问题 问答题 简答题

重症药疹的治疗原则。

答案

参考答案:

重症药疹的治疗原则:药疹确诊后应立即停用一切可疑致敏的药物,重症药疹亦如此。一经确诊,要及时抢救、降低死亡率、减少并发症、缩短病程。

(1)及早足量使用糖皮质激素:是降低死亡率的前提。一般用氢化可的松300~400mg/d或地塞米松10~20mg/d治疗,病情控制后再逐渐减量,并密切观察激素的副作用。

(2)预防和治疗感染:是降低死亡率的关键。应强调消毒隔离,必要时使用抗生素预防感染;如有感染,应选用不易过敏的抗生素,并可结合细菌培养及药敏试验结果来选择;治疗过程中应注意有无真菌感染的可能。

(3)加强对症支持治疗:维持水电解质平衡;补充蛋白质、血浆等以维持胶体渗透压,减少渗出,促进皮损愈合;如有高热、肝脏损害等症状时,应给予退热、护肝等相应的治疗。

(4)加强护理和局部治疗:是缩短病程、成功治疗的重要保障。注意保暖,勤换被单,严格消毒,防止褥疮的发生;累及口腔、眼等黏膜者,要加强口腔、眼睛等处的及时护理和治疗;对大面积糜烂、渗出的皮损,可用3%硼酸溶液等湿敷,并与暴露疗法交替治疗。

单项选择题

The Lake District in north-west England is an area remarkably little affected by industrialization. The principal activity is still sheep-farming, as it has been for a thousand years, and many ancient words like "fell" for "hill" and "tam" for "lake" are still in daily use. In spite of its heavy rainfall and relative inaccessibility, its special atmosphere and spectacular natural beauty combine to make this one of England’s favourite holiday areas at all seasons of the year. But at Christmas 1968, still gripped by the fear that foot-and-mouth disease could spread to the hill flocks and sweep like wildfire right up to the Scottish border, it was quieter than ever before in this century. Luckily not a single farm had caught tile infection, the nearest case having been an isolated one at Kendal several weeks before. But every Lakeland farmer knows that one case among the unfenced hill flocks on the fells could lead to complete annihilation of hundreds of thousands of sheep and the virtual end of the district’s principal industry; you cannot replace sheep, acclimatized to their own part of the fell for generations, in the same way that you can replace cattle in a field.
Nobody could remember a Christmas like it, especially Boxing Dab, which is traditionally one of the big outdoor holidays of the Lakeland year. Normally this is a day spent following the mountain packs of hounds, fell-walking and, if the weather is propitious, skiing and skating, but this time there were none of these things. Visitors were actively discouraged, and those who did come were asked not to go on the fells, footpaths or bridleways or near farmland, while motorists were requested not to drive on minor roads and to shun the smaller valleys. The enterprising hotels which had earlier in the year decided to keep open during the winter were by the end of October having a desperate time. Hundreds of bookings had been cancelled and scores of dinner parties and young farmers’ reunions eliminated. All youth hostels were closed. At least one climbing club, unable to climb, substituted a training programme of films and simulated climbs on the more substantial municipal buildings.
The weather in the area was dry, crisp, windless and cold, in fact ideal for brisk outdoor activities. But nobody was able to enjoy it. Everything was stopped: hunting, walking, climbing, skiing, motor cycle trials, sporting events of every description. All the seasonal dances, festivals, conferences, shepherds’ meets and a hundred and one, other social occasions abandoned. The ice was bearing on some of the lakes but you could not go skating there. Meanwhile the foxes, emboldened by an unprecedented freedom from harassment, were stalking closer to the farms and the flocks of Christmas turkeys, while the hounds sulked miserably in their kennels.
Farmers are apt to criticize some sections of the outdoor fraternity for their occasional thoughtless behaviour, but the way that walkers, climbers, skiers, fishermen, hunters and the rest went out of their way to help them at this time should never be forgotten. The general public, locals and visitors alike, tried to give the fell farmers a sporting chance, and this remarkable display of public spirit was the one bright note in a very sad time.

The district’s principal industry is______.

A.(A) fell-walking

B.(B) snow-skiing

C.(C) sheep-farming

D.(D) animal-hunting

单项选择题