问题 单项选择题 案例分析题

女性,53岁。呕血、便血6小时。量约3000ml,伴轻度意识障碍。患肝炎后肝硬化10年。入院体检:血压90/60mmHg,心率120次/分。巩膜轻度黄染,腹平、软,肝未及,脾肋下7cm,移动性浊音阳性,肠鸣音稍亢进。

患者经抗休克,输血,压迫止血等治疗后,生命体征逐渐平稳,但三腔二囊管压迫放气后,又再次发生出血,量约2000ml。腹腔积液。肝功能检查:血清胆红素70μmol/L,白蛋白25g/L。下一步治疗应考虑()

A.TIPS

B.胃大部切除术

C.急诊行分流术

D.急诊行断流术

E.急诊断流术+限制性分流术

答案

参考答案:A

选择题
单项选择题

On a weekday night this January, thousands of flag-waving youths packed Olaya Street, Riyadh’s main shopping strip, to cheer a memorable Saudi victory in the GCC Cup football final. One car, rock music blaring from its stereo, squealed to a stop, blocking an intersection. The passengers leapt out, clambered on to the roof and danced wildly in front of the honking crowd. Having paralyzed the traffic across half the city, they sped off before the police could catch them.

Such public occasion was once unthinkable in the rigid conformist kingdom, but now young people there and in other Gulf states are increasingly willing to challenge authority. That does not make them rebels: respect for elders, for religious duty and for maintaining family bonds remain pre-eminent values, and premarital sex is generally out of the question. Yet demography is beginning to put pressure on ultra-conservative norms.

After all, 60% of the Gulf’s native population is under the age of 25. With many more of its citizens in school than in the workforce, the region faces at least a generation of rocketing demand for employment. In every single GCC country the native workforce will double by 2020. In Saudi Arabia it will grow from 3.3m now to over 8m. The task of managing this surge would be daunting enough for any society, but is particularly forbidding in this region, for several reasons.

The first is that the Gulf suffers from a lopsided labor structure. This goes back to the 1970s, when ballooning oil incomes allowed governments to import millions of foreign workers and to dispense cozy jobs to the locals. The result is a two-tier workforce, with outsiders working mostly in the private sector and natives monopolizing the state bureaucracy. Private firms are as productive as any. But within the government, claims one study, workers are worth only a quarter of what they get paid.

Similarly, in the education sector, 30 years spent keeping pace with soaring student numbers has taken a heavy toll on standards. The Saudi school system, for instance, today has to cope with 5m students, eight times more than in 1970. And many Gulf countries adapted their curricula from Egyptian models that are now thoroughly discredited. They continue to favor rote learning of "facts" intended to instill patriotism or religious values.

Even worse, the system as a whole discourages intellectual curiosity. It channels students into acquiring prestige degrees rather than gaining marketable skills. Of the 120, 000 graduates that Saudi universities produced between 1995 and 1999, only 10,000 had studied technical subjects such as architecture or engineering. They accounted for only 2% of the total number of Saudis entering the job market.

The basic problem of people pressure facing the Saudi authority lies in()

A. expanding workforce

B. exploding population

C. practical intelligence

D. intellectual curiosity