问题 单项选择题

患者女性,35岁,经产妇,妊娠35周,突然出现 * * 流血,出血量较多,患者无腹痛,急诊入院。孕期无特殊,既往体健。入院查体,子宫无压痛。入院化验检查,Hb9g/dl,余未见异常。

上述患者心率120次/分,血压80/50mmHg,Hb降至7g/dl,下列处理,不正确的是

A.绝对卧床休息
B.抑制宫缩
C.纠正贫血
D.继续延长妊娠,提高胎儿存活率
E.积极准备后,行剖宫产终止妊娠

答案

参考答案:D

解析:根据病史、查体,患者最可能诊断是前置胎盘。延长妊娠适用于出血不多、生命体征平稳的患者。以胎盘边缘与宫颈内口的关系,将前置胎盘分为3种:①完全性前置胎盘:宫颈内口全部为胎盘组织覆盖;②部分性前置胎盘:宫颈内口部分为胎盘组织覆盖;③边缘性前置胎盘:胎盘边缘附着于子宫下段,不超越宫颈内口。因此,只有边缘性前置胎盘在胎头下降过程中,可经胎头压迫而止血。已有 * * 大量出血的患者考虑为完全性前置胎盘或部分性前置胎盘,大出血可以导致产妇休克,从而危及产妇及胎儿生命安全,不适合经 * * 分娩。处理原则是止血补血。该患者已有大量 * * 出血,应以剖宫产结束分娩,减少出血,保证母婴安全,术前准备包括绝对卧床休息、抑制宫缩,以减少出血,同时纠正贫血,改善孕妇状态及胎儿在宫内的缺氧状态。

单项选择题
单项选择题

When I was looking for a Christmas present for my daughter in a toy store, a nicely dressed little girl, with some money in her little hand, was looking at some beautiful dolls. When she saw a doll she liked, she would ask her father if she had enough money. He usually said yes.

At the same time, a boy, with old and small clothes, was looking at some video games. He, too, had money in his hand, but it looked no more than five dollars. Each time he picked up one of the video games and looked at his father, he shook his head.

The little girl had chosen her doll, a very beautiful one. However, she noticed the boy and his father. She saw the boy give up a video game with disappointment and walk to another corner of the store.

The little girl put her doll back to the shelf and ran over to the video game. After she talked to her father, she paid for the video game and whispered(耳语) to the shop assistant.

So the boy got the video game that he wanted for free—he was told it was a prize from the store. He smiled happily, although he felt it was so incredible. The girl saw all this happen. She smiled, too.

When I walked out of the store to my car, I heard the father ask his daughter why she had done that. I would never forget their short talk. " Daddy, didn’t Grandma want me to buy something that would make me happy"

He said, "Of course, she did. "

"Well, I just did!" With that, the little girl started skipping towards their car happily.

The boy ().

A.wore new and nice clothes

B.had much money in his hand

C.was from a poor family

D.wanted to get a doll very much