患者女，58岁，因劳力性气促、腹胀、双下肢水肿3年，加重7d伴黒蒙1次入院。8年前因病态窦房结综合征行永久人工心脏起搏器置入治疗（VVI起搏器），当时UCG和胸部X线检查均无异常。无慢性咳嗽和原发性高血压史。查体：Bp120/70mmHg，颈静脉怒张，双肺呼吸音粗，无啰音。心率50次/min，律齐，P2不亢进，胸骨左下缘可闻及4/6级全收缩期杂音，吸气时增强。肝大，双下肢水肿。
最佳治疗方案为（）（提示：食管超声发现三尖瓣间隔瓣穿孔，电极与瓣叶黏附牵连。）
A.利尿，纠正右心衰竭
B.使用降低肺动脉高压的药物
C.更换起搏器
D.外科手术三尖瓣修复或置换
E.心外膜永久起搏
F.拔出原心内膜电极
参考答案：A, C, D, E, F
| 完形填空 | ||||
I first met her on the beach near where I live.I drive to this beach a__1__o f three or four miles, whenever I'm feeling down.At that time she was__2__something. Looking__3__, she said, "Hello." I nodded, not wanting to__4__with a small child. "I'm Wendy and I  'm building something, " she said."I see.But what is it?" I asked, not__5__. "I don't know.I just like the__6__of sand." A sandpiper (矶鹞鸟) flew by. "That's a__7__.Mum says sandpipers come to bring us joy." "Goodbye, joy, " I thought to myself, "hello, __8__." and walked away.My life then seemed completely out of__9__. "Come again, " she called, "and have another__10__day." But the days and weeks that followed__11__to other people:naughty boys and a__12__mother. One morning I suddenly realized I needed my__13__and headed for the beach.The breeze was cool, but I walked along, trying to recapture (捕捉) the inner peace I needed.I had almost__14__the child so I was surprised when she appeared. "__15__do you live?" I asked.She pointed toward a summer cottage. Then one day, I rushed to my beach in great pain, even in no__16__to greet the girl."If you don't mind, " I said coldly, "I'd rather be__17__today." She seemed unusually__18__ and out of breath. "Why?" she asked. "My mother died!" "Did it hurt when she died?" "Of course it hurt!" I shouted, misunderstanding her. When I next went to the beach, she wasn't there.Feeling__19__, and admitting I__20__her, I went up to the cottage.A woman answered the door."Wendy, my daughter, died last week.She had leukemia (白血病). Maybe she didn't tell you." | ||||
|