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前者系活瓣机能先天性发育不全，后者继发于下尿路梗阻，如后尿道瓣膜及神经源性膀胱等。 | [
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"entity": "神经源性膀胱",
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1958年Politano-Leadbetter首先报道采用抗反流的输尿管膀胱再吻合术来解决膀胱输尿管反流。 | [
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胎儿肾积水中，由反流引起的也很常见。 | [
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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。 | [
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原发性膀胱输尿管反流与遗传之间的关系也有报告。 | [
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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。 | [
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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%。 | [
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因此凡超声发现的肾积水都应行VCUG，以排除反流。 | [
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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。 | [
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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。 | [
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"entity": "呕吐",
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"entity": "生长障碍",
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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。 | [
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"entity": "胶原蛋白",
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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。 | [
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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。 | [
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③冠状窦口型房间隔缺损：此型罕见。 | [
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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。 | [
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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。 | [
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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。 | [
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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。 | [
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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。 | [
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婴儿可表现广泛喘鸣。 | [
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随病情进展，出现气急、活动耐力差、生长发育障碍等。 | [
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常见并发症包括肺不张、咯血、气胸、肺动脉高压、呼吸衰竭等。 | [
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早期可出现肺气肿体征，散在或局部粗大啰音，伴杵状指（趾）。 | [
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晚期可出现发绀。 | [
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长期以来根据汗液试验进行确诊。 | [
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CF患儿的治疗应着重于对呼吸道感染的防治。 | [
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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。 | [
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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。 | [
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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。 | [
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亦可出现肾炎和肾病表现。 | [
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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。 | [
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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。 | [
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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。 | [
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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。 | [
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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。 | [
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治疗应广泛彻底切除肿瘤，至少包括瘤周围3cm的组织。 | [
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另外，胃灼热是GERD的又一主要症状。 | [
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}
] |
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。 | [
{
"id": 0,
"entity": "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",
"start_offset": 0,
"end_offset": 36,
"label": "sym"
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] |
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。 | [
{
"id": 0,
"entity": "食管黏膜则会发生糜烂",
"start_offset": 7,
"end_offset": 17,
"label": "sym"
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{
"id": 1,
"entity": "溃疡",
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"end_offset": 20,
"label": "sym"
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{
"id": 2,
"entity": "纤维组织增生及瘢痕形成等一系列改变",
"start_offset": 21,
"end_offset": 38,
"label": "sym"
},
{
"id": 3,
"entity": "食管壁的顺应性下降",
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"end_offset": 50,
"label": "sym"
},
{
"id": 4,
"entity": "导致食管狭窄",
"start_offset": 51,
"end_offset": 57,
"label": "sym"
},
{
"id": 5,
"entity": "患者逐渐出现吞咽困难",
"start_offset": 58,
"end_offset": 68,
"label": "sym"
}
] |
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。 | [
{
"id": 0,
"entity": "Barrett食管",
"start_offset": 6,
"end_offset": 15,
"label": "dis"
},
{
"id": 1,
"entity": "下端食管的鳞状上皮被化生的柱状上皮所代替",
"start_offset": 16,
"end_offset": 36,
"label": "sym"
}
] |
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。 | [
{
"id": 0,
"entity": "反复的呼吸道感染",
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{
"id": 1,
"entity": "呛咳",
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"label": "sym"
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{
"id": 2,
"entity": "声音嘶哑",
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"label": "sym"
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{
"id": 3,
"entity": "屏气",
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"label": "sym"
},
{
"id": 4,
"entity": "年长儿支气管哮喘发作",
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"end_offset": 33,
"label": "sym"
}
] |
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。 | [
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"id": 0,
"entity": "GERD",
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"end_offset": 14,
"label": "dis"
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{
"id": 1,
"entity": "吸入性肺炎",
"start_offset": 18,
"end_offset": 23,
"label": "sym"
},
{
"id": 2,
"entity": "吸入性窒息",
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"end_offset": 35,
"label": "sym"
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{
"id": 3,
"entity": "早产儿或婴儿猝死综合征",
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"end_offset": 47,
"label": "sym"
}
] |
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。 | [
{
"id": 0,
"entity": "少量多餐",
"start_offset": 1,
"end_offset": 5,
"label": "pro"
},
{
"id": 1,
"entity": "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",
"start_offset": 6,
"end_offset": 34,
"label": "pro"
},
{
"id": 2,
"entity": "婴儿可进食黏稠食物",
"start_offset": 35,
"end_offset": 44,
"label": "pro"
},
{
"id": 3,
"entity": "休息时保持头抬高30°的俯卧位等",
"start_offset": 45,
"end_offset": 61,
"label": "pro"
}
] |
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。 | [
{
"id": 0,
"entity": "GERD",
"start_offset": 40,
"end_offset": 44,
"label": "dis"
}
] |
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。 | [
{
"id": 0,
"entity": "小儿颅内肿瘤",
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"label": "dis"
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{
"id": 1,
"entity": "幕下",
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"end_offset": 28,
"label": "bod"
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{
"id": 2,
"entity": "胚胎残余组织",
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"label": "bod"
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{
"id": 3,
"entity": "肿瘤",
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"end_offset": 43,
"label": "dis"
},
{
"id": 4,
"entity": "胶质瘤",
"start_offset": 46,
"end_offset": 49,
"label": "dis"
}
] |
而成人多发生在幕上，以胶质瘤为主。 | [
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"entity": "幕上",
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"label": "bod"
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{
"id": 1,
"entity": "胶质瘤",
"start_offset": 11,
"end_offset": 14,
"label": "dis"
}
] |
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。 | [
{
"id": 0,
"entity": "脑瘤",
"start_offset": 57,
"end_offset": 59,
"label": "dis"
}
] |
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。 | [
{
"id": 0,
"entity": "胶质瘤",
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"end_offset": 20,
"label": "dis"
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{
"id": 1,
"entity": "星形细胞瘤",
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"end_offset": 28,
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{
"id": 2,
"entity": "少突胶质细胞瘤",
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"label": "dis"
},
{
"id": 3,
"entity": "室管膜瘤",
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"end_offset": 41,
"label": "dis"
},
{
"id": 4,
"entity": "神经源肿瘤",
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"end_offset": 47,
"label": "dis"
}
] |
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%。 | [
{
"id": 0,
"entity": "癫痫",
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"end_offset": 2,
"label": "dis"
},
{
"id": 1,
"entity": "肿瘤",
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"end_offset": 10,
"label": "dis"
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{
"id": 2,
"entity": "胶质瘤",
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"end_offset": 37,
"label": "dis"
},
{
"id": 3,
"entity": "癫痫",
"start_offset": 41,
"end_offset": 43,
"label": "dis"
}
] |
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。 | [
{
"id": 0,
"entity": "癫痫",
"start_offset": 27,
"end_offset": 29,
"label": "dis"
},
{
"id": 1,
"entity": "CT检查",
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"end_offset": 36,
"label": "pro"
},
{
"id": 2,
"entity": "影像学检查",
"start_offset": 51,
"end_offset": 56,
"label": "pro"
}
] |
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。 | [
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"id": 0,
"entity": "先天性心脏病",
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"end_offset": 41,
"label": "dis"
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{
"id": 1,
"entity": "先天性脑畸形",
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"end_offset": 48,
"label": "dis"
},
{
"id": 2,
"entity": "婴儿猝死综合征",
"start_offset": 63,
"end_offset": 70,
"label": "dis"
}
] |
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。 | [
{
"id": 0,
"entity": "先天畸形",
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"label": "dis"
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{
"id": 1,
"entity": "SIDS",
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"end_offset": 26,
"label": "dis"
}
] |
各国SIDS的发病率相差甚远。 | [
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"id": 0,
"entity": "SIDS",
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"end_offset": 6,
"label": "dis"
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] |
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。 | [
{
"id": 0,
"entity": "SIDS",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
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{
"id": 1,
"entity": "消化道",
"start_offset": 28,
"end_offset": 31,
"label": "bod"
}
] |
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。 | [
{
"id": 0,
"entity": "患儿常有反复喂养困难和睡眠时多汗",
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"end_offset": 16,
"label": "sym"
}
] |
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。 | [
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"id": 0,
"entity": "SIDS",
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"end_offset": 24,
"label": "dis"
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{
"id": 1,
"entity": "SIDS",
"start_offset": 78,
"end_offset": 82,
"label": "dis"
}
] |
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。 | [
{
"id": 0,
"entity": "脑脓疡",
"start_offset": 3,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "心房",
"start_offset": 25,
"end_offset": 27,
"label": "bod"
},
{
"id": 2,
"entity": "体循环",
"start_offset": 35,
"end_offset": 38,
"label": "bod"
},
{
"id": 3,
"entity": "细菌",
"start_offset": 40,
"end_offset": 42,
"label": "mic"
},
{
"id": 4,
"entity": "脑部",
"start_offset": 47,
"end_offset": 49,
"label": "bod"
},
{
"id": 5,
"entity": "脑脓疡",
"start_offset": 54,
"end_offset": 57,
"label": "dis"
}
] |
若患有感染性心内膜炎，细菌栓子亦可进入脑部。 | [
{
"id": 0,
"entity": "感染性心内膜炎",
"start_offset": 3,
"end_offset": 10,
"label": "dis"
},
{
"id": 1,
"entity": "细菌",
"start_offset": 11,
"end_offset": 13,
"label": "mic"
}
] |
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。 | [
{
"id": 0,
"entity": "青紫型先心",
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"label": "dis"
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{
"id": 1,
"entity": "头痛",
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"end_offset": 25,
"label": "sym"
},
{
"id": 2,
"entity": "呕吐",
"start_offset": 26,
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"label": "sym"
},
{
"id": 3,
"entity": "神经定位",
"start_offset": 29,
"end_offset": 33,
"label": "sym"
},
{
"id": 4,
"entity": "脑部",
"start_offset": 41,
"end_offset": 43,
"label": "bod"
}
] |
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。 | [
{
"id": 0,
"entity": "右心房造影",
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{
"id": 1,
"entity": "造影剂",
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"label": "equ"
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{
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"entity": "房间",
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"label": "bod"
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{
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"entity": "左心房",
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"label": "bod"
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{
"id": 4,
"entity": "下腔静脉",
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"label": "bod"
},
{
"id": 5,
"entity": "肝静脉",
"start_offset": 30,
"end_offset": 33,
"label": "bod"
}
] |
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。 | [
{
"id": 0,
"entity": "Fontan手术",
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"label": "pro"
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{
"id": 1,
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{
"id": 2,
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{
"id": 3,
"entity": "桥静脉",
"start_offset": 30,
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"label": "bod"
}
] |
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。 | [
{
"id": 0,
"entity": "Fontan手术",
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{
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"entity": "体静脉",
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"label": "bod"
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{
"id": 2,
"entity": "肺循环",
"start_offset": 26,
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"label": "bod"
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{
"id": 3,
"entity": "体肺循环",
"start_offset": 32,
"end_offset": 36,
"label": "bod"
}
] |
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。 | [
{
"id": 0,
"entity": "卵圆孔",
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"label": "bod"
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{
"id": 1,
"entity": "心排出量",
"start_offset": 7,
"end_offset": 11,
"label": "ite"
},
{
"id": 2,
"entity": "球囊房间隔造口术",
"start_offset": 16,
"end_offset": 24,
"label": "pro"
},
{
"id": 3,
"entity": "球囊扩张加房间隔撕裂术",
"start_offset": 36,
"end_offset": 47,
"label": "pro"
}
] |
静注NaHCO3纠正代谢性酸中毒。 | [
{
"id": 0,
"entity": "静注NaHCO3",
"start_offset": 0,
"end_offset": 8,
"label": "pro"
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] |
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。 | [
{
"id": 0,
"entity": "进行性低氧血症",
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"label": "dis"
},
{
"id": 1,
"entity": "缺氧",
"start_offset": 17,
"end_offset": 19,
"label": "sym"
}
] |
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。 | [
{
"id": 0,
"entity": "Blalock-Taussig分流术",
"start_offset": 14,
"end_offset": 32,
"label": "pro"
},
{
"id": 1,
"entity": "Goretex管",
"start_offset": 35,
"end_offset": 43,
"label": "equ"
},
{
"id": 2,
"entity": "锁骨下动脉",
"start_offset": 45,
"end_offset": 50,
"label": "bod"
},
{
"id": 3,
"entity": "肺动脉",
"start_offset": 53,
"end_offset": 56,
"label": "bod"
}
] |
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。 | [
{
"id": 0,
"entity": "Fontan术",
"start_offset": 0,
"end_offset": 7,
"label": "pro"
},
{
"id": 1,
"entity": "失蛋白性肠病",
"start_offset": 16,
"end_offset": 22,
"label": "dis"
},
{
"id": 2,
"entity": "胃肠道蛋白质",
"start_offset": 23,
"end_offset": 29,
"label": "bod"
},
{
"id": 3,
"entity": "低蛋白血症",
"start_offset": 36,
"end_offset": 41,
"label": "dis"
},
{
"id": 4,
"entity": "水肿",
"start_offset": 42,
"end_offset": 44,
"label": "sym"
}
] |
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。 | [
{
"id": 0,
"entity": "轻度贫血貌",
"start_offset": 14,
"end_offset": 19,
"label": "sym"
}
] |
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。 | [
{
"id": 0,
"entity": "静脉穿刺采血",
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"end_offset": 27,
"label": "pro"
},
{
"id": 1,
"entity": "贫血",
"start_offset": 34,
"end_offset": 36,
"label": "dis"
},
{
"id": 2,
"entity": "输血",
"start_offset": 45,
"end_offset": 47,
"label": "pro"
}
] |
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。 | [
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"id": 0,
"entity": "严重贫血",
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"label": "dis"
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{
"id": 1,
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"start_offset": 8,
"end_offset": 13,
"label": "dru"
},
{
"id": 2,
"entity": "血",
"start_offset": 53,
"end_offset": 54,
"label": "bod"
},
{
"id": 3,
"entity": "输注",
"start_offset": 54,
"end_offset": 56,
"label": "pro"
}
] |
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。 | [
{
"id": 0,
"entity": "维生素A缺乏症",
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"label": "dis"
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{
"id": 1,
"entity": "维生素A",
"start_offset": 13,
"end_offset": 17,
"label": "dru"
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{
"id": 2,
"entity": "蛋白质-能量营养不良",
"start_offset": 28,
"end_offset": 38,
"label": "sym"
}
] |
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。 | [
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{
"id": 1,
"entity": "活动性角膜溃疡",
"start_offset": 32,
"end_offset": 39,
"label": "dis"
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] |
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%。 | [
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"entity": "亚临床型维生素A缺乏",
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"id": 1,
"entity": "亚临床型维生素A缺乏",
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"end_offset": 40,
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] |
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。 | [
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"entity": "维生素A",
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"id": 1,
"entity": "维生素A缺乏症",
"start_offset": 26,
"end_offset": 33,
"label": "dru"
}
] |
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。 | [
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"id": 0,
"entity": "维生素A",
"start_offset": 2,
"end_offset": 6,
"label": "dru"
},
{
"id": 1,
"entity": "角膜干燥症",
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"end_offset": 19,
"label": "dis"
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{
"id": 2,
"entity": "畏光",
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},
{
"id": 3,
"entity": "视物变形",
"start_offset": 29,
"end_offset": 33,
"label": "sym"
}
] |
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。 | [
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"id": 0,
"entity": "睑板腺",
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"label": "bod"
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{
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{
"id": 2,
"entity": "睑缘",
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{
"id": 3,
"entity": "水泡",
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{
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{
"id": 5,
"entity": "基质浸润",
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"label": "sym"
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{
"id": 6,
"entity": "角膜",
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"label": "bod"
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{
"id": 7,
"entity": "角膜软化",
"start_offset": 55,
"end_offset": 59,
"label": "sym"
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{
"id": 8,
"entity": "变性",
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"end_offset": 62,
"label": "sym"
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{
"id": 9,
"entity": "溃疡",
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"label": "sym"
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{
"id": 10,
"entity": "穿孔",
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"label": "sym"
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{
"id": 11,
"entity": "晶状体",
"start_offset": 73,
"end_offset": 76,
"label": "bod"
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{
"id": 12,
"entity": "虹膜",
"start_offset": 77,
"end_offset": 79,
"label": "bod"
},
{
"id": 13,
"entity": "眼睛",
"start_offset": 86,
"end_offset": 88,
"label": "bod"
}
] |
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。 | [
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{
"id": 1,
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{
"id": 2,
"entity": "皮肤较正常干燥",
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{
"id": 3,
"entity": "毛囊上皮角化",
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{
"id": 4,
"entity": "毛囊性丘疹",
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{
"id": 5,
"entity": "角化过度的毛囊性丘疹",
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"label": "sym"
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{
"id": 6,
"entity": "大腿前外侧",
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"end_offset": 61,
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{
"id": 7,
"entity": "上臂后侧",
"start_offset": 62,
"end_offset": 66,
"label": "bod"
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{
"id": 8,
"entity": "上下肢",
"start_offset": 73,
"end_offset": 76,
"label": "bod"
},
{
"id": 9,
"entity": "肩",
"start_offset": 79,
"end_offset": 80,
"label": "bod"
},
{
"id": 10,
"entity": "下腹部",
"start_offset": 81,
"end_offset": 84,
"label": "bod"
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{
"id": 11,
"entity": "胸",
"start_offset": 89,
"end_offset": 90,
"label": "bod"
},
{
"id": 12,
"entity": "背",
"start_offset": 91,
"end_offset": 92,
"label": "bod"
},
{
"id": 13,
"entity": "臀",
"start_offset": 93,
"end_offset": 94,
"label": "bod"
}
] |
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。 | [
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{
"id": 1,
"entity": "免疫力低下",
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"label": "sym"
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{
"id": 2,
"entity": "脑积水",
"start_offset": 38,
"end_offset": 41,
"label": "dis"
}
] |
用维生素A治疗维生素A缺乏症，疗效迅速而有效。 | [
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"id": 0,
"entity": "维生素A",
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{
"id": 1,
"entity": "维生素A缺乏症",
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"label": "dis"
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] |
早产儿应适当早期添加维生素A。 | [
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"id": 0,
"entity": "维生素A",
"start_offset": 10,
"end_offset": 14,
"label": "dru"
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] |
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。 | [
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"id": 0,
"entity": "脑水肿",
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"label": "dis"
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{
"id": 1,
"entity": "肾上腺皮质激素",
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"end_offset": 15,
"label": "dru"
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{
"id": 2,
"entity": "颅内压增高较明显",
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{
"id": 3,
"entity": "静脉推注",
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"label": "pro"
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{
"id": 4,
"entity": "脱水剂",
"start_offset": 30,
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"label": "dru"
},
{
"id": 5,
"entity": "利尿剂",
"start_offset": 34,
"end_offset": 37,
"label": "dru"
}
] |
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。 | [
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"id": 0,
"entity": "蛛网膜下腔",
"start_offset": 0,
"end_offset": 5,
"label": "bod"
},
{
"id": 1,
"entity": "血液",
"start_offset": 6,
"end_offset": 8,
"label": "bod"
},
{
"id": 2,
"entity": "血凝块",
"start_offset": 9,
"end_offset": 12,
"label": "bod"
},
{
"id": 3,
"entity": "脑动脉",
"start_offset": 15,
"end_offset": 18,
"label": "bod"
},
{
"id": 4,
"entity": "炎症",
"start_offset": 19,
"end_offset": 21,
"label": "dis"
},
{
"id": 5,
"entity": "脑水肿",
"start_offset": 24,
"end_offset": 27,
"label": "dis"
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{
"id": 6,
"entity": "血管",
"start_offset": 32,
"end_offset": 34,
"label": "bod"
},
{
"id": 7,
"entity": "血管",
"start_offset": 41,
"end_offset": 43,
"label": "bod"
},
{
"id": 8,
"entity": "释放促血管痉挛物质而引起血管痉挛",
"start_offset": 29,
"end_offset": 45,
"label": "sym"
}
] |
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。 | [
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"id": 0,
"entity": "动脉瘤",
"start_offset": 0,
"end_offset": 3,
"label": "dis"
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{
"id": 1,
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"label": "dis"
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{
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"entity": "外科",
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"label": "dep"
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{
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"entity": "放射外科",
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{
"id": 4,
"entity": "儿童AVMs",
"start_offset": 51,
"end_offset": 57,
"label": "dis"
}
] |
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。 | [
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{
"id": 1,
"entity": "儿童AVMs",
"start_offset": 29,
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"label": "dis"
}
] |
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。 | [
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"id": 0,
"entity": "血小板",
"start_offset": 15,
"end_offset": 18,
"label": "bod"
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{
"id": 1,
"entity": "阿司匹林",
"start_offset": 27,
"end_offset": 31,
"label": "dru"
},
{
"id": 2,
"entity": "抗血小板药物",
"start_offset": 34,
"end_offset": 40,
"label": "dru"
},
{
"id": 3,
"entity": "头部",
"start_offset": 49,
"end_offset": 51,
"label": "bod"
},
{
"id": 4,
"entity": "外伤",
"start_offset": 51,
"end_offset": 53,
"label": "dis"
}
] |
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。 | [
{
"id": 0,
"entity": "Ⅷ因子",
"start_offset": 10,
"end_offset": 13,
"label": "dru"
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{
"id": 1,
"entity": "维生素K",
"start_offset": 26,
"end_offset": 30,
"label": "dru"
},
{
"id": 2,
"entity": "凝血因子复合物",
"start_offset": 31,
"end_offset": 38,
"label": "dru"
},
{
"id": 3,
"entity": "新鲜血",
"start_offset": 39,
"end_offset": 42,
"label": "dru"
}
] |
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。 | [
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"id": 0,
"entity": "心电图",
"start_offset": 0,
"end_offset": 3,
"label": "pro"
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{
"id": 1,
"entity": "内脏",
"start_offset": 8,
"end_offset": 10,
"label": "bod"
},
{
"id": 2,
"entity": "心房",
"start_offset": 27,
"end_offset": 29,
"label": "bod"
}
] |
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。 | [
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"entity": "超声心动图",
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{
"id": 1,
"entity": "内脏",
"start_offset": 7,
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"label": "bod"
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{
"id": 2,
"entity": "心内畸形",
"start_offset": 12,
"end_offset": 16,
"label": "sym"
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{
"id": 3,
"entity": "心脏",
"start_offset": 42,
"end_offset": 44,
"label": "bod"
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{
"id": 4,
"entity": "房室",
"start_offset": 47,
"end_offset": 49,
"label": "bod"
},
{
"id": 5,
"entity": "心室动脉",
"start_offset": 57,
"end_offset": 61,
"label": "bod"
}
] |
最常见的合并畸形为房室连接不一致（心室左襻），约占50%。 | [
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"entity": "畸形",
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{
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"entity": "房室连接不一致（心室左襻）",
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"end_offset": 22,
"label": "sym"
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] |
1/4的患儿伴有单心室，大多数患儿（60%）合并有室间隔缺损。 | [
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"entity": "单心室",
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{
"id": 1,
"entity": "室间隔缺损",
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"label": "sym"
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] |
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。 | [
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"entity": "畸形",
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{
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{
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{
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"entity": "大血管转位",
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{
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"entity": "右位心",
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"label": "bod"
},
{
"id": 5,
"entity": "内脏",
"start_offset": 30,
"end_offset": 32,
"label": "bod"
}
] |
我国多数报道活产婴儿窒息发生率约为5%～10%。 | [
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"entity": "窒息",
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] |
新生儿窒息多为产前或产时因素所致，产后因素较少。 | [
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"entity": "新生儿窒息",
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] |
血游离脂肪酸增加，促进钙离子与蛋白结合而致低钙血症。 | [
{
"id": 0,
"entity": "低钙血症",
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] |
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。 | [
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{
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{
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{
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{
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"entity": "胎粪吸入综合征",
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{
"id": 5,
"entity": "呼吸窘迫综合征",
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{
"id": 6,
"entity": "肺出血",
"start_offset": 54,
"end_offset": 57,
"label": "dis"
},
{
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"entity": "心血管系统",
"start_offset": 59,
"end_offset": 64,
"label": "bod"
},
{
"id": 8,
"entity": "缺氧缺血性心肌损害",
"start_offset": 65,
"end_offset": 74,
"label": "dis"
},
{
"id": 9,
"entity": "三尖瓣闭锁不全",
"start_offset": 75,
"end_offset": 82,
"label": "dis"
},
{
"id": 10,
"entity": "心力衰竭",
"start_offset": 83,
"end_offset": 87,
"label": "dis"
},
{
"id": 11,
"entity": "心源性休克",
"start_offset": 88,
"end_offset": 93,
"label": "dis"
},
{
"id": 12,
"entity": "泌尿系统",
"start_offset": 96,
"end_offset": 100,
"label": "bod"
},
{
"id": 13,
"entity": "肾功能不全",
"start_offset": 101,
"end_offset": 106,
"label": "dis"
},
{
"id": 14,
"entity": "衰竭",
"start_offset": 107,
"end_offset": 109,
"label": "dis"
},
{
"id": 15,
"entity": "肾静脉血栓",
"start_offset": 110,
"end_offset": 115,
"label": "dis"
},
{
"id": 16,
"entity": "低血糖",
"start_offset": 125,
"end_offset": 128,
"label": "dis"
},
{
"id": 17,
"entity": "低钙",
"start_offset": 129,
"end_offset": 131,
"label": "sym"
},
{
"id": 18,
"entity": "低钠血症",
"start_offset": 132,
"end_offset": 136,
"label": "dis"
},
{
"id": 19,
"entity": "消化系统",
"start_offset": 139,
"end_offset": 143,
"label": "bod"
},
{
"id": 20,
"entity": "应激性溃疡",
"start_offset": 144,
"end_offset": 149,
"label": "dis"
},
{
"id": 21,
"entity": "坏死性小肠结肠炎",
"start_offset": 150,
"end_offset": 158,
"label": "dis"
}
] |
原发肿瘤诊断明确并经治疗后转移至骨骼，一般较易发现。 | [
{
"id": 0,
"entity": "骨骼",
"start_offset": 16,
"end_offset": 18,
"label": "bod"
}
] |
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。 | [
{
"id": 0,
"entity": "转移性骨肿瘤",
"start_offset": 14,
"end_offset": 20,
"label": "bod"
},
{
"id": 1,
"entity": "转移性的骨肿瘤",
"start_offset": 43,
"end_offset": 50,
"label": "bod"
},
{
"id": 2,
"entity": "肿瘤",
"start_offset": 56,
"end_offset": 58,
"label": "bod"
}
] |
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。 | [
{
"id": 0,
"entity": "肿瘤",
"start_offset": 0,
"end_offset": 2,
"label": "dis"
},
{
"id": 1,
"entity": "骨骼",
"start_offset": 3,
"end_offset": 5,
"label": "bod"
},
{
"id": 2,
"entity": "静脉系统",
"start_offset": 9,
"end_offset": 13,
"label": "bod"
},
{
"id": 3,
"entity": "椎静脉系统",
"start_offset": 17,
"end_offset": 22,
"label": "bod"
}
] |
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。 | [
{
"id": 0,
"entity": "肿瘤骨骼",
"start_offset": 7,
"end_offset": 11,
"label": "dis"
},
{
"id": 1,
"entity": "神经母细胞瘤",
"start_offset": 15,
"end_offset": 21,
"label": "dis"
},
{
"id": 2,
"entity": "肺癌",
"start_offset": 22,
"end_offset": 24,
"label": "dis"
},
{
"id": 3,
"entity": "甲状腺癌",
"start_offset": 25,
"end_offset": 29,
"label": "dis"
},
{
"id": 4,
"entity": "乳腺癌",
"start_offset": 30,
"end_offset": 33,
"label": "dis"
}
] |
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。 | [
{
"id": 0,
"entity": "转移性骨肿瘤",
"start_offset": 0,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "躯干骨",
"start_offset": 9,
"end_offset": 12,
"label": "bod"
},
{
"id": 2,
"entity": "股骨",
"start_offset": 16,
"end_offset": 18,
"label": "bod"
},
{
"id": 3,
"entity": "肱骨",
"start_offset": 19,
"end_offset": 21,
"label": "bod"
},
{
"id": 4,
"entity": "股骨",
"start_offset": 28,
"end_offset": 30,
"label": "bod"
},
{
"id": 5,
"entity": "肱骨",
"start_offset": 31,
"end_offset": 33,
"label": "bod"
}
] |