our foreign policy. He continued talks in the Middle East. He continued close contact with the Soviet Union.
History will decide in the final view, as Kissinger--and many presidents--often said, on the value of his service. Whatever they decide, whether his actions are finally to be considered wise or foolish, he had a personal vision that will be difficult to match. (459 words)Notes: work out 制定。spell out 清楚地说明。wiretap 窃听(电话)。scandal 丑闻。