问题 单项选择题 A1/A2型题

患者男,32岁,因胃窦部溃疡并出血,行毕Ⅱ式胃大部分切除,术后第3天进无渣流质,第5天食少量肉汤和鸡蛋两个,第6日发生上腹饱胀,呕吐食物,无胆汁,诊断最大可能是()。

A.急性胃炎

B.空肠输入袢梗阻

C.空肠输出袢梗阻

D.胃空肠吻合口梗阻或胃排空障碍

E.倾倒综合征

答案

参考答案:D

解析:

吻合口梗阻:多在术后由流食改为半流食时出现。主要临床表现为上腹部膨胀感和溢出性呕吐,呕吐物含有或不含有胆汁。查体时有时可触到压痛性包块。胃肠减压可引出少量液体,减压后症状也随之缓解,但进食后可再次发作。一般持续10~20日开始缓解,且一旦缓解症状很快消失,2~3日即可进食。吻合口梗阻常见原因包括:胃肠吻合口开口过小、逆行套叠堵塞吻合口等。预防主要是术中避免吻合口开口过小、止血可靠、尽量减少对黏膜的损伤、注意无菌操作、纠正低蛋白血症等。治疗:若为吻合口过小需再次手术扩大吻合口,否则应采用非手术治疗,方法包括:禁食,胃肠减压,纠正水、电解质紊乱与酸碱失衡,营养代谢支持,适量输入血浆,胃内局部应用高渗盐水等。急性完全性输入段梗阻表现为:突发性上腹部剧烈疼痛,呕吐频繁但量不大,也不含胆汁,吐后症状不缓解。慢性不完全性输入段梗阻表现为:进食后30分钟左右,即感上腹部胀痛或绞痛,并放射到肩胛部,随即突然喷射性呕吐大量不含胆汁样液,吐后症状消失。输出段梗阻表现为:上腹部胀满,呕吐含胆汁的胃内容物。故答案应选D。

阅读理解

阅读理解。

     We are all busy talking about and using the Internet, but how many of us know the history of the

 Internet?

     Many people are surprised when they find that the Internet was set up in the 1960s. At that time ,

 computers were large and expensive. Computer networks (网络) didn't work well. If one computer in the

  networks broke down, then the whole network stopped. So a new network system (系统) had to be set

  up. It should be good enough to be used by many different computers. If part of the network was not

 working, information (信息) could be sent through another part. In this way computer network system

 would keep on working all the time.

     At first, the Internet was only used by the goverment (政府),but in the early 1970s, university (大学),

 hospitals and banks were allowed to use it too. Howerver,computers were still expensive and the Internet

  was difficult to become cheaper and easier to use. Scientists had also developed software (软件) that

 made "Surfing" (浏览) the Internet more convenient (方便).

     Today it is easy to get-on-line and it is said that millions of people use the internet every day. Sending

  e-mail is more and more popular among students.

     The Internet has now become one of the most important parts of people's life.

1. The Internet has a history of _____ years.

    A. about 40

    B. less than 30

     C. more than 45

    D. nearly 35

2. Scientists set up a new network system to _____ .

    A. make the computer cheaper.

    B. use the computer widely

    C. make the computer go well

    D. develop new softwares

3. The Internet was widely used in the _____ .

    A. 1960s

    B. 1970s

    C. 1980s

    D. 1990s

4. The underlined words "get-on-line" in Chinese means "_____ "

    A. 上机

    B. 上网

    C. 接线

    D. 买电脑

5. Which of the following is NOT ture?

    A. In the 1960s computer networks system went wrong easily.

    B. Computers are much cheaper than before.

    C. Today the Internet is used everywhere.

    D. People had enough softwares to get on-line fifteen years ago

问答题