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|---|---|
根据病史、症状、鼻腔检查及鼻窦华氏位摄影等检查，即可做出诊断。 | [
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"entity": "鼻窦华氏位摄影",
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必要时进行CT检查。 | [
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"entity": "CT检查",
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"end_offset": 9,
"label": "pro"
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] |
对慢性顽固性鼻窦炎患儿可采用内镜鼻窦手术治疗。 | [
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"entity": "慢性顽固性鼻窦炎",
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"id": 1,
"entity": "内镜鼻窦手术",
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当人、畜接触疫水时，尾蚴很快（短至2～10秒钟）从皮肤或黏膜钻入体内，脱落尾部变为童虫。 | [
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{
"id": 1,
"entity": "黏膜",
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潜伏期内40%～75%的患者于接触疫水部位出现尾蚴性皮炎。 | [
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"entity": "尾蚴性皮炎",
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胸部X线片一般仅见肺纹增粗、肺门阴影增宽，可有点状、云雾状或雪花状浸润性阴影，重者有粟粒状改变，3个月左右可自行吸收，不留痕迹。 | [
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"id": 1,
"entity": "肺纹增粗",
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"entity": "肺门阴影增宽",
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"id": 3,
"entity": "点状、云雾状或雪花状浸润性阴影",
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"end_offset": 38,
"label": "sym"
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"id": 4,
"entity": "粟粒状改变",
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无症状型起病常无明显症状而呈慢性经过，仅于普查时或因其他疾病就医时偶然发现；有症状型可表现腹胀，大便有时稀、次数增多，偶见黏液血便，食欲缺乏。 | [
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"entity": "偶见黏液血便",
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{
"id": 2,
"entity": "食欲缺乏",
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"end_offset": 70,
"label": "sym"
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微波ELISA是ELISA检测方法的改进，是一种快速、高效的血吸虫病免疫学诊断方法，具有实际应用价值。 | [
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"id": 2,
"entity": "血吸虫病免疫学诊断",
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巨脾、腹水等要与其他病因所致肝硬化鉴别。 | [
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"id": 2,
"entity": "肝硬化",
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晚期血吸虫病则用60mg/kg（儿童70mg/kg）分3天服用。 | [
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"entity": "血吸虫病",
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"label": "dis"
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消化系统症状有腹痛、恶心、腹胀、腹泻、口干。 | [
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"entity": "恶心",
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"entity": "腹胀",
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"entity": "腹泻",
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"entity": "口干",
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多数患儿除咳嗽及轻度呼吸困难外，缺乏一般症状。 | [
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"entity": "咳嗽",
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{
"id": 1,
"entity": "轻度呼吸困难外",
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一般无发热。 | [
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"entity": "无发热",
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急性期应进行体位引流及气管吸引，排出油剂。 | [
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"entity": "气管吸引",
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必要时进行纤维支气管镜下吸引。 | [
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"entity": "纤维支气管镜下吸引",
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多发生于左肺下叶，少数位于右下叶。 | [
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"entity": "右下叶",
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"label": "bod"
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肺外型及与支气管不相通的肺内型肺隔离症，一般不出现症状，常由于并发症或其他原因进行肺X线检查时才发现有阴影而疑及本病。 | [
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"entity": "肺内型肺隔离症",
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"entity": "肺X线检查",
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{
"id": 4,
"entity": "有阴影",
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胸部X线检查往往显示病变区出现大片致密阴影，其间可见单个或多个囊性透光区，囊壁厚薄不等，周围常有炎性浸润。 | [
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"entity": "其间可见单个或多个囊性透光区",
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{
"id": 3,
"entity": "囊壁厚薄不等",
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"label": "sym"
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{
"id": 4,
"entity": "周围常有炎性浸润",
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X线侧位片或CT能更清楚地显示病变的确切部位和范围，以及与邻近组织器官的关系，并可排除局灶性慢性脓胸等其他肺部疾病。 | [
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"entity": "邻近组织器官",
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"id": 3,
"entity": "局灶性慢性脓胸",
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当主要侵犯鼻、鼻咽和咽部时，常诊断为急性鼻咽炎、急性咽炎、急性扁桃体炎等，也可统称为上呼吸道感染。 | [
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"entity": "急性鼻咽炎",
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"entity": "急性咽炎",
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"entity": "急性扁桃体炎",
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"id": 6,
"entity": "上呼吸道感染",
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病毒、细菌和肺炎支原体等均可引起，但原发性上感以病毒引起者最为多见，约占90%以上，主要有呼吸道合胞病毒、流感病毒、副流感病毒、腺病毒、鼻病毒、柯萨奇病毒、埃可病毒、冠状病毒等。 | [
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"entity": "原发性上感",
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"entity": "呼吸道合胞病毒",
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"entity": "流感病毒",
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"entity": "腺病毒",
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"entity": "鼻病毒",
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"entity": "柯萨奇病毒",
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"id": 11,
"entity": "埃可病毒",
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{
"id": 12,
"entity": "冠状病毒",
"start_offset": 83,
"end_offset": 87,
"label": "mic"
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病毒感染后易继发细菌感染，形成混合感染。 | [
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"entity": "混合感染",
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常见于溶血性链球菌、肺炎链球菌、流感嗜血杆菌等。 | [
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"entity": "流感嗜血杆菌",
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以鼻塞、喷嚏、流涕、干咳、咽痛、发热等为主要症状。 | [
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"entity": "发热",
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婴幼儿局部症状不显著而全身症状重，可骤然起病，高热、咳嗽、食欲差，可伴有呕吐、腹泻、烦躁，甚至高热惊厥。 | [
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"entity": "呕吐",
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"entity": "高热惊厥",
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"label": "sym"
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体格检查可见咽部充血，扁桃体肿大，颌下淋巴结肿大、触痛等。 | [
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"entity": "触痛",
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病程约3～5天，如体温持续不退或病情加重，应考虑合并细菌感染或出现并发症。 | [
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我国新中国成立前每年约100万新生儿死于破伤风，建国后发病率和死亡率显著下降，但在边远农村、山区及私自接生者新生儿破伤风仍不罕见。 | [
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呼吸肌与喉肌痉挛引起呼吸困难、青紫、窒息；咽肌痉挛使唾液充满口腔；膀胱及直肠括约肌痉挛可导致尿潴留和便秘。 | [
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"entity": "咽肌痉挛",
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"entity": "唾液充满口腔",
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"entity": "膀胱及直肠括约肌痉挛",
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"entity": "尿潴留",
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{
"id": 7,
"entity": "便秘",
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NICH预后与其出血类型有关。 | [
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小脑出血预后差，出生后不久即死亡。 | [
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（1）两性霉素B：适应证为曲菌、念珠菌、隐球菌和组织胞质菌感染。 | [
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}
] |
（1）氟康唑：适应证为隐球菌和念珠菌感染，对曲菌感染无效。 | [
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"entity": "氟康唑",
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"id": 1,
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{
"id": 2,
"entity": "曲菌感染",
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"label": "dis"
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] |
本品在16岁以下儿童体内的血浆半衰期与成人不同，故对不同年龄儿童推荐剂量如下：＞4周的患儿：深部真菌感染，6mg/（kg•d），每日给药一次；严重威胁生命的感染，12mg/（kg•d），每日给药1次。 | [
{
"id": 0,
"entity": "深部真菌感染",
"start_offset": 46,
"end_offset": 52,
"label": "sym"
}
] |
（2）伊曲康唑：适应证为曲菌、念珠菌、隐球菌和组织胞质菌感染，对镰刀霉菌活性低，对毛霉菌无效。 | [
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"id": 0,
"entity": "伊曲康唑",
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{
"id": 1,
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"end_offset": 30,
"label": "dis"
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{
"id": 2,
"entity": "镰刀霉菌",
"start_offset": 32,
"end_offset": 36,
"label": "mic"
},
{
"id": 3,
"entity": "毛霉菌",
"start_offset": 41,
"end_offset": 44,
"label": "mic"
}
] |
（3）伏立康唑：适应证为曲菌、念珠菌以及镰刀霉菌感染，对接合菌无活性。 | [
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"id": 0,
"entity": "伏立康唑",
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{
"id": 1,
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"start_offset": 12,
"end_offset": 26,
"label": "dis"
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] |
应注意原发病的诊断，如胱氨酸储积病者，眼裂隙灯检查可见角膜有胱氨酸结晶沉着，骨髓或血白细胞中胱氨酸含量增加并见到胱氨酸结晶，对本病确切诊断十分重要。 | [
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"id": 0,
"entity": "胱氨酸储积病",
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"label": "dis"
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{
"id": 1,
"entity": "眼裂隙灯",
"start_offset": 19,
"end_offset": 23,
"label": "equ"
},
{
"id": 2,
"entity": "角膜",
"start_offset": 27,
"end_offset": 29,
"label": "bod"
},
{
"id": 3,
"entity": "角膜有胱氨酸结晶沉着",
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"label": "sym"
},
{
"id": 4,
"entity": "骨髓",
"start_offset": 38,
"end_offset": 40,
"label": "bod"
},
{
"id": 5,
"entity": "血白细胞",
"start_offset": 41,
"end_offset": 45,
"label": "bod"
},
{
"id": 6,
"entity": "骨髓或血白细胞中胱氨酸含量增加并见到胱氨酸结晶",
"start_offset": 38,
"end_offset": 61,
"label": "sym"
}
] |
临床上溶血症状较轻，常伴有雷诺症状，可发生肢端坏死、溃疡。 | [
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"id": 0,
"entity": "溶血",
"start_offset": 3,
"end_offset": 5,
"label": "sym"
},
{
"id": 1,
"entity": "肢端坏死",
"start_offset": 21,
"end_offset": 25,
"label": "sym"
},
{
"id": 2,
"entity": "溃疡",
"start_offset": 26,
"end_offset": 28,
"label": "sym"
}
] |
如以专抗IgG或IgM的抗血清作Coombs试验时，直接试验阴性，而抗补体Coombs试验则阳性。 | [
{
"id": 0,
"entity": "Coombs试验",
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"end_offset": 24,
"label": "pro"
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{
"id": 1,
"entity": "Coombs试验",
"start_offset": 37,
"end_offset": 45,
"label": "pro"
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] |
糖皮质激素对部分患儿有效，反复发作者可应用免疫抑制剂如苯丁酸氮芥、环磷酰胺、硫唑嘌呤等，有一定的疗效；本病可应用血浆分离法（plasmapheresis）去除冷凝抗体，有一定的短期疗效；此外，脾切除、输注洗涤红细胞等也有一定的疗效。 | [
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"id": 0,
"entity": "糖皮质激素",
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{
"id": 1,
"entity": "免疫抑制剂",
"start_offset": 21,
"end_offset": 26,
"label": "dru"
},
{
"id": 2,
"entity": "苯丁酸氮芥",
"start_offset": 27,
"end_offset": 32,
"label": "dru"
},
{
"id": 3,
"entity": "环磷酰胺",
"start_offset": 33,
"end_offset": 37,
"label": "dru"
},
{
"id": 4,
"entity": "硫唑嘌呤",
"start_offset": 38,
"end_offset": 42,
"label": "dru"
},
{
"id": 5,
"entity": "血浆",
"start_offset": 56,
"end_offset": 58,
"label": "bod"
},
{
"id": 6,
"entity": "红细胞",
"start_offset": 104,
"end_offset": 107,
"label": "bod"
}
] |
皮肤散在的自发性瘀点、瘀斑多为血小板减少性紫癜；肌肉血肿伴关节腔出血者多为血友病。 | [
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"entity": "自发性瘀点",
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"label": "sym"
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{
"id": 1,
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{
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{
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"entity": "肌肉血肿",
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{
"id": 4,
"entity": "关节腔出血",
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"end_offset": 34,
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},
{
"id": 5,
"entity": "血友病",
"start_offset": 37,
"end_offset": 40,
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}
] |
血小板减少者应观察骨髓巨核细胞分化和产血小板情况，测定PAIg。 | [
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"id": 0,
"entity": "血小板",
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{
"id": 1,
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"entity": "血小板",
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{
"id": 3,
"entity": "PAIg",
"start_offset": 27,
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"label": "bod"
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] |
当PCT正常、APTT、PT和TT均延长时，应属纤维蛋白生成障碍，涉及因子Ⅰ、Ⅻ异常或抗凝物质过多，可进一步测定纤维蛋白原量或作甲苯胺蓝纠正试验。 | [
{
"id": 0,
"entity": "PCT",
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"end_offset": 4,
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{
"id": 1,
"entity": "APTT",
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"end_offset": 11,
"label": "ite"
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{
"id": 2,
"entity": "PT",
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"label": "ite"
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{
"id": 3,
"entity": "TT",
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"label": "ite"
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{
"id": 4,
"entity": "纤维蛋白",
"start_offset": 24,
"end_offset": 28,
"label": "bod"
},
{
"id": 5,
"entity": "因子Ⅰ、Ⅻ异常",
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"label": "dis"
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{
"id": 6,
"entity": "纤维蛋白",
"start_offset": 56,
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"label": "bod"
},
{
"id": 7,
"entity": "甲苯胺蓝",
"start_offset": 64,
"end_offset": 68,
"label": "bod"
}
] |
播散性血管内凝血（DIC）引起的出血涉及多方面的原因，需作血小板计数、PT、血浆纤维蛋白原测定、血浆鱼精蛋白副凝固（3P）试验，血浆纤维蛋白降解产物（FDP）、D-二聚体测定和乙醇胶试验等确诊。 | [
{
"id": 0,
"entity": "凝血",
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"end_offset": 8,
"label": "bod"
},
{
"id": 1,
"entity": "DIC",
"start_offset": 9,
"end_offset": 12,
"label": "bod"
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{
"id": 2,
"entity": "出血",
"start_offset": 16,
"end_offset": 18,
"label": "sym"
},
{
"id": 3,
"entity": "血小板",
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"label": "bod"
},
{
"id": 4,
"entity": "PT",
"start_offset": 35,
"end_offset": 37,
"label": "bod"
},
{
"id": 5,
"entity": "血浆纤维蛋白原",
"start_offset": 38,
"end_offset": 45,
"label": "bod"
},
{
"id": 6,
"entity": "血浆鱼精蛋白副凝固",
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"label": "bod"
},
{
"id": 7,
"entity": "3P",
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"label": "bod"
},
{
"id": 8,
"entity": "血浆纤维蛋白",
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"end_offset": 70,
"label": "bod"
},
{
"id": 9,
"entity": "FDP",
"start_offset": 75,
"end_offset": 78,
"label": "bod"
},
{
"id": 10,
"entity": "D-二聚体",
"start_offset": 80,
"end_offset": 85,
"label": "bod"
},
{
"id": 11,
"entity": "乙醇胶",
"start_offset": 88,
"end_offset": 91,
"label": "bod"
}
] |
在存在中等流量的左向右分流时，早产儿比足月儿更早出现心力衰竭。 | [
{
"id": 0,
"entity": "心力衰竭",
"start_offset": 26,
"end_offset": 30,
"label": "dis"
}
] |
肺毛细血管通透性增加可致肺水肿。 | [
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"id": 0,
"entity": "肺毛细血管",
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"label": "bod"
},
{
"id": 1,
"entity": "肺水肿",
"start_offset": 12,
"end_offset": 15,
"label": "dis"
}
] |
早产儿动脉导管未闭的发病率极高。 | [
{
"id": 0,
"entity": "动脉导管未闭",
"start_offset": 3,
"end_offset": 9,
"label": "dis"
}
] |
在1750g以下的早产儿约有半数伴有动脉导管未闭，而在体重不到1200g者发生率可达80%左右。 | [
{
"id": 0,
"entity": "动脉导管未闭",
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"label": "dis"
}
] |
最初可在胸骨左缘第2肋间闻及短促、柔和的收缩期杂音，随着左向右分流的增加，周围血管搏动增强，心前区搏动活跃，杂音增强且延长至舒张期。 | [
{
"id": 0,
"entity": "胸骨",
"start_offset": 4,
"end_offset": 6,
"label": "bod"
},
{
"id": 1,
"entity": "血管",
"start_offset": 39,
"end_offset": 41,
"label": "bod"
},
{
"id": 2,
"entity": "心前区",
"start_offset": 46,
"end_offset": 49,
"label": "bod"
}
] |
动脉导管中等或较大的婴儿，因肺血管阻力逐渐降低，左向右分流增加，生后1～2月可出现心力衰竭症状。 | [
{
"id": 0,
"entity": "动脉导管",
"start_offset": 0,
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"label": "bod"
},
{
"id": 1,
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},
{
"id": 2,
"entity": "心力衰竭",
"start_offset": 41,
"end_offset": 45,
"label": "sym"
}
] |
此类患儿喂养困难，多汗，吸奶时呼吸短促，体重增长较慢，身长亦低于正常儿。 | [
{
"id": 0,
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{
"id": 1,
"entity": "多汗",
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{
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"entity": "吸奶时呼吸短促",
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{
"id": 3,
"entity": "体重增长较慢",
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"label": "sym"
},
{
"id": 4,
"entity": "身长亦低于正常儿",
"start_offset": 27,
"end_offset": 35,
"label": "sym"
}
] |
可有呼吸急促及肋间隙凹陷等呼吸系统体征，大量左向右分流时可见哈里森沟。 | [
{
"id": 0,
"entity": "呼吸急促",
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"end_offset": 6,
"label": "sym"
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{
"id": 1,
"entity": "肋间隙凹陷等呼吸系统体征",
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"label": "sym"
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{
"id": 2,
"entity": "大量左向右分流时可见哈里森沟",
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"end_offset": 34,
"label": "sym"
}
] |
由于脉压增大，婴儿可表现为周围血管搏动增强，而年长儿则表现为搏动减弱。 | [
{
"id": 0,
"entity": "脉压",
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{
"id": 1,
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{
"id": 2,
"entity": "搏动减弱",
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"label": "sym"
}
] |
少数未经治疗而存活的动脉导管粗大的患儿，由于肺血管阻力增加，将发生不可逆的肺血管病变。 | [
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"id": 0,
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{
"id": 1,
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{
"id": 2,
"entity": "肺血管病变",
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] |
其他先天性心脏病，如肺动脉闭锁、大动脉转位等伴发的动脉导管未闭可通过胸骨上矢状切面得到理想地显示。 | [
{
"id": 0,
"entity": "先天性心脏病",
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"label": "dis"
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{
"id": 1,
"entity": "肺动脉闭锁",
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"label": "dis"
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{
"id": 2,
"entity": "大动脉转位",
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{
"id": 3,
"entity": "动脉导管未闭",
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"label": "dis"
},
{
"id": 4,
"entity": "胸骨",
"start_offset": 34,
"end_offset": 36,
"label": "bod"
}
] |
对于生后体重低于1000g的早产儿在出生10天内静脉滴注吲哚美辛可有效关闭动脉导管。 | [
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"id": 0,
"entity": "静脉滴注",
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{
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{
"id": 2,
"entity": "动脉导管",
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"label": "bod"
}
] |
经治疗心功能不全不能纠正者，需手术结扎动脉导管。 | [
{
"id": 0,
"entity": "心功能不全",
"start_offset": 3,
"end_offset": 8,
"label": "dis"
},
{
"id": 1,
"entity": "手术结扎动脉导管",
"start_offset": 15,
"end_offset": 23,
"label": "pro"
}
] |
手术并发症并不多见，可有导管撕裂、膈神经麻痹、乳糜胸、误扎左肺动脉和降主动脉，故术后检查股动脉搏动十分必要。 | [
{
"id": 0,
"entity": "手术",
"start_offset": 0,
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"label": "pro"
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{
"id": 1,
"entity": "导管撕裂",
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"label": "dis"
},
{
"id": 2,
"entity": "膈神经麻痹",
"start_offset": 17,
"end_offset": 22,
"label": "dis"
},
{
"id": 3,
"entity": "乳糜胸",
"start_offset": 23,
"end_offset": 26,
"label": "dis"
},
{
"id": 4,
"entity": "误扎左肺动脉和降主动脉",
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"end_offset": 38,
"label": "dis"
},
{
"id": 5,
"entity": "术后检查股动脉搏动",
"start_offset": 40,
"end_offset": 49,
"label": "pro"
}
] |
胸腔镜手术已成功应用于儿童动脉导管的关闭。 | [
{
"id": 0,
"entity": "胸腔镜手术",
"start_offset": 0,
"end_offset": 5,
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{
"id": 1,
"entity": "儿童动脉导管",
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}
] |
常见促使发病的因素包括早产儿、新生儿、营养不良及久病虚弱，慢性消耗性疾病如恶性肿瘤，影响免疫功能的单核-吞噬细胞系统疾患及血液病，代谢性疾病及肾衰竭，长期使用肾上腺皮质激素及其他免疫抑制剂，先天性免疫功能缺陷，长期使用广谱抗生素等。 | [
{
"id": 0,
"entity": "恶性肿瘤",
"start_offset": 37,
"end_offset": 41,
"label": "dis"
},
{
"id": 1,
"entity": "单核-吞噬细胞系统疾患",
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"end_offset": 60,
"label": "dis"
},
{
"id": 2,
"entity": "血液病",
"start_offset": 61,
"end_offset": 64,
"label": "dis"
},
{
"id": 3,
"entity": "代谢性疾病",
"start_offset": 65,
"end_offset": 70,
"label": "dis"
},
{
"id": 4,
"entity": "肾衰竭",
"start_offset": 71,
"end_offset": 74,
"label": "dis"
},
{
"id": 5,
"entity": "肾上腺皮质激素",
"start_offset": 79,
"end_offset": 86,
"label": "dru"
},
{
"id": 6,
"entity": "免疫抑制剂",
"start_offset": 89,
"end_offset": 94,
"label": "dru"
},
{
"id": 7,
"entity": "先天性免疫功能缺陷",
"start_offset": 95,
"end_offset": 104,
"label": "dis"
},
{
"id": 8,
"entity": "广谱抗生素",
"start_offset": 109,
"end_offset": 114,
"label": "dru"
}
] |
真菌性肺炎的症状和体征无特异性，但可有以下特点：①持续高热不退；②明显烦躁不安；③咳痰无色透明、黏稠；④肺部可闻及粗细不等湿啰音，也可引起脓胸或肺实变体征；⑤同时伴有其他部位真菌感染的表现，如鹅口疮、大便呈豆渣样、肛周有白膜等；⑥病程迁延不愈，抗生素治疗无效，且病情日益加重。 | [
{
"id": 0,
"entity": "真菌性肺炎",
"start_offset": 0,
"end_offset": 5,
"label": "dis"
},
{
"id": 1,
"entity": "持续高热不退",
"start_offset": 25,
"end_offset": 31,
"label": "sym"
},
{
"id": 2,
"entity": "明显烦躁不安",
"start_offset": 33,
"end_offset": 39,
"label": "sym"
},
{
"id": 3,
"entity": "咳痰无色透明、黏稠",
"start_offset": 41,
"end_offset": 50,
"label": "sym"
},
{
"id": 4,
"entity": "肺部可闻及粗细不等湿啰音",
"start_offset": 52,
"end_offset": 64,
"label": "sym"
},
{
"id": 5,
"entity": "脓胸",
"start_offset": 69,
"end_offset": 71,
"label": "sym"
},
{
"id": 6,
"entity": "肺实变",
"start_offset": 72,
"end_offset": 75,
"label": "sym"
},
{
"id": 7,
"entity": "其他部位真菌感染",
"start_offset": 83,
"end_offset": 91,
"label": "sym"
},
{
"id": 8,
"entity": "鹅口疮",
"start_offset": 96,
"end_offset": 99,
"label": "sym"
},
{
"id": 9,
"entity": "大便呈豆渣样",
"start_offset": 100,
"end_offset": 106,
"label": "sym"
},
{
"id": 10,
"entity": "肛周有白膜",
"start_offset": 107,
"end_offset": 112,
"label": "sym"
},
{
"id": 11,
"entity": "病程迁延不愈",
"start_offset": 115,
"end_offset": 121,
"label": "sym"
},
{
"id": 12,
"entity": "抗生素治疗无效",
"start_offset": 122,
"end_offset": 129,
"label": "sym"
}
] |
治疗方法为停止使用抗生素及肾上腺皮质激素，酌情选择抗真菌药物治疗。 | [
{
"id": 0,
"entity": "抗生素",
"start_offset": 9,
"end_offset": 12,
"label": "dru"
},
{
"id": 1,
"entity": "肾上腺皮质激素",
"start_offset": 13,
"end_offset": 20,
"label": "dru"
},
{
"id": 2,
"entity": "抗真菌药物",
"start_offset": 25,
"end_offset": 30,
"label": "dru"
}
] |
两性霉素B对绝大多数真菌均有较强的抗菌活性，多年来广泛用于治疗各种真菌感染，具有较好的临床疗效。 | [
{
"id": 0,
"entity": "两性霉素B",
"start_offset": 0,
"end_offset": 5,
"label": "dru"
},
{
"id": 1,
"entity": "真菌",
"start_offset": 10,
"end_offset": 12,
"label": "mic"
},
{
"id": 2,
"entity": "真菌",
"start_offset": 33,
"end_offset": 35,
"label": "mic"
}
] |
但不良反应多，如发热、氮质血症、低钾血症、低镁血症、血栓性静脉炎等。 | [
{
"id": 0,
"entity": "发热",
"start_offset": 8,
"end_offset": 10,
"label": "sym"
},
{
"id": 1,
"entity": "氮质血症",
"start_offset": 11,
"end_offset": 15,
"label": "sym"
},
{
"id": 2,
"entity": "低钾血症",
"start_offset": 16,
"end_offset": 20,
"label": "sym"
},
{
"id": 3,
"entity": "低镁血症",
"start_offset": 21,
"end_offset": 25,
"label": "sym"
},
{
"id": 4,
"entity": "血栓性静脉炎",
"start_offset": 26,
"end_offset": 32,
"label": "sym"
}
] |
伏立康唑、卡泊芬净、伊曲康唑等对曲菌有良好的疗效。 | [
{
"id": 0,
"entity": "伏立康唑",
"start_offset": 0,
"end_offset": 4,
"label": "dru"
},
{
"id": 1,
"entity": "卡泊芬净",
"start_offset": 5,
"end_offset": 9,
"label": "dru"
},
{
"id": 2,
"entity": "伊曲康唑",
"start_offset": 10,
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"label": "dru"
},
{
"id": 3,
"entity": "曲菌",
"start_offset": 16,
"end_offset": 18,
"label": "mic"
}
] |
手术彻底切除肿瘤是唯一的治疗方法。 | [
{
"id": 0,
"entity": "手术",
"start_offset": 0,
"end_offset": 2,
"label": "pro"
},
{
"id": 1,
"entity": "肿瘤",
"start_offset": 6,
"end_offset": 8,
"label": "dis"
}
] |
该肿瘤对放疗无效，化疗很少能完全治疗，肿瘤多向肺转移，达80%左右，其次为淋巴结，也可能转移至肝、脾、胰、脑等部位，总之未能手术完全切除者，预后极差。 | [
{
"id": 0,
"entity": "肿瘤",
"start_offset": 1,
"end_offset": 3,
"label": "dis"
},
{
"id": 1,
"entity": "放疗",
"start_offset": 4,
"end_offset": 6,
"label": "pro"
},
{
"id": 2,
"entity": "化疗",
"start_offset": 9,
"end_offset": 11,
"label": "pro"
},
{
"id": 3,
"entity": "肿瘤",
"start_offset": 19,
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"label": "dis"
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{
"id": 4,
"entity": "肺",
"start_offset": 23,
"end_offset": 24,
"label": "bod"
},
{
"id": 5,
"entity": "淋巴结",
"start_offset": 37,
"end_offset": 40,
"label": "bod"
},
{
"id": 6,
"entity": "肝",
"start_offset": 47,
"end_offset": 48,
"label": "bod"
},
{
"id": 7,
"entity": "脾",
"start_offset": 49,
"end_offset": 50,
"label": "bod"
},
{
"id": 8,
"entity": "胰",
"start_offset": 51,
"end_offset": 52,
"label": "bod"
},
{
"id": 9,
"entity": "脑",
"start_offset": 53,
"end_offset": 54,
"label": "bod"
},
{
"id": 10,
"entity": "手术",
"start_offset": 62,
"end_offset": 64,
"label": "pro"
}
] |
病程第2周若无有效治疗，有10%～40%患儿在行B型超声或冠状动脉造影时见各种冠状动脉病变（动脉扩张，动脉瘤），冠状动脉扩张好发部位依次为左冠脉主干、左前降支及右冠状动脉近端（轻度扩张直径＞3mm而≤4mm、中度为瘤样扩张4～7mm、重度扩张为巨大冠脉瘤≥8mm）。 | [
{
"id": 0,
"entity": "B型超声",
"start_offset": 24,
"end_offset": 28,
"label": "pro"
},
{
"id": 1,
"entity": "冠状动脉造影",
"start_offset": 29,
"end_offset": 35,
"label": "pro"
},
{
"id": 2,
"entity": "冠状动脉",
"start_offset": 39,
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"label": "bod"
},
{
"id": 3,
"entity": "动脉扩张",
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"end_offset": 50,
"label": "dis"
},
{
"id": 4,
"entity": "动脉瘤",
"start_offset": 51,
"end_offset": 54,
"label": "dis"
},
{
"id": 5,
"entity": "冠状动脉扩张",
"start_offset": 56,
"end_offset": 62,
"label": "dis"
},
{
"id": 6,
"entity": "左冠脉主干",
"start_offset": 69,
"end_offset": 74,
"label": "bod"
},
{
"id": 7,
"entity": "左前降支",
"start_offset": 75,
"end_offset": 79,
"label": "bod"
},
{
"id": 8,
"entity": "右冠状动脉近端",
"start_offset": 80,
"end_offset": 87,
"label": "bod"
}
] |
其特征为呕吐、便秘，常有呼吸道感染，血钙特高，弱智，额突，斜视，眉嵴及下颌较突出，上唇短吊，有称此为William综合征者。 | [
{
"id": 0,
"entity": "呕吐、便秘",
"start_offset": 4,
"end_offset": 9,
"label": "sym"
},
{
"id": 1,
"entity": "呼吸道感染",
"start_offset": 12,
"end_offset": 17,
"label": "sym"
},
{
"id": 2,
"entity": "血钙特高",
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"label": "sym"
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{
"id": 3,
"entity": "弱智",
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"label": "sym"
},
{
"id": 4,
"entity": "额突",
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"label": "sym"
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{
"id": 5,
"entity": "斜视",
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"label": "sym"
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{
"id": 6,
"entity": "眉嵴",
"start_offset": 32,
"end_offset": 34,
"label": "bod"
},
{
"id": 7,
"entity": "下颌",
"start_offset": 35,
"end_offset": 37,
"label": "bod"
},
{
"id": 8,
"entity": "眉嵴及下颌较突出",
"start_offset": 32,
"end_offset": 40,
"label": "sym"
},
{
"id": 9,
"entity": "上唇",
"start_offset": 41,
"end_offset": 43,
"label": "bod"
},
{
"id": 10,
"entity": "上唇短吊",
"start_offset": 41,
"end_offset": 45,
"label": "sym"
},
{
"id": 11,
"entity": "William综合征",
"start_offset": 50,
"end_offset": 60,
"label": "dis"
}
] |
X线胸片无特征性表现。 | [
{
"id": 0,
"entity": "X线胸片",
"start_offset": 0,
"end_offset": 4,
"label": "pro"
}
] |
心电图可显示左心室肥厚，如狭窄严重则左胸导联可出现T波倒置。 | [
{
"id": 0,
"entity": "心电图",
"start_offset": 0,
"end_offset": 3,
"label": "pro"
},
{
"id": 1,
"entity": "左心室",
"start_offset": 6,
"end_offset": 9,
"label": "bod"
},
{
"id": 2,
"entity": "左心室肥厚",
"start_offset": 6,
"end_offset": 11,
"label": "sym"
},
{
"id": 3,
"entity": "左胸",
"start_offset": 18,
"end_offset": 20,
"label": "bod"
}
] |
心导管及心血管造影术可证实诊断及确定严重程度。 | [
{
"id": 0,
"entity": "心导管及心血管造影术",
"start_offset": 0,
"end_offset": 10,
"label": "pro"
}
] |
一般认为跨狭窄段压差＞50mmHg有手术指征。 | [
{
"id": 0,
"entity": "手术",
"start_offset": 18,
"end_offset": 20,
"label": "pro"
}
] |
呼吸性碱中毒临床主要出现原发疾病所致的相应症状及体征。 | [
{
"id": 0,
"entity": "呼吸性碱中毒",
"start_offset": 0,
"end_offset": 6,
"label": "dis"
}
] |
同时可伴呕吐、胸痛、吞咽困难、消化道出血及肠梗阻症状。 | [
{
"id": 0,
"entity": "呕吐",
"start_offset": 4,
"end_offset": 6,
"label": "sym"
},
{
"id": 1,
"entity": "胸痛",
"start_offset": 7,
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"label": "sym"
},
{
"id": 2,
"entity": "吞咽困难",
"start_offset": 10,
"end_offset": 14,
"label": "sym"
},
{
"id": 3,
"entity": "消化道出血",
"start_offset": 15,
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"label": "sym"
},
{
"id": 4,
"entity": "肠梗阻症状",
"start_offset": 21,
"end_offset": 26,
"label": "sym"
}
] |
新生儿期出现呼吸困难及阵发性发绀时，应考虑到本病可能。 | [
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"id": 0,
"entity": "呼吸困难",
"start_offset": 6,
"end_offset": 10,
"label": "sym"
},
{
"id": 1,
"entity": "阵发性发绀",
"start_offset": 11,
"end_offset": 16,
"label": "sym"
}
] |
X线检查是确诊先天性膈疝的依据。 | [
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"id": 0,
"entity": "X线检查",
"start_offset": 0,
"end_offset": 4,
"label": "ite"
},
{
"id": 1,
"entity": "先天性膈疝",
"start_offset": 7,
"end_offset": 12,
"label": "dis"
}
] |
有文献报道对危重症患儿，术前先采取体外膜肺（ECMO）、允许性高碳酸血症、NO吸入、表面活性物质等控制持续肺动脉高压，改善氧合，病情稳定后再手术可改善预后。 | [
{
"id": 0,
"entity": "体外膜肺（ECMO）",
"start_offset": 17,
"end_offset": 27,
"label": "pro"
},
{
"id": 1,
"entity": "允许性高碳酸血症",
"start_offset": 28,
"end_offset": 36,
"label": "pro"
},
{
"id": 2,
"entity": "NO吸入",
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"end_offset": 41,
"label": "pro"
},
{
"id": 3,
"entity": "表面活性物质",
"start_offset": 42,
"end_offset": 48,
"label": "pro"
},
{
"id": 4,
"entity": "肺动脉高压",
"start_offset": 53,
"end_offset": 58,
"label": "dis"
}
] |
有人甚至用水汽雾化的方法，提高暖箱内的湿度达到100%。 | [
{
"id": 0,
"entity": "水汽雾化",
"start_offset": 5,
"end_offset": 9,
"label": "pro"
},
{
"id": 1,
"entity": "暖箱",
"start_offset": 15,
"end_offset": 17,
"label": "equ"
}
] |
密切观察有无呼吸暂停的发作，对已经出现呼吸暂停的新生儿可以使用咖啡因或氨茶碱进行治疗，应以前者为主。 | [
{
"id": 0,
"entity": "呼吸暂停",
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"end_offset": 10,
"label": "sym"
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{
"id": 1,
"entity": "呼吸暂停",
"start_offset": 19,
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{
"id": 2,
"entity": "咖啡因",
"start_offset": 31,
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"label": "dru"
},
{
"id": 3,
"entity": "氨茶碱",
"start_offset": 35,
"end_offset": 38,
"label": "dru"
}
] |
对于因PDA引起的充血性心力衰竭，可以使用洋地黄类药物治疗，但要注意对其血浓度的监测。 | [
{
"id": 0,
"entity": "PDA",
"start_offset": 3,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "充血性心力衰竭",
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"end_offset": 16,
"label": "sym"
},
{
"id": 2,
"entity": "洋地黄类药物",
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},
{
"id": 3,
"entity": "血浓度",
"start_offset": 36,
"end_offset": 39,
"label": "ite"
}
] |
病变发生于直接受损部位，多见于舌的侧缘，也可发生于唇、颊及他处黏膜，可表现为红肿、出血或溃疡，伴有局部疼痛，如继发感染，则可引起局部淋巴结肿大。 | [
{
"id": 0,
"entity": "舌",
"start_offset": 15,
"end_offset": 16,
"label": "bod"
},
{
"id": 1,
"entity": "唇",
"start_offset": 25,
"end_offset": 26,
"label": "bod"
},
{
"id": 2,
"entity": "颊",
"start_offset": 27,
"end_offset": 28,
"label": "bod"
},
{
"id": 3,
"entity": "黏膜",
"start_offset": 31,
"end_offset": 33,
"label": "bod"
},
{
"id": 4,
"entity": "红肿",
"start_offset": 38,
"end_offset": 40,
"label": "sym"
},
{
"id": 5,
"entity": "出血",
"start_offset": 41,
"end_offset": 43,
"label": "sym"
},
{
"id": 6,
"entity": "溃疡",
"start_offset": 44,
"end_offset": 46,
"label": "sym"
},
{
"id": 7,
"entity": "伴有局部疼痛",
"start_offset": 47,
"end_offset": 53,
"label": "sym"
},
{
"id": 8,
"entity": "如继发感染",
"start_offset": 54,
"end_offset": 59,
"label": "sym"
},
{
"id": 9,
"entity": "局部淋巴结肿大",
"start_offset": 64,
"end_offset": 71,
"label": "dis"
}
] |
患儿血小板数量少，形态小并有致密颗粒减少，临床上多在婴幼儿期发病，出血重，多死于反复感染和出血。 | [
{
"id": 0,
"entity": "血小板",
"start_offset": 2,
"end_offset": 5,
"label": "bod"
},
{
"id": 1,
"entity": "出血",
"start_offset": 33,
"end_offset": 35,
"label": "sym"
},
{
"id": 2,
"entity": "感染",
"start_offset": 42,
"end_offset": 44,
"label": "sym"
},
{
"id": 3,
"entity": "出血",
"start_offset": 45,
"end_offset": 47,
"label": "sym"
}
] |
此外还可出现体重下降或生长发育不良。 | [
{
"id": 0,
"entity": "体重下降",
"start_offset": 6,
"end_offset": 10,
"label": "sym"
},
{
"id": 1,
"entity": "生长发育不良",
"start_offset": 11,
"end_offset": 17,
"label": "sym"
}
] |
在明确为其他疾病前，1岁以内患儿发生胆汁性呕吐应首先考虑肠旋转不良。 | [
{
"id": 0,
"entity": "胆汁性呕吐",
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"end_offset": 23,
"label": "sym"
},
{
"id": 1,
"entity": "肠旋转不良",
"start_offset": 28,
"end_offset": 33,
"label": "dis"
}
] |
中肠扭转目前无法预测何时或在何种情况下会发生，故对胆汁性呕吐患儿，必须积极诊治，绝不允许只作观察而任其发展至绞窄性肠梗阻。 | [
{
"id": 0,
"entity": "中肠扭转",
"start_offset": 0,
"end_offset": 4,
"label": "sym"
},
{
"id": 1,
"entity": "胆汁性呕吐",
"start_offset": 25,
"end_offset": 30,
"label": "sym"
},
{
"id": 2,
"entity": "绞窄性肠梗阻",
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"end_offset": 60,
"label": "dis"
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] |
除了胆汁性呕吐，患儿可有腹胀、脱水和激惹等；绞窄性肠梗阻患儿则有意识淡漠及感染性休克表现；其他临床表现包括腹壁潮红、腹膜炎、酸中毒、血小板减少、白细胞增多或减少，以及由肠黏液局部缺血所至肠道出血和（或）黑便。 | [
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"id": 0,
"entity": "胆汁性呕吐",
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},
{
"id": 1,
"entity": "腹胀",
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"label": "sym"
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{
"id": 2,
"entity": "脱水",
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"label": "sym"
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{
"id": 3,
"entity": "激惹",
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"label": "sym"
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{
"id": 4,
"entity": "绞窄性肠梗阻",
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},
{
"id": 5,
"entity": "意识淡漠",
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{
"id": 6,
"entity": "感染性休克",
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"label": "sym"
},
{
"id": 7,
"entity": "腹壁潮红",
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"label": "sym"
},
{
"id": 8,
"entity": "腹膜炎",
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"label": "sym"
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{
"id": 9,
"entity": "酸中毒",
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"label": "sym"
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{
"id": 10,
"entity": "血小板减少",
"start_offset": 66,
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"label": "sym"
},
{
"id": 11,
"entity": "白细胞增多或减少",
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"end_offset": 80,
"label": "sym"
},
{
"id": 12,
"entity": "肠黏液局部缺血",
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"label": "sym"
},
{
"id": 13,
"entity": "肠道出血",
"start_offset": 93,
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"label": "sym"
},
{
"id": 14,
"entity": "黑便",
"start_offset": 101,
"end_offset": 103,
"label": "sym"
}
] |
中肠扭转影像学表现有：①胃出口梗阻，可见扩张的胃泡，远端气体减少；②典型的双泡征提示十二指肠梗阻。 | [
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{
"id": 1,
"entity": "胃出口梗阻",
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{
"id": 2,
"entity": "可见扩张的胃泡",
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"label": "sym"
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{
"id": 3,
"entity": "远端气体减少",
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{
"id": 4,
"entity": "十二指肠梗阻",
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] |
中肠扭转最典型表现是十二指肠第2、3段出现“鸟嘴样”改变；十二指肠部分梗阻则可呈“螺旋样”改变。 | [
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{
"id": 1,
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] |
正常情况下，肠系膜上静脉（SMV）位于SMA右侧，若位于SMA前方或左侧，提示可能存在肠旋转不良。 | [
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{
"id": 1,
"entity": "SMV",
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{
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"entity": "SMA",
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{
"id": 3,
"entity": "SMA",
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},
{
"id": 4,
"entity": "肠旋转不良",
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"label": "dis"
}
] |
肠旋转不良松解术后，常见胃肠道蠕动功能紊乱；而假性神经性肠梗阻提示小肠存在内在神经支配缺陷可能。 | [
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"id": 0,
"entity": "肠旋转不良",
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{
"id": 1,
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"label": "dis"
},
{
"id": 2,
"entity": "小肠",
"start_offset": 33,
"end_offset": 35,
"label": "bod"
}
] |
其他术后并发症包括：绞窄性肠梗阻、迟发性肠梗阻及手术相关出血，另外肠扭转复位可致小肠再灌注损伤。 | [
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"id": 0,
"entity": "肠梗阻",
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"label": "dis"
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{
"id": 1,
"entity": "迟发性肠梗阻",
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"label": "dis"
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{
"id": 2,
"entity": "肠扭转",
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"label": "dis"
},
{
"id": 3,
"entity": "小肠",
"start_offset": 40,
"end_offset": 42,
"label": "bod"
}
] |
天然变应性原制剂疗法有几十年的历史，是IgE介导的过敏疾患的唯一对因疗法。 | [
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"entity": "天然变应性原制剂疗法",
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"label": "pro"
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{
"id": 1,
"entity": "IgE",
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] |
但具体开始治疗年龄还要考虑治疗的安全性，目前多在5岁以后才开始考虑进行变应原特异性免疫治疗，治疗之前应进行特异性变应原诊断试验，以明确机体对什么过敏，以及过敏的强度，特异性诊断试验包括皮肤试验、变应原支气管激发试验、血清变应原特异性IgE测定等方法。 | [
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"entity": "变应原特异性免疫治疗",
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{
"id": 1,
"entity": "特异性诊断试验",
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"label": "pro"
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{
"id": 2,
"entity": "皮肤试验",
"start_offset": 92,
"end_offset": 96,
"label": "pro"
},
{
"id": 3,
"entity": "变应原支气管激发试验",
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"label": "pro"
},
{
"id": 4,
"entity": "血清变应原特异性IgE测定",
"start_offset": 108,
"end_offset": 121,
"label": "pro"
}
] |
一般而言，免疫反应是一种生理性保护反应，一旦这种适度、有益的保护性反应失衡，即可导致异常免疫反应，产生变态反应性疾病、自身免疫性疾病、免疫缺陷病及肿瘤。 | [
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"id": 0,
"entity": "变态反应性疾病",
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},
{
"id": 1,
"entity": "自身免疫性疾病",
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"label": "dis"
},
{
"id": 2,
"entity": "免疫缺陷病",
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"label": "dis"
},
{
"id": 3,
"entity": "肿瘤",
"start_offset": 73,
"end_offset": 75,
"label": "dis"
}
] |
在47，XYY及48，XXYY核型，具有两个Y染色体患者高体型表现更为明显。 | [
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"id": 0,
"entity": "XYY",
"start_offset": 4,
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},
{
"id": 1,
"entity": "XXYY",
"start_offset": 11,
"end_offset": 15,
"label": "bod"
},
{
"id": 2,
"entity": "Y染色体",
"start_offset": 22,
"end_offset": 26,
"label": "bod"
}
] |
我国近年来已开展了儿童言语和语言障碍的临床诊治。 | [
{
"id": 0,
"entity": "言语和语言障碍",
"start_offset": 11,
"end_offset": 18,
"label": "dis"
}
] |
大脑的损伤或肿瘤使儿童产生获得性失语症，即在儿童发展了说话成句的语言能力后，因为大脑的病灶致使语言损害。 | [
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"id": 0,
"entity": "大脑的损伤或肿瘤",
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{
"id": 1,
"entity": "获得性失语症",
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"label": "dis"
},
{
"id": 2,
"entity": "大脑",
"start_offset": 40,
"end_offset": 42,
"label": "bod"
}
] |
临床上出现不同类型的失语症，例如，儿童听觉理解障碍但言语流利的，称为感觉性失语症；对目标物不能命名的称为命名性失语症；难以找到适当词语表达的称为表达性失语症；言语不流利且费力的称为运动性失语症。 | [
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"id": 0,
"entity": "失语症",
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{
"id": 1,
"entity": "感觉性失语症",
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"label": "dis"
},
{
"id": 2,
"entity": "命名性失语症",
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"label": "dis"
},
{
"id": 3,
"entity": "表达性失语症",
"start_offset": 72,
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"label": "dis"
},
{
"id": 4,
"entity": "运动性失语症",
"start_offset": 90,
"end_offset": 96,
"label": "dis"
}
] |
例如选择性缄默症是一种较少的语言障碍，通常在5岁前发病，患儿在某些特定的情境中如学校等不说话。 | [
{
"id": 0,
"entity": "选择性缄默症",
"start_offset": 2,
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"label": "dis"
}
] |