问题 多项选择题 案例分析题

患者男,26岁,因“急性阑尾炎术后9d,腹泻、发热6d,气促6h”入ICU。9d前因急性阑尾炎行手术治疗,术中发现阑尾坏死、穿孔,腹腔内有大量脓性液体,手术切除坏死阑尾,并给予大量0.9%氯化钠溶液冲洗腹腔。术后患者体温波动在37~39℃,予抗感染治疗。术后第3天患者出现黄绿色稀水便,每次100~300ml,每天10~15次。腹部超声:肠间和肝下有少量液性暗区。考虑为术后腹腔感染,继续抗感染治疗。术后第7天粪培养为金黄色葡萄球菌,考虑菌群失调,停用抗生素。但患者仍发热、腹泻,并在术后第9天出现呼吸急促,为进一步治疗收入ICU。既往体健。查体:T38.5℃,P100次/min,R30次/min,BP105/60mmHg;双肺呼吸音清,心律齐,未闻杂音;腹软,手术切口愈合好,伤口周围有压痛,移动性浊音(-),肠鸣音活跃(7次/min)。血常规:WBC14×109/L,N0.88,Hb140g/L,PLT300×109/L。粪常规:球杆比例为6︰4。血电解质:Na+128mmol/L,K-3.0mmol/L。BG5.5mmol/L。肾功能正常;肝功能:ALT、AST正常,总胆红素67μmol/L,直接胆红素31μmol/L,总蛋白67g/L,清蛋白31g/L。普通面罩吸氧(氧流量4L/min),血气分析:pH7.45,PaCO234mmHg,PaO290mmHg,BE2mmol/L,血糖9mmol/L。ECG:窦性心动过速。胸部X线片:无明显异常。

患者目前腹泻最可能的原因是()

A.腹腔感染引起肠蠕动增加

B.抗生素相关菌群失调

C.电解质紊乱

D.不全肠梗阻

E.急性细菌性痢疾

F.手术致肠道功能紊乱

答案

参考答案:B

阅读理解

阅读理解。

     When Kyle walked into Ernie's Pet World, he looked very anxious. The shop owner, Ernie, jumped out

of his seat to greet Kyle. He was the shop's first customer of the day.

     "Good morning, sir!" Ernie said, "What can I help you with?"

      "Well, I……" Kyle started to say.

     "Wait, don't tell me," Ernie stopped him. "You're looking for a…a little dog… for your daughter's birthday,

Right?"

     "Not really, I just…"

      Ernie didn't let him finish."Ah, I've got it, You just moved to a new office, and you want some fish for it,

I have some very nice fish bowls over here."

      "In fact, I…"Kyle was starting to look very nervous and strange.

      "No fish? Ah, a cat! You look like a cat person. At Ernie's Pet World, we have the best cats. Take a look

at this lovely one with long, white hair, She's looking at you. She's thinking, 'Take me home. Take me home.

'Would you like some cat food and toys, too?" .

     By this time, he was walking up and down. He had a terrible look on his face. "Really, I'm not interested in

cats or fish or little dogs."

     "What do you want, then?" Ernie asked.

     Kyle looked like he was going to cry. "I just want to know if can use your toilet!" he said at last.

1. Which is TRUE about Ernie's Pet World?

A. It has many workers.

B. Kyle goes there often.

C. It sells school things.

D. Ernie is the owner of the shop.

2. What kind of person is Ernie?

A. Very lazy.

B. Rather shy.

C. Over warm-hearted.

D. Not friendly.

3. Kyle went into the Ernie's Pet World to ______.

A. buy a little dog

B. take fish home

C. meet the shop owner

D. look for a washroom

4. What does the underlined word "anxious" mean in Chinese?

A. 焦急的

B. 兴奋的

C. 生气的

D. 失望的

5. What is the best title of the story?

A. Kyle and Ernie

B. Pet or Toilet

C. A Pet Lover

D. A Busy Pet Shop

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