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种族与原发性膀胱输尿管反流也有关，如白人女孩是黑人女孩的10倍，但一旦发生，其程度和自然缓解的可能性没有区别。 | [
{
"indices": [
3,
4,
5,
6,
7,
8,
9,
10,
11,
12
],
"label": "dis",
"score": 1,
"text": "原发性膀胱输尿管反流"
}
] |
原发性膀胱输尿管反流与遗传之间的关系也有报告。 | [
{
"indices": [
0,
1,
2,
3,
4,
5,
6,
7,
8,
9
],
"label": "dis",
"score": 1,
"text": "原发性膀胱输尿管反流"
}
] |
故现提倡凡直系亲属有反流病史的均应接受排尿性膀胱尿道造影（VCUG）筛查。 | [
{
"indices": [
10,
11
],
"label": "sym",
"score": 1,
"text": "反流"
},
{
"indices": [
19,
20,
21,
22,
23,
24,
25,
26,
27
],
"label": "pro",
"score": 1,
"text": "排尿性膀胱尿道造影"
},
{
"indices": [
29,
30,
31,
32
],
"label": "pro",
"score": 1,
"text": "VCUG"
}
] |
高血压的发生与肾瘢痕有关，肾瘢痕越多，发生高血压的危险越高，患双侧严重肾瘢痕的小儿随访20年以上，20%有高血压，单侧病变者为8%。 | [
{
"indices": [
0,
1,
2
],
"label": "dis",
"score": 1,
"text": "高血压"
},
{
"indices": [
7,
8,
9
],
"label": "dis",
"score": 1,
"text": "肾瘢痕"
},
{
"indices": [
13,
14,
15,
16,
17,
18,
19,
20,
21,
22,
23,
24,
25,
26,
27,
28
],
"label": "sym",
"score": 1,
"text": "肾瘢痕越多，发生高血压的危险越高"
},
{
"indices": [
13
],
"label": "bod",
"score": 1,
"text": "肾"
},
{
"indices": [
31,
32,
33,
34,
35,
36,
37
],
"label": "dis",
"score": 1,
"text": "双侧严重肾瘢痕"
},
{
"indices": [
53,
54,
55
],
"label": "dis",
"score": 1,
"text": "高血压"
},
{
"indices": [
57,
58,
59,
60
],
"label": "dis",
"score": 1,
"text": "单侧病变"
}
] |
因此凡超声发现的肾积水都应行VCUG，以排除反流。 | [
{
"indices": [
3,
4
],
"label": "pro",
"score": 1,
"text": "超声"
},
{
"indices": [
8,
9,
10
],
"label": "dis",
"score": 1,
"text": "肾积水"
},
{
"indices": [
14,
15,
16,
17
],
"label": "pro",
"score": 1,
"text": "VCUG"
},
{
"indices": [
22,
23
],
"label": "sym",
"score": 1,
"text": "反流"
}
] |
由于相当一部分患儿是无症状反流，在高危人群中用超声进行反流筛查有实际意义。 | [
{
"indices": [
10,
11,
12,
13,
14
],
"label": "sym",
"score": 1,
"text": "无症状反流"
},
{
"indices": [
23,
24
],
"label": "pro",
"score": 1,
"text": "超声"
},
{
"indices": [
27,
28,
29,
30
],
"label": "pro",
"score": 1,
"text": "反流筛查"
}
] |
尿路感染在儿童中更多的表现是非特异性的，包括发热、嗜睡、无力、厌食、恶心、呕吐和生长障碍等。 | [
{
"indices": [
0,
1,
2,
3
],
"label": "dis",
"score": 1,
"text": "尿路感染"
},
{
"indices": [
22,
23
],
"label": "sym",
"score": 1,
"text": "发热"
},
{
"indices": [
25,
26
],
"label": "sym",
"score": 1,
"text": "嗜睡"
},
{
"indices": [
28,
29
],
"label": "sym",
"score": 1,
"text": "无力"
},
{
"indices": [
31,
32
],
"label": "sym",
"score": 1,
"text": "厌食"
},
{
"indices": [
34,
35
],
"label": "sym",
"score": 1,
"text": "恶心"
},
{
"indices": [
37,
38
],
"label": "sym",
"score": 1,
"text": "呕吐"
},
{
"indices": [
40,
41,
42,
43
],
"label": "sym",
"score": 1,
"text": "生长障碍"
}
] |
采用膀胱镜于输尿管开口旁注射某些固体物质如Teflon或胶原蛋白等，阻止尿液反流，是当前欧美地区应用比较多的一种非手术治疗方法，尤其是注射用的固体物质的研究，开展得相当多。 | [
{
"indices": [
2,
3,
4
],
"label": "equ",
"score": 1,
"text": "膀胱镜"
},
{
"indices": [
6,
7,
8,
9,
10,
11,
12,
13
],
"label": "pro",
"score": 1,
"text": "输尿管开口旁注射"
},
{
"indices": [
21,
22,
23,
24,
25,
26
],
"label": "dru",
"score": 1,
"text": "Teflon"
},
{
"indices": [
28,
29,
30,
31
],
"label": "dru",
"score": 1,
"text": "胶原蛋白"
},
{
"indices": [
36,
37,
38,
39
],
"label": "sym",
"score": 1,
"text": "尿液反流"
},
{
"indices": [
36,
37
],
"label": "bod",
"score": 1,
"text": "尿液"
},
{
"indices": [
57,
58,
59,
60
],
"label": "pro",
"score": 1,
"text": "手术治疗"
},
{
"indices": [
67,
68
],
"label": "pro",
"score": 1,
"text": "注射"
}
] |
发生率为1/1500，临床上较常见，占所有先心病的6%～10%，以女性多见，男女比例约为2∶1。 | [
{
"indices": [
21,
22,
23
],
"label": "dis",
"score": 1,
"text": "先心病"
}
] |
最近Benson等发现部分家族性房间隔缺损5p染色体可有基因突变。 | [
{
"indices": [
13,
14,
15,
16,
17,
18,
19,
20
],
"label": "dis",
"score": 1,
"text": "家族性房间隔缺损"
},
{
"indices": [
21,
22,
23,
24,
25
],
"label": "bod",
"score": 1,
"text": "5p染色体"
},
{
"indices": [
28,
29,
30,
31
],
"label": "sym",
"score": 1,
"text": "基因突变"
},
{
"indices": [
28,
29
],
"label": "bod",
"score": 1,
"text": "基因"
}
] |
③冠状窦口型房间隔缺损：此型罕见。 | [
{
"indices": [
1,
2,
3,
4,
5,
6,
7,
8,
9,
10
],
"label": "dis",
"score": 1,
"text": "冠状窦口型房间隔缺损"
}
] |
伴有中等量左向右分流的患儿多无症状，即使有症状，也多为轻度的乏力和气促。 | [
{
"indices": [
8,
9
],
"label": "sym",
"score": 1,
"text": "分流"
},
{
"indices": [
27,
28,
29,
30,
31
],
"label": "sym",
"score": 1,
"text": "轻度的乏力"
},
{
"indices": [
33,
34
],
"label": "sym",
"score": 1,
"text": "气促"
}
] |
髓鞘化障碍是婴幼儿神经系统疾病，尤其是神经变性病和代谢病的主要表现之一。 | [
{
"indices": [
0,
1,
2,
3,
4
],
"label": "dis",
"score": 1,
"text": "髓鞘化障碍"
},
{
"indices": [
6,
7,
8,
9,
10,
11,
12,
13,
14
],
"label": "dis",
"score": 1,
"text": "婴幼儿神经系统疾病"
},
{
"indices": [
19,
20,
21,
22,
23
],
"label": "dis",
"score": 1,
"text": "神经变性病"
},
{
"indices": [
25,
26,
27
],
"label": "dis",
"score": 1,
"text": "代谢病"
}
] |
研究已发现700多种基因突变与CF有关，但均定位于第7号染色体长臂单一位点。 | [
{
"indices": [
10,
11
],
"label": "bod",
"score": 1,
"text": "基因"
},
{
"indices": [
10,
11,
12,
13
],
"label": "sym",
"score": 1,
"text": "基因突变"
},
{
"indices": [
15,
16
],
"label": "dis",
"score": 1,
"text": "CF"
},
{
"indices": [
25,
26,
27,
28,
29,
30,
31,
32,
33,
34,
35,
36
],
"label": "bod",
"score": 1,
"text": "第7号染色体长臂单一位点"
}
] |
新生儿期可因胎粪性肠梗阻、腹膜炎而引起注意并得到诊断。 | [
{
"indices": [
6,
7,
8,
9,
10,
11
],
"label": "dis",
"score": 1,
"text": "胎粪性肠梗阻"
},
{
"indices": [
13,
14,
15
],
"label": "dis",
"score": 1,
"text": "腹膜炎"
}
] |
持续咳嗽是最常见的症状，开始为干咳，以后伴黏稠痰或脓痰，不易咳出。 | [
{
"indices": [
0,
1,
2,
3
],
"label": "sym",
"score": 1,
"text": "持续咳嗽"
},
{
"indices": [
12,
13,
14,
15,
16,
17,
18,
19,
20,
21,
22,
23,
24,
25,
26,
27,
28,
29,
30,
31
],
"label": "sym",
"score": 1,
"text": "开始为干咳，以后伴黏稠痰或脓痰，不易咳出"
},
{
"indices": [
23
],
"label": "bod",
"score": 1,
"text": "痰"
},
{
"indices": [
26
],
"label": "bod",
"score": 1,
"text": "痰"
}
] |
婴儿可表现广泛喘鸣。 | [
{
"indices": [
7,
8
],
"label": "sym",
"score": 1,
"text": "喘鸣"
}
] |
随病情进展，出现气急、活动耐力差、生长发育障碍等。 | [
{
"indices": [
8,
9
],
"label": "sym",
"score": 1,
"text": "气急"
},
{
"indices": [
11,
12,
13,
14,
15
],
"label": "sym",
"score": 1,
"text": "活动耐力差"
},
{
"indices": [
17,
18,
19,
20,
21,
22
],
"label": "dis",
"score": 1,
"text": "生长发育障碍"
}
] |
常见并发症包括肺不张、咯血、气胸、肺动脉高压、呼吸衰竭等。 | [
{
"indices": [
7,
8,
9
],
"label": "dis",
"score": 1,
"text": "肺不张"
},
{
"indices": [
11,
12
],
"label": "sym",
"score": 1,
"text": "咯血"
},
{
"indices": [
12
],
"label": "bod",
"score": 1,
"text": "血"
},
{
"indices": [
14,
15
],
"label": "dis",
"score": 1,
"text": "气胸"
},
{
"indices": [
17,
18,
19,
20,
21
],
"label": "dis",
"score": 1,
"text": "肺动脉高压"
},
{
"indices": [
23,
24,
25,
26
],
"label": "dis",
"score": 1,
"text": "呼吸衰竭"
}
] |
早期可出现肺气肿体征，散在或局部粗大啰音，伴杵状指（趾）。 | [
{
"indices": [
5,
6,
7
],
"label": "dis",
"score": 1,
"text": "肺气肿"
},
{
"indices": [
11,
12,
13,
14,
15,
16,
17,
18,
19
],
"label": "sym",
"score": 1,
"text": "散在或局部粗大啰音"
},
{
"indices": [
22,
23,
24,
25,
26,
27
],
"label": "sym",
"score": 1,
"text": "杵状指（趾）"
},
{
"indices": [
24,
25,
26,
27
],
"label": "bod",
"score": 1,
"text": "指（趾）"
}
] |
晚期可出现发绀。 | [
{
"indices": [
5,
6
],
"label": "sym",
"score": 1,
"text": "发绀"
}
] |
长期以来根据汗液试验进行确诊。 | [
{
"indices": [
6,
7,
8,
9
],
"label": "pro",
"score": 1,
"text": "汗液试验"
}
] |
CF患儿的治疗应着重于对呼吸道感染的防治。 | [
{
"indices": [
0,
1
],
"label": "dis",
"score": 1,
"text": "CF"
},
{
"indices": [
12,
13,
14,
15,
16
],
"label": "dis",
"score": 1,
"text": "呼吸道感染"
}
] |
有黏液气道阻塞者可进行气管支气管吸引，或在纤维支气管镜下用生理盐水或黏液溶解剂进行灌洗。 | [
{
"indices": [
1,
2,
3,
4,
5,
6
],
"label": "sym",
"score": 1,
"text": "黏液气道阻塞"
},
{
"indices": [
1,
2,
3,
4
],
"label": "bod",
"score": 1,
"text": "黏液气道"
},
{
"indices": [
11,
12,
13,
14,
15,
16,
17
],
"label": "pro",
"score": 1,
"text": "气管支气管吸引"
},
{
"indices": [
21,
22,
23,
24,
25,
26
],
"label": "equ",
"score": 1,
"text": "纤维支气管镜"
},
{
"indices": [
29,
30,
31,
32
],
"label": "dru",
"score": 1,
"text": "生理盐水"
},
{
"indices": [
34,
35,
36,
37,
38
],
"label": "dru",
"score": 1,
"text": "黏液溶解剂"
},
{
"indices": [
41,
42
],
"label": "pro",
"score": 1,
"text": "灌洗"
}
] |
机会感染（隐球菌病和曲菌病）和恶性肿瘤（Kaposi肉瘤）均可引起儿童和成人AIDS的心脏疾患。 | [
{
"indices": [
2,
3
],
"label": "dis",
"score": 1,
"text": "感染"
},
{
"indices": [
5,
6,
7,
8
],
"label": "dis",
"score": 1,
"text": "隐球菌病"
},
{
"indices": [
10,
11,
12
],
"label": "dis",
"score": 1,
"text": "曲菌病"
},
{
"indices": [
15,
16,
17,
18
],
"label": "dis",
"score": 1,
"text": "恶性肿瘤"
},
{
"indices": [
20,
21,
22,
23,
24,
25,
26,
27
],
"label": "dis",
"score": 1,
"text": "Kaposi肉瘤"
},
{
"indices": [
38,
39,
40,
41
],
"label": "dis",
"score": 1,
"text": "AIDS"
},
{
"indices": [
43,
44
],
"label": "bod",
"score": 1,
"text": "心脏"
}
] |
临床上可见充血性心力衰竭、心包填塞、非细菌性血栓性心内膜炎、传导紊乱和猝死等。 | [
{
"indices": [
5,
6,
7,
8,
9,
10,
11
],
"label": "dis",
"score": 1,
"text": "充血性心力衰竭"
},
{
"indices": [
13,
14,
15,
16
],
"label": "dis",
"score": 1,
"text": "心包填塞"
},
{
"indices": [
18,
19,
20,
21,
22,
23,
24,
25,
26,
27,
28
],
"label": "dis",
"score": 1,
"text": "非细菌性血栓性心内膜炎"
},
{
"indices": [
30,
31,
32,
33
],
"label": "dis",
"score": 1,
"text": "传导紊乱"
},
{
"indices": [
35,
36
],
"label": "dis",
"score": 1,
"text": "猝死"
}
] |
亦可出现肾炎和肾病表现。 | [
{
"indices": [
4,
5
],
"label": "dis",
"score": 1,
"text": "肾炎"
},
{
"indices": [
7,
8
],
"label": "dis",
"score": 1,
"text": "肾病"
}
] |
软组织肉瘤的临床表现是肿块，但肿块本身没有功能，故只有肿块增大压迫周围组织时才产生症状。 | [
{
"indices": [
0,
1,
2,
3,
4
],
"label": "dis",
"score": 1,
"text": "软组织肉瘤"
},
{
"indices": [
11,
12
],
"label": "sym",
"score": 1,
"text": "肿块"
},
{
"indices": [
15,
16
],
"label": "sym",
"score": 1,
"text": "肿块"
},
{
"indices": [
27,
28
],
"label": "bod",
"score": 1,
"text": "肿块"
},
{
"indices": [
27,
28,
29,
30,
31,
32,
33,
34,
35,
36
],
"label": "sym",
"score": 1,
"text": "肿块增大压迫周围组织"
},
{
"indices": [
33,
34,
35,
36
],
"label": "bod",
"score": 1,
"text": "周围组织"
}
] |
其确诊靠病理切片，但没有特征性的组织化学或免疫学、生物学标记。 | [
{
"indices": [
4,
5,
6,
7
],
"label": "pro",
"score": 1,
"text": "病理切片"
},
{
"indices": [
16,
17
],
"label": "bod",
"score": 1,
"text": "组织"
}
] |
软组织肉瘤的治疗主要是手术切除，恶性程度相差较大，放疗和化疗的效果对各具体肿瘤不尽相同。 | [
{
"indices": [
0,
1,
2,
3,
4
],
"label": "dis",
"score": 1,
"text": "软组织肉瘤"
},
{
"indices": [
11,
12,
13,
14
],
"label": "pro",
"score": 1,
"text": "手术切除"
},
{
"indices": [
25,
26
],
"label": "pro",
"score": 1,
"text": "放疗"
},
{
"indices": [
28,
29
],
"label": "pro",
"score": 1,
"text": "化疗"
},
{
"indices": [
37,
38
],
"label": "dis",
"score": 1,
"text": "肿瘤"
}
] |
先天性及婴儿纤维肉瘤细胞有丝分裂比较多见，可有淋巴细胞散在。 | [
{
"indices": [
6,
7,
8,
9,
10,
11
],
"label": "bod",
"score": 1,
"text": "纤维肉瘤细胞"
},
{
"indices": [
23,
24,
25,
26
],
"label": "bod",
"score": 1,
"text": "淋巴细胞"
}
] |
主要是足、踝和小腿，故上肢以手、腕和前臂较多，躯干、腹膜后和腮腺、口腔黏膜、扁桃体、乳突等也可生长此瘤。 | [
{
"indices": [
3
],
"label": "bod",
"score": 1,
"text": "足"
},
{
"indices": [
5
],
"label": "bod",
"score": 1,
"text": "踝"
},
{
"indices": [
7,
8
],
"label": "bod",
"score": 1,
"text": "小腿"
},
{
"indices": [
11,
12
],
"label": "bod",
"score": 1,
"text": "上肢"
},
{
"indices": [
14
],
"label": "bod",
"score": 1,
"text": "手"
},
{
"indices": [
16
],
"label": "bod",
"score": 1,
"text": "腕"
},
{
"indices": [
18,
19
],
"label": "bod",
"score": 1,
"text": "前臂"
},
{
"indices": [
23,
24
],
"label": "bod",
"score": 1,
"text": "躯干"
},
{
"indices": [
26,
27,
28
],
"label": "bod",
"score": 1,
"text": "腹膜后"
},
{
"indices": [
30,
31
],
"label": "bod",
"score": 1,
"text": "腮腺"
},
{
"indices": [
33,
34,
35,
36
],
"label": "bod",
"score": 1,
"text": "口腔黏膜"
},
{
"indices": [
38,
39,
40
],
"label": "bod",
"score": 1,
"text": "扁桃体"
},
{
"indices": [
42,
43
],
"label": "bod",
"score": 1,
"text": "乳突"
},
{
"indices": [
50
],
"label": "dis",
"score": 1,
"text": "瘤"
}
] |
治疗应广泛彻底切除肿瘤，至少包括瘤周围3cm的组织。 | [
{
"indices": [
7,
8,
9,
10
],
"label": "pro",
"score": 1,
"text": "切除肿瘤"
},
{
"indices": [
16,
17,
18,
19,
20,
21,
22,
23,
24
],
"label": "bod",
"score": 1,
"text": "瘤周围3cm的组织"
}
] |
另外，胃灼热是GERD的又一主要症状。 | [
{
"indices": [
3,
4,
5
],
"label": "sym",
"score": 1,
"text": "胃灼热"
},
{
"indices": [
3
],
"label": "bod",
"score": 1,
"text": "胃"
},
{
"indices": [
7,
8,
9,
10
],
"label": "dis",
"score": 1,
"text": "GERD"
}
] |
当反流已引起食管黏膜损伤甚至溃疡时，患者会诉吞咽痛，体检可发现剑突下压痛。 | [
{
"indices": [
1,
2,
3,
4,
5,
6,
7,
8,
9,
10,
11,
12,
13,
14,
15
],
"label": "sym",
"score": 1,
"text": "反流已引起食管黏膜损伤甚至溃疡"
},
{
"indices": [
6,
7,
8,
9
],
"label": "bod",
"score": 1,
"text": "食管黏膜"
},
{
"indices": [
22,
23,
24
],
"label": "sym",
"score": 1,
"text": "吞咽痛"
},
{
"indices": [
26,
27
],
"label": "pro",
"score": 1,
"text": "体检"
},
{
"indices": [
31,
32,
33,
34,
35
],
"label": "sym",
"score": 1,
"text": "剑突下压痛"
},
{
"indices": [
31,
32,
33
],
"label": "bod",
"score": 1,
"text": "剑突下"
}
] |
如果长期反流，食管黏膜则会发生糜烂、溃疡、纤维组织增生及瘢痕形成等一系列改变，最后食管壁的顺应性下降，导致食管狭窄，患者逐渐出现吞咽困难。 | [
{
"indices": [
2,
3,
4,
5
],
"label": "sym",
"score": 1,
"text": "长期反流"
},
{
"indices": [
7,
8,
9,
10,
11,
12,
13,
14,
15,
16
],
"label": "sym",
"score": 1,
"text": "食管黏膜则会发生糜烂"
},
{
"indices": [
7,
8,
9,
10
],
"label": "bod",
"score": 1,
"text": "食管黏膜"
},
{
"indices": [
18,
19
],
"label": "dis",
"score": 1,
"text": "溃疡"
},
{
"indices": [
21,
22,
23,
24,
25,
26,
27,
28,
29,
30,
31,
32,
33,
34,
35,
36,
37
],
"label": "sym",
"score": 1,
"text": "纤维组织增生及瘢痕形成等一系列改变"
},
{
"indices": [
21,
22,
23,
24
],
"label": "bod",
"score": 1,
"text": "纤维组织"
},
{
"indices": [
28,
29
],
"label": "bod",
"score": 1,
"text": "瘢痕"
},
{
"indices": [
41,
42,
43,
44,
45,
46,
47,
48,
49
],
"label": "sym",
"score": 1,
"text": "食管壁的顺应性下降"
},
{
"indices": [
41,
42,
43
],
"label": "bod",
"score": 1,
"text": "食管壁"
},
{
"indices": [
53,
54,
55,
56
],
"label": "dis",
"score": 1,
"text": "食管狭窄"
},
{
"indices": [
64,
65,
66,
67
],
"label": "sym",
"score": 1,
"text": "吞咽困难"
}
] |
另一并发症是Barrett食管，下端食管的鳞状上皮被化生的柱状上皮所代替。 | [
{
"indices": [
6,
7,
8,
9,
10,
11,
12,
13,
14
],
"label": "dis",
"score": 1,
"text": "Barrett食管"
},
{
"indices": [
16,
17,
18,
19,
20,
21,
22,
23,
24,
25,
26,
27,
28,
29,
30,
31,
32,
33,
34,
35
],
"label": "sym",
"score": 1,
"text": "下端食管的鳞状上皮被化生的柱状上皮所代替"
},
{
"indices": [
16,
17,
18,
19,
20,
21,
22,
23,
24
],
"label": "bod",
"score": 1,
"text": "下端食管的鳞状上皮"
},
{
"indices": [
29,
30,
31,
32
],
"label": "bod",
"score": 1,
"text": "柱状上皮"
}
] |
另外，反复的呼吸道感染、呛咳、声音嘶哑、屏气，年长儿支气管哮喘发作等都与之有关。 | [
{
"indices": [
6,
7,
8,
9,
10
],
"label": "dis",
"score": 1,
"text": "呼吸道感染"
},
{
"indices": [
12,
13
],
"label": "sym",
"score": 1,
"text": "呛咳"
},
{
"indices": [
15,
16,
17,
18
],
"label": "sym",
"score": 1,
"text": "声音嘶哑"
},
{
"indices": [
20,
21
],
"label": "sym",
"score": 1,
"text": "屏气"
},
{
"indices": [
26,
27,
28,
29,
30
],
"label": "dis",
"score": 1,
"text": "支气管哮喘"
}
] |
在新生儿及婴幼儿中，GERD极易引起吸入性肺炎，有时甚至导致吸入性窒息、早产儿或婴儿猝死综合征的严重后果。 | [
{
"indices": [
10,
11,
12,
13
],
"label": "dis",
"score": 1,
"text": "GERD"
},
{
"indices": [
18,
19,
20,
21,
22
],
"label": "dis",
"score": 1,
"text": "吸入性肺炎"
},
{
"indices": [
30,
31,
32,
33,
34
],
"label": "dis",
"score": 1,
"text": "吸入性窒息"
},
{
"indices": [
36,
37,
38,
39,
40,
41,
42,
43,
44,
45,
46
],
"label": "dis",
"score": 1,
"text": "早产儿或婴儿猝死综合征"
}
] |
如少量多餐，避免高脂肪及巧克力等可能降低LES张力、延缓胃排空的食物；婴儿可进食黏稠食物，休息时保持头抬高30°的俯卧位等。 | [
{
"indices": [
1,
2,
3,
4
],
"label": "pro",
"score": 1,
"text": "少量多餐"
},
{
"indices": [
6,
7,
8,
9,
10,
11,
12,
13,
14,
15,
16,
17,
18,
19,
20,
21,
22,
23,
24,
25,
26,
27,
28,
29,
30,
31,
32,
33
],
"label": "pro",
"score": 1,
"text": "避免高脂肪及巧克力等可能降低LES张力、延缓胃排空的食物"
},
{
"indices": [
35,
36,
37,
38,
39,
40,
41,
42,
43
],
"label": "pro",
"score": 1,
"text": "婴儿可进食黏稠食物"
},
{
"indices": [
45,
46,
47,
48,
49,
50,
51,
52,
53,
54,
55,
56,
57,
58,
59,
60
],
"label": "pro",
"score": 1,
"text": "休息时保持头抬高30°的俯卧位等"
}
] |
Nissan术应用至今已有40余年，仍被认为是最安全有效的方法，能迅速有效地解除GERD的症状。 | [
{
"indices": [
0,
1,
2,
3,
4,
5,
6
],
"label": "pro",
"score": 1,
"text": "Nissan术"
},
{
"indices": [
40,
41,
42,
43
],
"label": "dis",
"score": 1,
"text": "GERD"
}
] |
小儿颅内肿瘤发生部位与成人不同，40%～60%发生在幕下，并且以胚胎残余组织发生的肿瘤为主，胶质瘤相对较少。 | [
{
"indices": [
0,
1,
2,
3,
4,
5
],
"label": "dis",
"score": 1,
"text": "小儿颅内肿瘤"
},
{
"indices": [
26,
27
],
"label": "bod",
"score": 1,
"text": "幕下"
},
{
"indices": [
32,
33,
34,
35,
36,
37
],
"label": "bod",
"score": 1,
"text": "胚胎残余组织"
},
{
"indices": [
41,
42
],
"label": "dis",
"score": 1,
"text": "肿瘤"
},
{
"indices": [
46,
47,
48
],
"label": "dis",
"score": 1,
"text": "胶质瘤"
}
] |
而成人多发生在幕上，以胶质瘤为主。 | [
{
"indices": [
7,
8
],
"label": "bod",
"score": 1,
"text": "幕上"
},
{
"indices": [
11,
12,
13
],
"label": "dis",
"score": 1,
"text": "胶质瘤"
}
] |
在化学因素中，多环芳香碳氢化合物和硝酸化合物，如甲基胆蒽、苯并比、甲基亚硝脲、亚硝基哌啶，在一些动物实验中都可诱发脑瘤。 | [
{
"indices": [
57,
58
],
"label": "dis",
"score": 1,
"text": "脑瘤"
}
] |
较有影响的是Kernohan提出将胶质瘤，包括星形细胞瘤、少突胶质细胞瘤、室管膜瘤和神经源肿瘤等，按其分化程度分为Ⅰ～Ⅳ级，根据这个分类似乎能够容易地判断肿瘤的发展和病人的预后，因此受到临床医师欢迎，在国内国际上使用多年。 | [
{
"indices": [
17,
18,
19
],
"label": "dis",
"score": 1,
"text": "胶质瘤"
},
{
"indices": [
23,
24,
25,
26,
27
],
"label": "dis",
"score": 1,
"text": "星形细胞瘤"
},
{
"indices": [
29,
30,
31,
32,
33,
34,
35
],
"label": "dis",
"score": 1,
"text": "少突胶质细胞瘤"
},
{
"indices": [
37,
38,
39,
40
],
"label": "dis",
"score": 1,
"text": "室管膜瘤"
},
{
"indices": [
42,
43,
44,
45,
46
],
"label": "dis",
"score": 1,
"text": "神经源肿瘤"
},
{
"indices": [
77,
78
],
"label": "dis",
"score": 1,
"text": "肿瘤"
}
] |
癫痫的发生主要由肿瘤的类型、生长速度及部位而定，生长缓慢的位置表浅的胶质瘤最易诱发癫痫，其发生率可达50%。 | [
{
"indices": [
0,
1
],
"label": "dis",
"score": 1,
"text": "癫痫"
},
{
"indices": [
8,
9
],
"label": "dis",
"score": 1,
"text": "肿瘤"
},
{
"indices": [
34,
35,
36
],
"label": "dis",
"score": 1,
"text": "胶质瘤"
},
{
"indices": [
41,
42
],
"label": "dis",
"score": 1,
"text": "癫痫"
}
] |
另外，10%～20%的病人，尤其是难治性的复杂性部分性癫痫，早期CT检查可呈阴性结果，因此必要时需重复影像学检查。 | [
{
"indices": [
27,
28
],
"label": "dis",
"score": 1,
"text": "癫痫"
},
{
"indices": [
32,
33,
34,
35
],
"label": "pro",
"score": 1,
"text": "CT检查"
},
{
"indices": [
51,
52,
53,
54,
55
],
"label": "pro",
"score": 1,
"text": "影像学检查"
}
] |
在临床上，仅依靠病史和常规检查不足以排除导致小儿突然死亡的其他疾病（如先天性心脏病、先天性脑畸形、儿童虐待等），故在怀疑死者为婴儿猝死综合征时，通常需进行尸检进行鉴别。 | [
{
"indices": [
11,
12,
13,
14
],
"label": "pro",
"score": 1,
"text": "常规检查"
},
{
"indices": [
35,
36,
37,
38,
39,
40
],
"label": "dis",
"score": 1,
"text": "先天性心脏病"
},
{
"indices": [
42,
43,
44,
45,
46,
47
],
"label": "dis",
"score": 1,
"text": "先天性脑畸形"
},
{
"indices": [
63,
64,
65,
66,
67,
68,
69
],
"label": "dis",
"score": 1,
"text": "婴儿猝死综合征"
}
] |
在美国，除小儿先天畸形、早产、低出生体重外，SIDS目前是婴儿死亡最常见的原因。 | [
{
"indices": [
7,
8,
9,
10
],
"label": "dis",
"score": 1,
"text": "先天畸形"
},
{
"indices": [
12,
13
],
"label": "dis",
"score": 1,
"text": "早产"
},
{
"indices": [
15,
16,
17,
18,
19
],
"label": "dis",
"score": 1,
"text": "低出生体重"
},
{
"indices": [
22,
23,
24,
25
],
"label": "dis",
"score": 1,
"text": "SIDS"
}
] |
各国SIDS的发病率相差甚远。 | [
{
"indices": [
2,
3,
4,
5
],
"label": "dis",
"score": 1,
"text": "SIDS"
}
] |
SIDS的发病与发病前2周所患的疾病、就诊次数增加、伴有消化道疾病以及精神不振有关。 | [
{
"indices": [
0,
1,
2,
3
],
"label": "dis",
"score": 1,
"text": "SIDS"
},
{
"indices": [
28,
29,
30,
31,
32
],
"label": "dis",
"score": 1,
"text": "消化道疾病"
},
{
"indices": [
35,
36,
37,
38
],
"label": "sym",
"score": 1,
"text": "精神不振"
}
] |
患儿常有反复喂养困难和睡眠时多汗，但这些症状较难用已知的疾病来解释。 | [
{
"indices": [
4,
5,
6,
7,
8,
9
],
"label": "sym",
"score": 1,
"text": "反复喂养困难"
},
{
"indices": [
11,
12,
13,
14,
15
],
"label": "sym",
"score": 1,
"text": "睡眠时多汗"
}
] |
内容包括对父母和看护者进行培训，使之熟悉SIDS的疾病过程和危险因素，并进行一些有益于预防的措施如给用安慰奶嘴、避免俯卧位等见表6-6，但母婴同床是否对预防SIDS有利仍有争论。 | [
{
"indices": [
20,
21,
22,
23
],
"label": "dis",
"score": 1,
"text": "SIDS"
},
{
"indices": [
49,
50,
51,
52,
53,
54
],
"label": "pro",
"score": 1,
"text": "给用安慰奶嘴"
},
{
"indices": [
56,
57,
58,
59,
60
],
"label": "pro",
"score": 1,
"text": "避免俯卧位"
},
{
"indices": [
78,
79,
80,
81
],
"label": "dis",
"score": 1,
"text": "SIDS"
}
] |
年长儿脑脓疡的发病率较高，引起此类疾病的原因是由于心房水平右向左分流，体循环中的细菌可直接到达脑部繁殖，产生脑脓疡。 | [
{
"indices": [
3,
4,
5
],
"label": "dis",
"score": 1,
"text": "脑脓疡"
},
{
"indices": [
25,
26
],
"label": "bod",
"score": 1,
"text": "心房"
},
{
"indices": [
35,
36,
37
],
"label": "bod",
"score": 1,
"text": "体循环"
},
{
"indices": [
40,
41
],
"label": "mic",
"score": 1,
"text": "细菌"
},
{
"indices": [
47,
48
],
"label": "bod",
"score": 1,
"text": "脑部"
},
{
"indices": [
54,
55,
56
],
"label": "dis",
"score": 1,
"text": "脑脓疡"
}
] |
若患有感染性心内膜炎，细菌栓子亦可进入脑部。 | [
{
"indices": [
3,
4,
5,
6,
7,
8,
9
],
"label": "dis",
"score": 1,
"text": "感染性心内膜炎"
},
{
"indices": [
11,
12,
13,
14
],
"label": "mic",
"score": 1,
"text": "细菌栓子"
},
{
"indices": [
19,
20
],
"label": "bod",
"score": 1,
"text": "脑部"
}
] |
所以，对于任何大于2岁的青紫型先心患儿，当出现头痛、呕吐、神经定位症状时，尚需考虑脑部疾病的存在。 | [
{
"indices": [
12,
13,
14,
15,
16
],
"label": "dis",
"score": 1,
"text": "青紫型先心"
},
{
"indices": [
23,
24
],
"label": "sym",
"score": 1,
"text": "头痛"
},
{
"indices": [
23
],
"label": "bod",
"score": 1,
"text": "头"
},
{
"indices": [
26,
27
],
"label": "sym",
"score": 1,
"text": "呕吐"
},
{
"indices": [
29,
30,
31,
32
],
"label": "sym",
"score": 1,
"text": "神经定位"
},
{
"indices": [
29,
30
],
"label": "bod",
"score": 1,
"text": "神经"
},
{
"indices": [
41,
42,
43,
44
],
"label": "dis",
"score": 1,
"text": "脑部疾病"
}
] |
右心房造影，造影剂经房间交通入左心房，同时可逆流入下腔静脉、肝静脉。 | [
{
"indices": [
0,
1,
2,
3,
4
],
"label": "pro",
"score": 1,
"text": "右心房造影"
},
{
"indices": [
6,
7,
8
],
"label": "dru",
"score": 1,
"text": "造影剂"
},
{
"indices": [
10,
11
],
"label": "bod",
"score": 1,
"text": "房间"
},
{
"indices": [
15,
16,
17
],
"label": "bod",
"score": 1,
"text": "左心房"
},
{
"indices": [
25,
26,
27,
28
],
"label": "bod",
"score": 1,
"text": "下腔静脉"
},
{
"indices": [
30,
31,
32
],
"label": "bod",
"score": 1,
"text": "肝静脉"
}
] |
在行Fontan手术前，还应通过造影明确是否存在左上腔静脉及桥静脉。 | [
{
"indices": [
2,
3,
4,
5,
6,
7,
8,
9
],
"label": "pro",
"score": 1,
"text": "Fontan手术"
},
{
"indices": [
16,
17
],
"label": "pro",
"score": 1,
"text": "造影"
},
{
"indices": [
24,
25,
26,
27,
28
],
"label": "bod",
"score": 1,
"text": "左上腔静脉"
},
{
"indices": [
30,
31,
32
],
"label": "bod",
"score": 1,
"text": "桥静脉"
}
] |
在年长儿中，可作Fontan手术直接将体静脉血回流入肺循环，达到体肺循环分离。 | [
{
"indices": [
8,
9,
10,
11,
12,
13,
14,
15
],
"label": "pro",
"score": 1,
"text": "Fontan手术"
},
{
"indices": [
19,
20,
21,
22
],
"label": "bod",
"score": 1,
"text": "体静脉血"
},
{
"indices": [
26,
27,
28
],
"label": "bod",
"score": 1,
"text": "肺循环"
},
{
"indices": [
32,
33,
34,
35
],
"label": "bod",
"score": 1,
"text": "体肺循环"
}
] |
如卵圆孔太小，心排出量降低，可行球囊房间隔造口术；对大婴儿及年长儿，可行球囊扩张加房间隔撕裂术。 | [
{
"indices": [
1,
2,
3
],
"label": "bod",
"score": 1,
"text": "卵圆孔"
},
{
"indices": [
1,
2,
3,
4,
5,
6,
7,
8,
9,
10,
11,
12
],
"label": "sym",
"score": 1,
"text": "卵圆孔太小，心排出量降低"
},
{
"indices": [
7,
8,
9,
10
],
"label": "ite",
"score": 1,
"text": "心排出量"
},
{
"indices": [
16,
17,
18,
19,
20,
21,
22,
23
],
"label": "pro",
"score": 1,
"text": "球囊房间隔造口术"
},
{
"indices": [
36,
37,
38,
39,
40,
41,
42,
43,
44,
45,
46
],
"label": "pro",
"score": 1,
"text": "球囊扩张加房间隔撕裂术"
}
] |
静注NaHCO3纠正代谢性酸中毒。 | [
{
"indices": [
0,
1
],
"label": "pro",
"score": 1,
"text": "静注"
},
{
"indices": [
2,
3,
4,
5,
6,
7
],
"label": "dru",
"score": 1,
"text": "NaHCO3"
},
{
"indices": [
10,
11,
12,
13,
14,
15
],
"label": "dis",
"score": 1,
"text": "代谢性酸中毒"
}
] |
此类型小儿及有进行性低氧血症或频繁缺氧发作的婴儿需行体-肺静脉分流术。 | [
{
"indices": [
7,
8,
9,
10,
11,
12,
13
],
"label": "dis",
"score": 1,
"text": "进行性低氧血症"
},
{
"indices": [
17,
18
],
"label": "dis",
"score": 1,
"text": "缺氧"
},
{
"indices": [
26,
27,
28,
29,
30,
31,
32,
33
],
"label": "pro",
"score": 1,
"text": "体-肺静脉分流术"
}
] |
小于6个月的婴儿，可行改良的Blalock-Taussig分流术，即以Goretex管放于锁骨下动脉与同侧肺动脉之间，两端均作端侧吻合。 | [
{
"indices": [
14,
15,
16,
17,
18,
19,
20,
21,
22,
23,
24,
25,
26,
27,
28,
29,
30,
31
],
"label": "pro",
"score": 1,
"text": "Blalock-Taussig分流术"
},
{
"indices": [
35,
36,
37,
38,
39,
40,
41,
42
],
"label": "equ",
"score": 1,
"text": "Goretex管"
},
{
"indices": [
45,
46,
47,
48,
49
],
"label": "bod",
"score": 1,
"text": "锁骨下动脉"
},
{
"indices": [
51,
52,
53,
54,
55
],
"label": "bod",
"score": 1,
"text": "同侧肺动脉"
}
] |
Fontan术后4%～13%并发失蛋白性肠病，胃肠道蛋白质极度流失能导致低蛋白血症和水肿。 | [
{
"indices": [
0,
1,
2,
3,
4,
5,
6
],
"label": "pro",
"score": 1,
"text": "Fontan术"
},
{
"indices": [
16,
17,
18,
19,
20,
21
],
"label": "dis",
"score": 1,
"text": "失蛋白性肠病"
},
{
"indices": [
23,
24,
25,
26,
27,
28
],
"label": "bod",
"score": 1,
"text": "胃肠道蛋白质"
},
{
"indices": [
23,
24,
25,
26,
27,
28,
29,
30,
31,
32
],
"label": "sym",
"score": 1,
"text": "胃肠道蛋白质极度流失"
},
{
"indices": [
36,
37,
38,
39,
40
],
"label": "dis",
"score": 1,
"text": "低蛋白血症"
},
{
"indices": [
42,
43
],
"label": "sym",
"score": 1,
"text": "水肿"
}
] |
临床上患儿一般情况良好，除有轻度贫血貌外，无其他阳性体征。 | [
{
"indices": [
14,
15,
16,
17,
18
],
"label": "sym",
"score": 1,
"text": "轻度贫血貌"
}
] |
值得注意的是，因诊断和监护的需要而进行反复静脉穿刺采血，可以成为患儿贫血的主要原因，需进行输血治疗。 | [
{
"indices": [
21,
22,
23,
24,
25,
26
],
"label": "pro",
"score": 1,
"text": "静脉穿刺采血"
},
{
"indices": [
34,
35
],
"label": "dis",
"score": 1,
"text": "贫血"
},
{
"indices": [
45,
46
],
"label": "pro",
"score": 1,
"text": "输血"
}
] |
严重贫血时，可输红细胞悬液，每次10～15ml/kg，体重＜1250g的未成熟儿必须尽量采用同一个供血者的血输注。 | [
{
"indices": [
0,
1,
2,
3
],
"label": "dis",
"score": 1,
"text": "严重贫血"
},
{
"indices": [
7,
8,
9,
10,
11,
12
],
"label": "pro",
"score": 1,
"text": "输红细胞悬液"
},
{
"indices": [
53
],
"label": "bod",
"score": 1,
"text": "血"
},
{
"indices": [
54,
55
],
"label": "pro",
"score": 1,
"text": "输注"
}
] |
维生素A缺乏症是一种因体内维生素A缺乏引起的疾病，常伴随蛋白质-能量营养不良。 | [
{
"indices": [
0,
1,
2,
3,
4,
5,
6
],
"label": "dis",
"score": 1,
"text": "维生素A缺乏症"
},
{
"indices": [
13,
14,
15,
16
],
"label": "bod",
"score": 1,
"text": "维生素A"
},
{
"indices": [
28,
29,
30,
31,
32,
33,
34,
35,
36,
37
],
"label": "dis",
"score": 1,
"text": "蛋白质-能量营养不良"
}
] |
据WHO报道，因维生素A缺乏，全世界每年有50万名学龄前儿童患有活动性角膜溃疡。 | [
{
"indices": [
8,
9,
10,
11,
12,
13
],
"label": "dis",
"score": 1,
"text": "维生素A缺乏"
},
{
"indices": [
32,
33,
34,
35,
36,
37,
38
],
"label": "dis",
"score": 1,
"text": "活动性角膜溃疡"
}
] |
据报道，我国为儿童亚临床型维生素A缺乏的国家，城市学龄前儿童亚临床型维生素A缺乏发生率约20%，农村约45%。 | [
{
"indices": [
9,
10,
11,
12,
13,
14,
15,
16,
17,
18
],
"label": "dis",
"score": 1,
"text": "亚临床型维生素A缺乏"
},
{
"indices": [
30,
31,
32,
33,
34,
35,
36,
37,
38,
39
],
"label": "dis",
"score": 1,
"text": "亚临床型维生素A缺乏"
}
] |
母乳中的维生素A含量丰富，一般母乳喂养的小儿不会发生维生素A缺乏症。 | [
{
"indices": [
4,
5,
6,
7
],
"label": "bod",
"score": 1,
"text": "维生素A"
},
{
"indices": [
26,
27,
28,
29,
30,
31,
32
],
"label": "dru",
"score": 1,
"text": "维生素A缺乏症"
}
] |
如果维生素A持续缺乏，将发生角膜干燥症，伴有畏光，随后发生视物变形。 | [
{
"indices": [
2,
3,
4,
5
],
"label": "bod",
"score": 1,
"text": "维生素A"
},
{
"indices": [
2,
3,
4,
5,
6,
7,
8,
9
],
"label": "sym",
"score": 1,
"text": "维生素A持续缺乏"
},
{
"indices": [
14,
15,
16,
17,
18
],
"label": "dis",
"score": 1,
"text": "角膜干燥症"
},
{
"indices": [
22,
23
],
"label": "sym",
"score": 1,
"text": "畏光"
},
{
"indices": [
29,
30,
31,
32
],
"label": "sym",
"score": 1,
"text": "视物变形"
}
] |
睑板腺肿大，并且沿着睑缘出现一串特征性的水泡，表面上皮的连续性遭到破坏，伴有非炎症性的溃疡形成和基质浸润，引起角膜软化、变性、溃疡甚至穿孔等损害，晶状体、虹膜脱出，造成整个眼睛的损害，通常为双侧性的，单侧发病少见。 | [
{
"indices": [
0,
1,
2
],
"label": "bod",
"score": 1,
"text": "睑板腺"
},
{
"indices": [
0,
1,
2,
3,
4
],
"label": "sym",
"score": 1,
"text": "睑板腺肿大"
},
{
"indices": [
8,
9,
10,
11,
12,
13,
14,
15,
16,
17,
18,
19,
20,
21
],
"label": "sym",
"score": 1,
"text": "沿着睑缘出现一串特征性的水泡"
},
{
"indices": [
10,
11
],
"label": "bod",
"score": 1,
"text": "睑缘"
},
{
"indices": [
23,
24,
25,
26
],
"label": "bod",
"score": 1,
"text": "表面上皮"
},
{
"indices": [
38,
39,
40,
41,
42,
43,
44,
45,
46,
47,
48,
49,
50,
51
],
"label": "sym",
"score": 1,
"text": "非炎症性的溃疡形成和基质浸润"
},
{
"indices": [
55,
56,
57,
58,
59,
60,
61,
62,
63,
64,
65,
66,
67,
68
],
"label": "sym",
"score": 1,
"text": "角膜软化、变性、溃疡甚至穿孔"
},
{
"indices": [
55,
56
],
"label": "bod",
"score": 1,
"text": "角膜"
},
{
"indices": [
73,
74,
75
],
"label": "bod",
"score": 1,
"text": "晶状体"
},
{
"indices": [
73,
74,
75,
76,
77,
78,
79,
80
],
"label": "sym",
"score": 1,
"text": "晶状体、虹膜脱出"
},
{
"indices": [
77,
78
],
"label": "bod",
"score": 1,
"text": "虹膜"
},
{
"indices": [
86,
87
],
"label": "bod",
"score": 1,
"text": "眼睛"
}
] |
维生素A缺乏也可引起皮肤的改变，开始时皮肤较正常干燥，以后由于毛囊上皮角化，发生角化过度的毛囊性丘疹，主要分布在大腿前外侧、上臂后侧，后逐渐扩展到上下肢伸侧、肩和下腹部，很少累及胸、背和臀。 | [
{
"indices": [
0,
1,
2,
3,
4,
5
],
"label": "dis",
"score": 1,
"text": "维生素A缺乏"
},
{
"indices": [
10,
11
],
"label": "bod",
"score": 1,
"text": "皮肤"
},
{
"indices": [
19,
20,
21,
22,
23,
24,
25
],
"label": "sym",
"score": 1,
"text": "皮肤较正常干燥"
},
{
"indices": [
19,
20
],
"label": "bod",
"score": 1,
"text": "皮肤"
},
{
"indices": [
31,
32,
33,
34,
35,
36
],
"label": "sym",
"score": 1,
"text": "毛囊上皮角化"
},
{
"indices": [
31,
32,
33,
34
],
"label": "bod",
"score": 1,
"text": "毛囊上皮"
},
{
"indices": [
40,
41,
42,
43,
44,
45,
46,
47,
48,
49
],
"label": "sym",
"score": 1,
"text": "角化过度的毛囊性丘疹"
},
{
"indices": [
45,
46,
47,
48,
49
],
"label": "dis",
"score": 1,
"text": "毛囊性丘疹"
},
{
"indices": [
56,
57,
58,
59,
60
],
"label": "bod",
"score": 1,
"text": "大腿前外侧"
},
{
"indices": [
62,
63,
64,
65
],
"label": "bod",
"score": 1,
"text": "上臂后侧"
},
{
"indices": [
73,
74,
75,
76,
77
],
"label": "bod",
"score": 1,
"text": "上下肢伸侧"
},
{
"indices": [
79
],
"label": "bod",
"score": 1,
"text": "肩"
},
{
"indices": [
81,
82,
83
],
"label": "bod",
"score": 1,
"text": "下腹部"
},
{
"indices": [
89
],
"label": "bod",
"score": 1,
"text": "胸"
},
{
"indices": [
91
],
"label": "bod",
"score": 1,
"text": "背"
},
{
"indices": [
93
],
"label": "bod",
"score": 1,
"text": "臀"
}
] |
维生素A缺乏可使小儿的免疫力低下，容易反复出现感染；容易有精神障碍，甚至出现脑积水。 | [
{
"indices": [
0,
1,
2,
3,
4,
5
],
"label": "dis",
"score": 1,
"text": "维生素A缺乏"
},
{
"indices": [
11,
12,
13,
14,
15
],
"label": "sym",
"score": 1,
"text": "免疫力低下"
},
{
"indices": [
23,
24
],
"label": "dis",
"score": 1,
"text": "感染"
},
{
"indices": [
29,
30,
31,
32
],
"label": "sym",
"score": 1,
"text": "精神障碍"
},
{
"indices": [
38,
39,
40
],
"label": "dis",
"score": 1,
"text": "脑积水"
}
] |
用维生素A治疗维生素A缺乏症，疗效迅速而有效。 | [
{
"indices": [
1,
2,
3,
4,
5,
6
],
"label": "pro",
"score": 1,
"text": "维生素A治疗"
},
{
"indices": [
7,
8,
9,
10,
11,
12,
13
],
"label": "dis",
"score": 1,
"text": "维生素A缺乏症"
}
] |
早产儿应适当早期添加维生素A。 | [
{
"indices": [
0,
1,
2
],
"label": "dis",
"score": 1,
"text": "早产儿"
},
{
"indices": [
10,
11,
12,
13
],
"label": "dru",
"score": 1,
"text": "维生素A"
}
] |
脑水肿的处理可用肾上腺皮质激素，如颅内压增高较明显可静脉推注脱水剂或利尿剂。 | [
{
"indices": [
0,
1,
2
],
"label": "dis",
"score": 1,
"text": "脑水肿"
},
{
"indices": [
8,
9,
10,
11,
12,
13,
14
],
"label": "dru",
"score": 1,
"text": "肾上腺皮质激素"
},
{
"indices": [
17,
18,
19,
20,
21,
22,
23,
24
],
"label": "sym",
"score": 1,
"text": "颅内压增高较明显"
},
{
"indices": [
17
],
"label": "bod",
"score": 1,
"text": "颅"
},
{
"indices": [
26,
27,
28,
29
],
"label": "pro",
"score": 1,
"text": "静脉推注"
},
{
"indices": [
30,
31,
32
],
"label": "dru",
"score": 1,
"text": "脱水剂"
},
{
"indices": [
34,
35,
36
],
"label": "dru",
"score": 1,
"text": "利尿剂"
}
] |
蛛网膜下腔的血液和血凝块可引起脑动脉的炎症反应和脑水肿，可释放促血管痉挛物质而引起血管痉挛。 | [
{
"indices": [
0,
1,
2,
3,
4,
5,
6,
7,
8,
9,
10,
11
],
"label": "bod",
"score": 1,
"text": "蛛网膜下腔的血液和血凝块"
},
{
"indices": [
15,
16,
17
],
"label": "bod",
"score": 1,
"text": "脑动脉"
},
{
"indices": [
19,
20
],
"label": "dis",
"score": 1,
"text": "炎症"
},
{
"indices": [
24,
25,
26
],
"label": "dis",
"score": 1,
"text": "脑水肿"
},
{
"indices": [
32,
33
],
"label": "bod",
"score": 1,
"text": "血管"
},
{
"indices": [
41,
42,
43,
44
],
"label": "dis",
"score": 1,
"text": "血管痉挛"
}
] |
动脉瘤和动静脉畸形（AVMs）采用外科或血管内闭塞治疗对于许多病人来说是非常有效的，但是放射外科学针对儿童AVMs病灶太小或很难用外科手术方法解决的病例，应用越来越多。 | [
{
"indices": [
0,
1,
2
],
"label": "dis",
"score": 1,
"text": "动脉瘤"
},
{
"indices": [
4,
5,
6,
7,
8
],
"label": "dis",
"score": 1,
"text": "动静脉畸形"
},
{
"indices": [
10,
11,
12,
13
],
"label": "dis",
"score": 1,
"text": "AVMs"
},
{
"indices": [
17,
18
],
"label": "dep",
"score": 1,
"text": "外科"
},
{
"indices": [
20,
21,
22,
23,
24,
25,
26
],
"label": "pro",
"score": 1,
"text": "血管内闭塞治疗"
},
{
"indices": [
44,
45,
46,
47
],
"label": "dep",
"score": 1,
"text": "放射外科"
},
{
"indices": [
51,
52,
53,
54,
55,
56
],
"label": "dis",
"score": 1,
"text": "儿童AVMs"
},
{
"indices": [
57,
58
],
"label": "bod",
"score": 1,
"text": "病灶"
},
{
"indices": [
65,
66,
67,
68
],
"label": "pro",
"score": 1,
"text": "外科手术"
}
] |
数个较大的回顾性研究报道，放射外科学是非常安全而且对于治疗儿童AVMs是明显有效的。 | [
{
"indices": [
13,
14,
15,
16
],
"label": "dep",
"score": 1,
"text": "放射外科"
},
{
"indices": [
29,
30,
31,
32,
33,
34
],
"label": "dis",
"score": 1,
"text": "儿童AVMs"
}
] |
对于血小板减少症患者应及时输注血小板或新鲜血，避免服用阿司匹林或其他抗血小板药物，或是避免可能导致头部外伤的刺激。 | [
{
"indices": [
2,
3,
4,
5,
6,
7
],
"label": "dis",
"score": 1,
"text": "血小板减少症"
},
{
"indices": [
13,
14
],
"label": "pro",
"score": 1,
"text": "输注"
},
{
"indices": [
15,
16,
17
],
"label": "dru",
"score": 1,
"text": "血小板"
},
{
"indices": [
19,
20,
21
],
"label": "dru",
"score": 1,
"text": "新鲜血"
},
{
"indices": [
25,
26
],
"label": "pro",
"score": 1,
"text": "服用"
},
{
"indices": [
27,
28,
29,
30
],
"label": "dru",
"score": 1,
"text": "阿司匹林"
},
{
"indices": [
32,
33,
34,
35,
36,
37,
38,
39
],
"label": "dru",
"score": 1,
"text": "其他抗血小板药物"
},
{
"indices": [
49,
50
],
"label": "bod",
"score": 1,
"text": "头部"
},
{
"indices": [
51,
52
],
"label": "dis",
"score": 1,
"text": "外伤"
}
] |
对于血友病患者应输注Ⅷ因子，晚发性维生素K缺乏应输注维生素K和凝血因子复合物或新鲜血等。 | [
{
"indices": [
2,
3,
4
],
"label": "dis",
"score": 1,
"text": "血友病"
},
{
"indices": [
8,
9
],
"label": "pro",
"score": 1,
"text": "输注"
},
{
"indices": [
10,
11,
12
],
"label": "dru",
"score": 1,
"text": "Ⅷ因子"
},
{
"indices": [
14,
15,
16,
17,
18,
19,
20,
21,
22
],
"label": "dis",
"score": 1,
"text": "晚发性维生素K缺乏"
},
{
"indices": [
24,
25
],
"label": "pro",
"score": 1,
"text": "输注"
},
{
"indices": [
26,
27,
28,
29
],
"label": "dru",
"score": 1,
"text": "维生素K"
},
{
"indices": [
31,
32,
33,
34,
35,
36,
37
],
"label": "dru",
"score": 1,
"text": "凝血因子复合物"
},
{
"indices": [
39,
40,
41
],
"label": "dru",
"score": 1,
"text": "新鲜血"
}
] |
心电图同样有助于内脏位置的判断，P波电轴朝向左下，提示心房正位；P波电轴朝向右侧提示内脏反位。 | [
{
"indices": [
0,
1,
2
],
"label": "pro",
"score": 1,
"text": "心电图"
},
{
"indices": [
8,
9
],
"label": "bod",
"score": 1,
"text": "内脏"
},
{
"indices": [
27,
28
],
"label": "bod",
"score": 1,
"text": "心房"
},
{
"indices": [
42,
43
],
"label": "bod",
"score": 1,
"text": "内脏"
}
] |
超声心动图可对内脏位置及心内畸形进行准确的诊断，检查内容包括：腹部内脏位置、体静脉与心脏连接、房室连接、心室解剖、心室动脉连接及主动脉、肺动脉的解剖。 | [
{
"indices": [
0,
1,
2,
3,
4
],
"label": "pro",
"score": 1,
"text": "超声心动图"
},
{
"indices": [
7,
8
],
"label": "bod",
"score": 1,
"text": "内脏"
},
{
"indices": [
12,
13,
14,
15
],
"label": "dis",
"score": 1,
"text": "心内畸形"
},
{
"indices": [
31,
32,
33,
34,
35,
36
],
"label": "ite",
"score": 1,
"text": "腹部内脏位置"
},
{
"indices": [
38,
39,
40,
41,
42,
43,
44,
45
],
"label": "ite",
"score": 1,
"text": "体静脉与心脏连接"
},
{
"indices": [
47,
48,
49,
50
],
"label": "ite",
"score": 1,
"text": "房室连接"
},
{
"indices": [
52,
53,
54,
55
],
"label": "ite",
"score": 1,
"text": "心室解剖"
},
{
"indices": [
57,
58,
59,
60,
61,
62,
63,
64,
65,
66,
67,
68,
69,
70,
71,
72,
73
],
"label": "ite",
"score": 1,
"text": "心室动脉连接及主动脉、肺动脉的解剖"
}
] |
最常见的合并畸形为房室连接不一致（心室左襻），约占50%。 | [
{
"indices": [
6,
7
],
"label": "dis",
"score": 1,
"text": "畸形"
},
{
"indices": [
9,
10,
11,
12,
13,
14,
15,
16,
17,
18,
19,
20,
21
],
"label": "sym",
"score": 1,
"text": "房室连接不一致（心室左襻）"
},
{
"indices": [
9,
10
],
"label": "bod",
"score": 1,
"text": "房室"
}
] |
1/4的患儿伴有单心室，大多数患儿（60%）合并有室间隔缺损。 | [
{
"indices": [
8,
9,
10
],
"label": "sym",
"score": 1,
"text": "单心室"
},
{
"indices": [
25,
26,
27,
28,
29
],
"label": "dis",
"score": 1,
"text": "室间隔缺损"
}
] |
伴发畸形主要有为房室连接不一致及大血管转位，但明显较右位心伴内脏正位少见。 | [
{
"indices": [
2,
3
],
"label": "dis",
"score": 1,
"text": "畸形"
},
{
"indices": [
8,
9,
10,
11,
12,
13,
14
],
"label": "sym",
"score": 1,
"text": "房室连接不一致"
},
{
"indices": [
8,
9
],
"label": "bod",
"score": 1,
"text": "房室"
},
{
"indices": [
16,
17,
18,
19,
20
],
"label": "sym",
"score": 1,
"text": "大血管转位"
},
{
"indices": [
16,
17,
18
],
"label": "bod",
"score": 1,
"text": "大血管"
},
{
"indices": [
26,
27,
28
],
"label": "bod",
"score": 1,
"text": "右位心"
},
{
"indices": [
30,
31
],
"label": "bod",
"score": 1,
"text": "内脏"
}
] |
我国多数报道活产婴儿窒息发生率约为5%～10%。 | [
{
"indices": [
8,
9,
10,
11
],
"label": "dis",
"score": 1,
"text": "婴儿窒息"
}
] |
新生儿窒息多为产前或产时因素所致，产后因素较少。 | [
{
"indices": [
0,
1,
2,
3,
4
],
"label": "dis",
"score": 1,
"text": "新生儿窒息"
}
] |
血游离脂肪酸增加，促进钙离子与蛋白结合而致低钙血症。 | [
{
"indices": [
15,
16
],
"label": "bod",
"score": 1,
"text": "蛋白"
},
{
"indices": [
21,
22,
23,
24
],
"label": "dis",
"score": 1,
"text": "低钙血症"
}
] |
常见并发症有如下几种：①中枢神经系统：缺氧缺血性脑病和颅内出血；②呼吸系统：胎粪吸入综合征、呼吸窘迫综合征及肺出血；③心血管系统：缺氧缺血性心肌损害（三尖瓣闭锁不全、心力衰竭、心源性休克）；④泌尿系统：肾功能不全或衰竭及肾静脉血栓形成等；⑤代谢方面：低血糖、低钙及低钠血症等；⑥消化系统：应激性溃疡和坏死性小肠结肠炎等。 | [
{
"indices": [
12,
13,
14,
15,
16,
17
],
"label": "bod",
"score": 1,
"text": "中枢神经系统"
},
{
"indices": [
19,
20,
21,
22,
23,
24,
25
],
"label": "dis",
"score": 1,
"text": "缺氧缺血性脑病"
},
{
"indices": [
27,
28,
29,
30
],
"label": "dis",
"score": 1,
"text": "颅内出血"
},
{
"indices": [
33,
34,
35,
36
],
"label": "bod",
"score": 1,
"text": "呼吸系统"
},
{
"indices": [
38,
39,
40,
41,
42,
43,
44
],
"label": "dis",
"score": 1,
"text": "胎粪吸入综合征"
},
{
"indices": [
46,
47,
48,
49,
50,
51,
52
],
"label": "dis",
"score": 1,
"text": "呼吸窘迫综合征"
},
{
"indices": [
54,
55,
56
],
"label": "dis",
"score": 1,
"text": "肺出血"
},
{
"indices": [
59,
60,
61,
62,
63
],
"label": "bod",
"score": 1,
"text": "心血管系统"
},
{
"indices": [
65,
66,
67,
68,
69,
70,
71,
72,
73
],
"label": "dis",
"score": 1,
"text": "缺氧缺血性心肌损害"
},
{
"indices": [
75,
76,
77,
78,
79,
80,
81
],
"label": "dis",
"score": 1,
"text": "三尖瓣闭锁不全"
},
{
"indices": [
83,
84,
85,
86
],
"label": "dis",
"score": 1,
"text": "心力衰竭"
},
{
"indices": [
88,
89,
90,
91,
92
],
"label": "dis",
"score": 1,
"text": "心源性休克"
},
{
"indices": [
96,
97,
98,
99
],
"label": "bod",
"score": 1,
"text": "泌尿系统"
},
{
"indices": [
101,
102,
103,
104,
105
],
"label": "dis",
"score": 1,
"text": "肾功能不全"
},
{
"indices": [
107,
108
],
"label": "dis",
"score": 1,
"text": "衰竭"
},
{
"indices": [
110,
111,
112,
113,
114
],
"label": "dis",
"score": 1,
"text": "肾静脉血栓"
},
{
"indices": [
125,
126,
127
],
"label": "dis",
"score": 1,
"text": "低血糖"
},
{
"indices": [
129,
130
],
"label": "sym",
"score": 1,
"text": "低钙"
},
{
"indices": [
132,
133,
134,
135
],
"label": "dis",
"score": 1,
"text": "低钠血症"
},
{
"indices": [
139,
140,
141,
142
],
"label": "bod",
"score": 1,
"text": "消化系统"
},
{
"indices": [
144,
145,
146,
147,
148
],
"label": "dis",
"score": 1,
"text": "应激性溃疡"
},
{
"indices": [
150,
151,
152,
153,
154,
155,
156,
157
],
"label": "dis",
"score": 1,
"text": "坏死性小肠结肠炎"
}
] |
原发肿瘤诊断明确并经治疗后转移至骨骼，一般较易发现。 | [
{
"indices": [
0,
1,
2,
3,
4,
5
],
"label": "pro",
"score": 1,
"text": "原发肿瘤诊断"
},
{
"indices": [
16,
17
],
"label": "bod",
"score": 1,
"text": "骨骼"
}
] |
但原发肿瘤部位和症状隐匿，以转移性骨肿瘤作为主要就诊主诉时，诊断上往往容易混淆，甚至将转移性的骨肿瘤当作骨原发的肿瘤进行诊断和治疗。 | [
{
"indices": [
1,
2,
3,
4
],
"label": "dis",
"score": 1,
"text": "原发肿瘤"
},
{
"indices": [
14,
15,
16,
17,
18,
19
],
"label": "dis",
"score": 1,
"text": "转移性骨肿瘤"
},
{
"indices": [
43,
44,
45,
46,
47,
48,
49
],
"label": "dis",
"score": 1,
"text": "转移性的骨肿瘤"
},
{
"indices": [
52
],
"label": "bod",
"score": 1,
"text": "骨"
},
{
"indices": [
56,
57
],
"label": "dis",
"score": 1,
"text": "肿瘤"
}
] |
肿瘤的骨骼转移中，静脉系统、特别是椎静脉系统起着主要的作用。 | [
{
"indices": [
0,
1
],
"label": "dis",
"score": 1,
"text": "肿瘤"
},
{
"indices": [
3,
4
],
"label": "bod",
"score": 1,
"text": "骨骼"
},
{
"indices": [
9,
10,
11,
12
],
"label": "bod",
"score": 1,
"text": "静脉系统"
},
{
"indices": [
17,
18,
19,
20,
21
],
"label": "bod",
"score": 1,
"text": "椎静脉系统"
}
] |
儿童中最易产生肿瘤骨骼转移的是神经母细胞瘤、肺癌、甲状腺癌、乳腺癌。 | [
{
"indices": [
7,
8,
9,
10
],
"label": "dis",
"score": 1,
"text": "肿瘤骨骼"
},
{
"indices": [
15,
16,
17,
18,
19,
20
],
"label": "dis",
"score": 1,
"text": "神经母细胞瘤"
},
{
"indices": [
22,
23
],
"label": "dis",
"score": 1,
"text": "肺癌"
},
{
"indices": [
25,
26,
27,
28
],
"label": "dis",
"score": 1,
"text": "甲状腺癌"
},
{
"indices": [
30,
31,
32
],
"label": "dis",
"score": 1,
"text": "乳腺癌"
}
] |
转移性骨肿瘤好发于躯干骨，其次是股骨和肱骨的近端，发生在股骨和肱骨远端的较少。 | [
{
"indices": [
0,
1,
2,
3,
4,
5
],
"label": "dis",
"score": 1,
"text": "转移性骨肿瘤"
},
{
"indices": [
9,
10,
11
],
"label": "bod",
"score": 1,
"text": "躯干骨"
},
{
"indices": [
16,
17,
18,
19,
20,
21,
22,
23
],
"label": "bod",
"score": 1,
"text": "股骨和肱骨的近端"
},
{
"indices": [
28,
29,
30,
31,
32,
33,
34
],
"label": "bod",
"score": 1,
"text": "股骨和肱骨远端"
}
] |
转移性骨肿瘤的部位也同原发肿瘤生长的部位有关，如乳腺癌的骨转移通常发生在胸椎和肱骨近端，甲状腺癌则常见于颈椎和颅骨，当然有时转移性肿瘤的发生也与原发肿瘤的部位无关。 | [
{
"indices": [
0,
1,
2,
3,
4,
5
],
"label": "dis",
"score": 1,
"text": "转移性骨肿瘤"
},
{
"indices": [
11,
12,
13,
14
],
"label": "dis",
"score": 1,
"text": "原发肿瘤"
},
{
"indices": [
24,
25,
26,
27,
28,
29,
30,
31,
32,
33,
34,
35,
36,
37,
38,
39,
40,
41,
42
],
"label": "sym",
"score": 1,
"text": "乳腺癌的骨转移通常发生在胸椎和肱骨近端"
},
{
"indices": [
24,
25,
26
],
"label": "dis",
"score": 1,
"text": "乳腺癌"
},
{
"indices": [
28
],
"label": "bod",
"score": 1,
"text": "骨"
},
{
"indices": [
36,
37
],
"label": "bod",
"score": 1,
"text": "胸椎"
},
{
"indices": [
39,
40,
41,
42
],
"label": "bod",
"score": 1,
"text": "肱骨近端"
},
{
"indices": [
44,
45,
46,
47
],
"label": "dis",
"score": 1,
"text": "甲状腺癌"
},
{
"indices": [
52,
53
],
"label": "bod",
"score": 1,
"text": "颈椎"
},
{
"indices": [
55,
56
],
"label": "bod",
"score": 1,
"text": "颅骨"
},
{
"indices": [
62,
63,
64,
65,
66
],
"label": "dis",
"score": 1,
"text": "转移性肿瘤"
},
{
"indices": [
72,
73,
74,
75
],
"label": "dis",
"score": 1,
"text": "原发肿瘤"
}
] |
骨盆的转移性肿瘤常同时累及髂骨、耻骨和坐骨，脊椎的转移性肿瘤有时同时侵犯邻近的几个椎体和肋骨。 | [
{
"indices": [
0,
1,
2,
3,
4,
5,
6,
7,
8,
9,
10,
11,
12,
13,
14,
15,
16,
17,
18,
19,
20
],
"label": "sym",
"score": 1,
"text": "骨盆的转移性肿瘤常同时累及髂骨、耻骨和坐骨"
},
{
"indices": [
0,
1,
2,
3,
4,
5,
6,
7
],
"label": "dis",
"score": 1,
"text": "骨盆的转移性肿瘤"
},
{
"indices": [
13,
14
],
"label": "bod",
"score": 1,
"text": "髂骨"
},
{
"indices": [
16,
17
],
"label": "bod",
"score": 1,
"text": "耻骨"
},
{
"indices": [
19,
20
],
"label": "bod",
"score": 1,
"text": "坐骨"
},
{
"indices": [
22,
23,
24,
25,
26,
27,
28,
29,
30,
31,
32,
33,
34,
35,
36,
37,
38,
39,
40,
41,
42,
43,
44,
45
],
"label": "sym",
"score": 1,
"text": "脊椎的转移性肿瘤有时同时侵犯邻近的几个椎体和肋骨"
},
{
"indices": [
22,
23,
24,
25,
26,
27,
28,
29
],
"label": "dis",
"score": 1,
"text": "脊椎的转移性肿瘤"
},
{
"indices": [
36,
37,
38,
39,
40,
41,
42
],
"label": "bod",
"score": 1,
"text": "邻近的几个椎体"
},
{
"indices": [
44,
45
],
"label": "bod",
"score": 1,
"text": "肋骨"
}
] |
但有些以骨肿瘤为首发症状的转移性骨肿瘤在诊断上往往要依赖于各种实验室检查。 | [
{
"indices": [
4,
5,
6
],
"label": "dis",
"score": 1,
"text": "骨肿瘤"
},
{
"indices": [
13,
14,
15,
16,
17,
18
],
"label": "dis",
"score": 1,
"text": "转移性骨肿瘤"
},
{
"indices": [
31,
32,
33,
34,
35
],
"label": "pro",
"score": 1,
"text": "实验室检查"
}
] |