试述腹部手术切口裂开的原因及其预防和处理。
参考答案：
（1）切口裂开原因：
①营养不良，组织愈合能力低。
②术后腹压增高，如腹胀、剧烈咳嗽。
③缝合腹壁的技术有缺点，如打结不紧，缝合时腹膜有撕裂等。
（2）预防：应根据可能发生的原因采取相应措施，如术前提高营养状况，强调在腹壁松弛状态下，精工缝合技术。
对估计容易发生此类并发症的病人，可采取：
①术时用减张缝线，即在依层缝合腹壁的基础上，加用全层腹壁缝合。
②及时处理腹胀。
③咳嗽时，最好平卧以减轻咳嗽时横膈突然大幅度下降所骤然增加的腹内压力。
④用腹带作腹部包扎。
⑤预防感染。
（3）处理措施：腹壁切口完全或部分裂开，都应立即送手术室，在无菌条件下，用粗丝线或合金线做腹壁全层间断缝合。因常有腹胀肠麻痹，故应采用胃肠减压。
While I was waiting to enter university, I saw an advertisement in a newspaper –a teaching job wanted at a school. The school was about ten miles from where I lived. I was in great of money and wanted to do something useful, so I . Three days later, a letter arrived. It asked me to meet the principal of the school at Croydon. It proved to be a(n) journey -a train to Croydon station, a ten-minute bus ride and then a walk of a quarter of a mile. A man who was short and round seemed to be the principal and he opened the door for me. "The school," he said, "has a group of twenty-four boys between seven and thirteen years old." According to the man, I should have to teach all the subjects art, which the man himself taught. I should have to the class into three groups and teach them at three different levels, and I was not glad at the of teaching Maths -a subject which I wasn't good at. It was that I had to teach them on Saturday afternoon because most of my friends would be themselves at that time. Before I had time to ask about my ,the man got up to his feet. "Now," he said,“You'd better meet my wife. She is the one who really runs this school.”
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