【正文】 s rival, the National Basketball League, had existed since the 1930s, had better players, like Mikan of the Minneapolis Lakers, Bob Davies of the Rochester Royals, and Dolph Shayes of the Syracuse Nationals, but operated in much worse facilities and did not do much better at attracting audiences. In 1948, Podoloff lured the Lakers, Royals, and two other teams to the BAA and proposed a merger of the two leagues for the 1949–1950 season. The result was the National Basketball Association (NBA), with Podoloff its first missioner. The seventeenteam league struggled at first but soon reduced its size and gained stability, in large part because of Mikan39。s development: zone defenses, the weave, the passing game, and the fast break. In the decade preceding World War II, five events changed college basketball and allowed it to bee a major spectator sport. In 1929, the rules mittee reversed a decision that would have outlawed dribbling and slowed the game considerably. Five years later, promoter Edward Ned Irish staged the first intersectional twin bill in Madison Square Garden in New York City and attracted more than 16,000 fans. He demonstrated the appeal of major college ball and made New York its center. In December 1936, Hank Luisetti of Stanford revealed the virtues of the onehanded shot to an amazed Garden audience and became the first major collegiate star. Soon thereafter, Luisetti scored an incredible fifty points against Duquesne, thus ending the East39。s Philadelphia SPHAs (South Philadelphia Hebrew Association)。s World Basketball Association, before the WNBA debuted in 1997 with the support of the NBA. James Naismith, originally from Almonte, Ontario, invented basketball at the International YMCA Training School in Springfield, Massachusetts, in 1891. The game was first played with peach baskets (hence the name) and a soccer ball and was intended to provide indoor exercise for football players. As a result, it was originally a rough sport. Although ten of Naismith39。s basketball league in the United States was the National Basketball League (NBL), which debuted in 1898. Players were paid on a pergame basis, and this league and others were hurt by the poor quality of games and the everchanging players on a team. After the Great Depression, a new NBL was organized in 1937, and the Basketball Association of America was organized in 1946. The two leagues came to agree that players had to be assigned to teams on a contract basis and that high standards had to govern the game。s basketball. Until World War II, basketball became increasingly popular in the United States especially at the high school and college levels. After World War II, its popularity grew around the world. In the 1980s, interest in the game truly exploded because of television exposure. Broadcast of the NCAA Championship Games began in 1963, and, by the 1980s, cable television was carrying regular season college games and even high school championships in some states. Players like Bill Russell, Wilt Chamberlain, and Lew Alcindor (Kareem AbdulJabbar) became nationally famous at the college level and carried their fans along in their professional basketball careers. The women39。 England in 1894。s five basic principles center on the ball, which was described as large, light, and handled with the hands. Players could not move the ball by running alone, and none of the players was restricted against handling the ball. The playing area was also open to all players, but there was to be no physical contact between players。s games measures in (7576 cm) in circumference, and a women39。有口腔內(nèi)感染的病人，術(shù)前應(yīng)做必要治療，以減少術(shù)后食管內(nèi)感染的機(jī)會。⑧糖尿?。禾悄虿∪耍瑹o論Ⅰ型或Ⅱ型，術(shù)前均應(yīng)使用胰島素，使血糖穩(wěn)定在輕度升高狀態(tài)(100～200毫克/分升)，這樣不僅對人體無害，且不至因胰島素過多而發(fā)生低血糖，也不至因胰島素過少而發(fā)生酸中毒。急性心肌梗塞病人的手術(shù)耐受力很差，6個月內(nèi)最好不施行擇期手術(shù)；6個月以上，只要沒有心絞痛發(fā)作，在監(jiān)測條件下，可以施行手術(shù)。蛋白質(zhì)缺乏也常引起組織水腫，影響愈合。部分食管癌病人進(jìn)食困難，易有水電解質(zhì)代謝及酸堿平衡失調(diào)，應(yīng)予以糾正。②適應(yīng)手術(shù)后變化的鍛煉：多數(shù)病人不習(xí)慣在床上大小便，手術(shù)前應(yīng)練習(xí)?？梢?，遺傳因素在食管癌的發(fā)病中有一定關(guān)系，也可能是內(nèi)外因素的共同作用。②此病人術(shù)前最主要的問題是什么?③主要術(shù)前準(zhǔn)備有哪些？答：　　食管其他病變：某些食管病變，如食管賁門失弛緩癥、食管炎、食管良性狹窄、食管粘膜白斑等食管病的患者，其食管癌的發(fā)病率較高，可能與食管粘膜病變遭受長期刺激有關(guān)。既往吸煙50年，每日1包口平時喜食脂制食品口其 弟因食管癌去世。③如系急性膿胸，術(shù)中宜取分泌物作常規(guī)檢驗、細(xì)菌培養(yǎng)及藥物敏感度試驗。②如何護(hù)理留置胸腔閉式引流管的病人?答：適應(yīng)證：急性膿胸、胸外傷、肺及其他胸腔手術(shù)后、氣胸（尤張力性）。胸部外傷致右側(cè)第5脅骨骨折并發(fā)氣胸，呼吸極度困難，發(fā)鉗，出冷汗。脈搏120次/分，呼吸20次/ 分，血壓150/70 mmHg，體溫37. 2 39。這一點醫(yī)生護(hù)士會向病人交待，他們也會及時觀察。在這種情況下就必須再次緊急手術(shù)，清除血腫，只要發(fā)現(xiàn)及時，措施得當(dāng)，絕大部分病人可以獲得良好的效果。列舉可能導(dǎo)致頸椎前路手術(shù)病人術(shù)后呼吸困難的原因及護(hù)理要點。⑥根據(jù)醫(yī)屬預(yù)防性應(yīng)用抗菌藥物及破傷風(fēng)抗毒素或破傷風(fēng)類毒素。②估計腦脊液外漏量。⑥防治代謝性疾病，如甲狀腺功能亢進(jìn)者應(yīng)行手術(shù)治療。答：①養(yǎng)成多飲水的習(xí)慣：多飲水可稀釋尿液，降低尿內(nèi)晶體濃度，沖洗尿路，有利于預(yù)防結(jié)石形成及促使尿石排出，一般成人每日飲開水或磁化水2000毫升以上，對預(yù)防結(jié)石有一定意義。答：疼痛是一種復(fù)雜現(xiàn)象，它是由身體、社會和心理因素相互作用形成的“總體疼痛”的感覺。每4小時一次。答：食管癌病人術(shù)后需禁飲食，一般3～4天后，腸蠕動恢復(fù)，拔除胃管，第五天可進(jìn)無渣流質(zhì)飲食。具有侵襲性小，出血少及恢復(fù)快的優(yōu)點。手術(shù)后的化療也是必須的，包括全身的及肝臟局部的。所以還是手術(shù)。 階梯性采用上述方案，使膽總管結(jié)石的微創(chuàng)手術(shù)治療總成功率99%以上，從而就避免了傳統(tǒng)開腹手術(shù)給病人造成的痛苦，達(dá)到了最佳的治療效果，并且明顯縮短了住院時間。 如果病人既有膽囊結(jié)石又有膽總管結(jié)石，可以先采取上述方法(經(jīng)內(nèi)鏡取凈膽總管中結(jié)石)，再采用腹腔鏡膽囊切除術(shù)(“打眼”)切除膽囊，徹底治愈疾病。它有許多優(yōu)點： (1)不需要全身麻醉，尤其對于高齡、有手術(shù)禁忌癥者更為適合。139。 手術(shù)后近期發(fā)生的粘連性腸梗阻應(yīng)與手術(shù)后腸麻痹恢復(fù)期的腸蠕動功能失調(diào)相鑒別，后者多發(fā)生在手術(shù)后3—4日，當(dāng)自肛門排氣排便后，癥狀便自行消失。如手術(shù)后早期發(fā)生的粘連性腸梗阻，多為單純性腸梗阻，而且這種新形成的粘連，日后可部分或全部吸收，非手術(shù)治療效果常較滿意。因為手術(shù)治療并不能消除粘連，相反地，術(shù)后必然還要形成新的粘連，所以對單純性腸梗阻，不完全性梗阻。36. 8OC，因4次/分， R20次/分， BP90/ 60mmHg，皮膚粘膜干燥，眼窩凹陷，中等程度腹脹，全腹輕壓痛， 無固定壓痛點，腸鳴音亢進(jìn)，移動性濁音陰性，腹部X線平片可見小腸多個氣液平面。彈力襪清洗時冷水和中性肥皂，輕柔搓洗，不能烘烤或在陽光下暴曬，以防影響使用壽命。鼓勵患者深呼吸并經(jīng)常變動體位，保持呼吸道通暢防止肺部感染。答：術(shù)后平臥24 h，同時避免腹部用力。（2）在左腹直肌處臍旁平面，這是最常用的部位，優(yōu)點是可以預(yù)防造口旁疝。③避免進(jìn)行增加腹壓的活動。應(yīng)警惕絞窄性腸梗阻的發(fā)生，及時手術(shù)治療。簡述腸梗阻病人胃腸減壓的護(hù)理要點。后天的原因有腸套疊，蛔蟲團(tuán)堵塞、腸扭轉(zhuǎn)、腫瘤壓迫、炎癥或手術(shù)后腸粘連等。二、簡答題：列舉腸梗阻的病因和分類。是膽結(jié)石、急性膽囊炎、慢性膽囊炎、膽道蛔蟲癥和急性梗阻性化膿性膽管炎等病中的一個重要癥狀。故臨床治療宜標(biāo)本兼顧，以調(diào)補肝、腎為關(guān)鍵，同時采用舒肝理氣、化痰散結(jié)、健脾養(yǎng)心等法。近半年來發(fā)現(xiàn)，站立時陰囊部 位出現(xiàn)腫塊，呈梨形，平臥時可還納。如果患甲亢之前無心臟病史，患甲亢后出現(xiàn)心臟病，應(yīng)考慮為甲亢性心臟病。③心肌病類型：表現(xiàn)為心肌擴(kuò)大，往往是全心擴(kuò)大，早期心功能正常，后期可能發(fā)生心力衰竭。④外周組織耗氧增加，血管阻力減少。問:①列出該病人術(shù)前存在的兩個主要的護(hù)理診斷/問題。腫大。（2）術(shù)后第6天病人并發(fā)盆腔膿腫。病人出院前健康指導(dǎo)：①關(guān)于上肢功能鍛煉方面，術(shù)后24h鼓勵病人做腕部、肘部的屈曲和延伸運動，但避免外展上臂；48h可下床，但肩關(guān)節(jié)制動；術(shù)后1周開始作肩部運動；術(shù)后10~12天鼓勵病人用術(shù)側(cè)手進(jìn)行自我照顧，并開始進(jìn)行肩關(guān)節(jié)全方位活動，如爬墻運動、舉杠運動、滑繩運動。②適當(dāng)?shù)闹v解乳癌治療的有關(guān)知識，說明手術(shù)治療的必要性，特別是我國在乳癌治療中取得的成就，使病人樹立戰(zhàn)勝疾病的信心。（3）綜合治療：遵醫(yī)囑堅持放療、化療，定期去醫(yī)院復(fù)查。長期持續(xù)水腫引起水腫區(qū)組織、細(xì)胞營養(yǎng)不良，對感染的抵抗力下降，易發(fā)生皮膚潰瘍和繼發(fā)感染，且傷口不易修復(fù)。（2）皮膚完整性受損／有皮膚完整性受損的危險：與水腫所致組織細(xì)胞營養(yǎng)不良有關(guān)。（3）直腸、肛門或肛管出血，血色鮮紅附于糞便表面，或為便后有鮮血滴出。本題主要考查的是不同部位消化道出血的血便的特點，一般分為上消化道出血和下消化道出血，