临床上为便于胃癌时淋巴结清扫，将胃周淋巴结分为（    ）

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• 1胃癌的主要转移方式为（    ）

  A.血行转移

  B.直接蔓延

  C.淋巴转移

  D.腹腔种植

  E.直接至卵巢

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• 2胃大部切除术后发生，胃肠吻合口破裂或漏均少见，但多发生在术后（    ）

  A.1〜2天

  B.3〜6天

  C.5〜7天

  D.7〜9天

  E.9〜11天

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• 3胃十二指肠溃疡大出血大部分病人经内科保守治疗可以治愈，其中需外科手术治疗的比例约为（    ）

  A.5%〜10%

  B.15%〜20%

  C.25%〜30%

  D.35%〜40%

  E.40%〜45%

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• 4早期胃癌的概念是（    ）

  A.局限于胃窦内

  B.局限于黏膜及黏膜下层

  C.直径在2cm以内

  D.无淋巴结转移

  E.尚未侵及浆膜层

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• 5下列哪项不是胃大部切除治疗溃疡的原理（    ）

  A.切除溃疡本身

  B.壁细胞和主细胞数量减少

  C.切除胃窦部，减少C细胞分泌促胃液素所引起的胃酸分泌

  D.切除溃疡的好发部位

  E.消除神经性胃酸分泌

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• 6对胃酸低，全身情况差的老年人，诊断为瘢痕性幽门梗阻，应采取的治疗方式是（    ）

  A.输血，输液，加强营养

  B.胃空肠吻合术

  C.迷走神经切断术

  D.迷走神经切断术加幽门成形术

  E.高选择性迷走神经切断术

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• 7Which if the following is the most common site of lymphatic metastasis of gastric carcinoma?（    ）

  A.Right supraclavicular lymph node

  B.Left supraclavicular lymph node

  C.Right jugular Lymph node

  D.Left jugular lymph node

  E.Left submandibular lymph node

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• 8A 25-year old male，who had undergone subtotal gastrectomy because of acute du­odenum ulcer perforation and had had uneventful recovery after thesurgery，had vSudden on­set of repeated vomiting on his 8th postoperative day during meal. Which of the following approach is inappropriate?（    ）

  A.gastrointestinal decompression

  B.TPN

  C.Neostigmine injection

  D.Fasting

  E.immediate exploratorylaparotomy

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• 9Which of the following is a correct indication for operation on duodenal ulcer?（    ）

  A.Immediate surgery should be made in all suspected acute perforation cases.

  B.Pyloric obstruction must be surgically managed.

  C.Surgical management is needed in case two courses of medical treatment fails.

  D.C.Surgical management is needed in case two courses of medical treatment fails.D.The patient has a long history，frequent episodes，serious symptoms，ineffective medical management， and inability of normal work and living.

  E.None of the above.

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• 10Duodenal ulcer perforation often happens in the（    ）

  A.Duodenal bulb

  B.Front wal lof duodenal bulb

  C.Back wall of duodenal bulb

  D.Back of duodenal bulb

  E.Juxtapyloric duodenum

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