胸部闭合性损伤（肋骨骨折、血胸和气胸）的临床表现及病理生理基_爱下问搜题

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胸部闭合性损伤（肋骨骨折、血胸和气胸）的临床表现及病理生理基础

答案

参考答案：

（1）胸痛：常位于受伤处，并有压痛，呼吸时加剧，尤以肋骨骨折者为甚。

（2）呼吸困难：疼痛可使胸廓活动受限，呼吸浅快。如气管、支气管有血液或分泌物堵塞，不能咳出，或肺挫伤后产生出血、淤血或肺水肿，则更易导致和加重缺氧和二氧化碳潴留。如有多根多处肋骨骨折，胸壁软化，影响正常呼吸运动，则呼吸更加困难，出现胸廓反常呼吸活动、气促、端坐呼吸、发绀、烦躁不安等。（3）其他：肺或支气管损伤者，痰中常带血或咯血；肺爆震伤后，多咳出泡沫样血痰；大量积气特别是张力性气胸，除影响肺功能外尚可阻碍静脉血液回流；心包腔内出血则引起心脏压塞。

（4）局部体征：按损伤性质和伤情轻重而有所不同，可有胸壁挫裂伤、胸廓畸形、反常呼吸运动、皮下气肿、局部压痛、骨摩擦音和气管、心脏移位征象。胸部叩诊：积气呈鼓音，积血则呈浊音。听诊：呼吸音减低或消失，或可听到痰鸣音、啰音。

完形填空

Directions: Read the following passage. Fill in the numbered blanks by using the information from the passage.

Write NO MORE THAN THREE WORDS for each answer.

An apprenticeship is a form of on-the-job training that combines workplace experience and classroom learning. It can last anywhere from one to six years, but four years is typical for most. An apprentice spends the majority of the time in a workplace environment learning the practical skills of a career from a journeyman--someone who has done the job for many years. The rest of the apprentice's time is spent in a classroom environment learning the theoretical skills the career requires. Being an apprentice is a full-time undertaking.

One of the advantages of apprenticeship is that it does not cost apprentices anything. The companies that hire them pay for school. What's more, it offers apprentices an "earn while you learn" opportunity. They usually start out at half the pay of a journeyman, and the pay increases gradually as they move further along in the job and studies. Near the end of the apprenticeship, their wages are usually 90 percent of what a journeyman would receive. Apprenticeship also pays off for employers. It can offer employers a pool of well-trained workers to draw from.

Despite the advantages, apprentices are usually required to work during the day and attend classes at night, which leaves little time for anything else. Sometimes, they might be laid off(下岗) if business for the employers is slow.

Once they have completed the apprenticeship and become journeymen, they receive a nationally recognized and portable certification and their pay also increases again. Some journeymen continue employment with the companies they apprenticed with; others go onto different companies or become self-employed contractors.

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