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常发生致死性单核细胞增多症、继发性低或无免疫球蛋白血症、恶性多克隆源性淋巴瘤、再生障碍性贫血、慢性淋巴细胞性间质性肺炎等。 | [
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"id": 1,
"entity": "继发性低或无免疫球蛋白血症",
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"id": 2,
"entity": "恶性多克隆源性淋巴瘤",
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"label": "dis"
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"id": 3,
"entity": "再生障碍性贫血",
"start_offset": 39,
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"label": "dis"
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{
"id": 4,
"entity": "慢性淋巴细胞性间质性肺炎",
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还可用免疫标记技术检测样本中病毒抗原，如EBNA、潜伏膜抗原（LYDMA成分之一）。 | [
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{
"id": 2,
"entity": "EBNA",
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遇有发热、扁桃体炎、咽峡炎和颈淋巴结肿大时应与链球菌性扁桃体炎和咽炎相鉴别，后者血象中性粒细胞增多，咽拭培养可检出细菌，青霉素治疗有效。 | [
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"entity": "颈淋巴结",
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"entity": "颈淋巴结肿大",
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"entity": "链球菌性扁桃体炎",
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"entity": "咽炎",
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"entity": "中性粒细胞",
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"entity": "血象中性粒细胞增多",
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"id": 9,
"entity": "青霉素",
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如表现为传单（80%～95%由EBV所致），应与HCMV、弓形虫、腺病毒、风疹病毒和HAV等其他病原所致传单样综合征相鉴别，后者嗜异性抗体阴性，主要靠病原学检查区别。 | [
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"entity": "弓形虫",
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"entity": "腺病毒",
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"label": "mic"
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"entity": "风疹病毒",
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"entity": "HAV",
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"entity": "传单样综合征",
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脾大者恢复期应避免明显身体活动或运动，以防脾破裂；脾破裂时应紧急处理。 | [
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"entity": "脾破裂",
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因深部上呼吸道炎症致完全呼吸道梗阻时宜行气管插管。 | [
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"entity": "气管插管",
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初步研究显示，对严重EBV诱导的淋巴增生性疾病使用抗B细胞单抗和照射过的移植供体白细胞，同时减少免疫抑制剂用量有一定疗效。 | [
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"id": 1,
"entity": "淋巴增生性疾病",
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尤其当胃肠道功能不成熟或者因疾病或手术前后不能耐受正常喂养时，往往营养素的需求是得不到满足的，可迅速发展为蛋白质-热能营养不良。 | [
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此时，可通过肠道内管饲或经肠外营养输注进行营养干预。 | [
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肿瘤好发于下肢，膝关节最多见，其他依次为足、踝、髋；上肢主要发生于腕、肩、肘和手的关节。 | [
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"entity": "肘和手的关节",
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头颈部肿瘤可能引起吞咽或呼吸困难。 | [
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一般主张切除肿瘤，还要切除肿瘤附近的肌群或做截肢，区域淋巴结清扫。 | [
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患儿一般出生体重较低，胎盘常常很小，多为单侧脐动脉。 | [
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降低这类患儿的出生是优生优育的关键，取羊水细胞进行染色体检查是常用的产前诊断方法，核型分析类同外周血淋巴细胞染色体检查。 | [
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对于染色体易位型患儿，则需检查其父母的染色体，以确定他们之一是否是平衡易位的携带者。 | [
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外周血白细胞计数常明显升高，伴核左移。 | [
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确诊必须依靠特殊的化验检查，如应用特殊培养基从呼吸道标本或血、胸水中分离出病菌；应用免疫荧光或免疫酶法测定上述标本中的军团菌抗原或血清标本中的特异抗体。 | [
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"entity": "胸水",
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"entity": "免疫荧光",
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"entity": "免疫酶法",
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"entity": "军团菌抗原",
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"entity": "血清标本",
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首选大环内酯类，如红霉素及阿奇霉素、克拉霉素、罗红霉素等，疗程为2～3周。 | [
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可加用利福平。 | [
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喹诺酮类和氨基糖苷类虽有较好的抗菌活性，但儿童期尤其是年幼儿童禁用。 | [
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在病毒感染的基础上，易继发细菌感染，常见的致病菌为肺炎链球菌、流感嗜血杆菌等。 | [
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"entity": "流感嗜血杆菌",
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多数患儿先有上呼吸道感染症状，3～4天后逐渐出现明显的咳嗽。 | [
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重者可有发热、头痛、乏力、胸骨后不适或胸前疼痛、腹痛、呕吐、腹泻等消化道症状。 | [
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"entity": "消化道",
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开始为干咳，数天后咳嗽有痰，呈白色黏液痰或黄色脓痰，一般持续7～10天。 | [
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如不及时治疗，可向下蔓延导致肺炎。 | [
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胸部听诊可闻不固定干啰音及大、中水泡音，咳嗽或体位变化后可减少或消失。 | [
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以化痰治疗为主。 | [
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感染、生理和心理因素已被鉴定为CVS的触发因素。 | [
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CRF的清晨峰值也可解释CVS多于清晨发作的原因。 | [
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CVS发病时许多症状如苍白、发热、嗜睡、恶心、呕吐及过量流涎等都为自主神经功能紊乱症状。 | [
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"label": "sym"
},
{
"id": 3,
"entity": "恶心",
"start_offset": 20,
"end_offset": 22,
"label": "sym"
},
{
"id": 4,
"entity": "呕吐",
"start_offset": 23,
"end_offset": 25,
"label": "sym"
},
{
"id": 5,
"entity": "过量流涎",
"start_offset": 26,
"end_offset": 30,
"label": "sym"
},
{
"id": 6,
"entity": "自主神经功能紊乱",
"start_offset": 33,
"end_offset": 41,
"label": "dis"
}
] |
临床以会阴及肛门附近瘙痒为特征。 | [
{
"id": 0,
"entity": "会阴",
"start_offset": 3,
"end_offset": 5,
"label": "bod"
},
{
"id": 1,
"entity": "肛门",
"start_offset": 6,
"end_offset": 8,
"label": "bod"
},
{
"id": 2,
"entity": "会阴及肛门附近瘙痒",
"start_offset": 3,
"end_offset": 12,
"label": "sym"
}
] |
雌虫有时亦可侵入阴道、输卵管及腹腔而引起阴道炎、盆腔腹膜炎，侵入尿道可引起尿道炎，侵入阑尾引起阑尾炎。 | [
{
"id": 0,
"entity": "雌虫",
"start_offset": 0,
"end_offset": 2,
"label": "mic"
},
{
"id": 1,
"entity": "阴道",
"start_offset": 8,
"end_offset": 10,
"label": "bod"
},
{
"id": 2,
"entity": "输卵管",
"start_offset": 11,
"end_offset": 14,
"label": "bod"
},
{
"id": 3,
"entity": "腹腔",
"start_offset": 15,
"end_offset": 17,
"label": "bod"
},
{
"id": 4,
"entity": "阴道炎",
"start_offset": 20,
"end_offset": 23,
"label": "dis"
},
{
"id": 5,
"entity": "盆腔腹膜炎",
"start_offset": 24,
"end_offset": 29,
"label": "dis"
},
{
"id": 6,
"entity": "尿道",
"start_offset": 32,
"end_offset": 34,
"label": "bod"
},
{
"id": 7,
"entity": "尿道炎",
"start_offset": 37,
"end_offset": 40,
"label": "dis"
},
{
"id": 8,
"entity": "阑尾",
"start_offset": 43,
"end_offset": 45,
"label": "bod"
},
{
"id": 9,
"entity": "阑尾炎",
"start_offset": 47,
"end_offset": 50,
"label": "dis"
}
] |
有时可见恶心、呕吐、腹泻、腹痛、食欲缺乏等症状。 | [
{
"id": 0,
"entity": "恶心",
"start_offset": 4,
"end_offset": 6,
"label": "sym"
},
{
"id": 1,
"entity": "呕吐",
"start_offset": 7,
"end_offset": 9,
"label": "sym"
},
{
"id": 2,
"entity": "腹泻",
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"end_offset": 12,
"label": "sym"
},
{
"id": 3,
"entity": "腹痛",
"start_offset": 13,
"end_offset": 15,
"label": "sym"
},
{
"id": 4,
"entity": "食欲缺乏",
"start_offset": 16,
"end_offset": 20,
"label": "sym"
}
] |
可有不安、夜惊、精神易激动及其他神经症状。 | [
{
"id": 0,
"entity": "不安",
"start_offset": 2,
"end_offset": 4,
"label": "sym"
},
{
"id": 1,
"entity": "夜惊",
"start_offset": 5,
"end_offset": 7,
"label": "sym"
},
{
"id": 2,
"entity": "精神易激动",
"start_offset": 8,
"end_offset": 13,
"label": "sym"
}
] |
亦有鼻蛲虫的报道，主要表现为鼻部瘙痒、鼻出血、鼻塞、流涕，查体可见鼻前庭皮肤增厚、慢性出血、鼻中隔黏膜糜烂、溃疡、渗血。 | [
{
"id": 0,
"entity": "鼻蛲虫",
"start_offset": 2,
"end_offset": 5,
"label": "mic"
},
{
"id": 1,
"entity": "鼻部",
"start_offset": 14,
"end_offset": 16,
"label": "bod"
},
{
"id": 2,
"entity": "鼻部瘙痒",
"start_offset": 14,
"end_offset": 18,
"label": "sym"
},
{
"id": 3,
"entity": "鼻",
"start_offset": 19,
"end_offset": 20,
"label": "bod"
},
{
"id": 4,
"entity": "鼻出血",
"start_offset": 19,
"end_offset": 22,
"label": "sym"
},
{
"id": 5,
"entity": "鼻塞",
"start_offset": 23,
"end_offset": 25,
"label": "sym"
},
{
"id": 6,
"entity": "流涕",
"start_offset": 26,
"end_offset": 28,
"label": "sym"
},
{
"id": 7,
"entity": "查体",
"start_offset": 29,
"end_offset": 31,
"label": "ite"
},
{
"id": 8,
"entity": "鼻前庭皮肤增厚",
"start_offset": 33,
"end_offset": 40,
"label": "sym"
},
{
"id": 9,
"entity": "慢性出血",
"start_offset": 41,
"end_offset": 45,
"label": "sym"
},
{
"id": 10,
"entity": "鼻中隔黏膜",
"start_offset": 46,
"end_offset": 51,
"label": "bod"
},
{
"id": 11,
"entity": "鼻中隔黏膜糜烂、溃疡、渗血",
"start_offset": 46,
"end_offset": 59,
"label": "sym"
}
] |
近年来被明确归入功能性胃肠道疾病，目前公认的定义为3次或反复多次的发作性顽固的恶心和呕吐，每次发作持续数小时至数日，2次发作间期有长达数周至数日的完全无症状间隙期。 | [
{
"id": 0,
"entity": "功能性胃肠道疾病",
"start_offset": 8,
"end_offset": 16,
"label": "dis"
},
{
"id": 1,
"entity": "3次或反复多次的发作性顽固的恶心和呕吐，每次发作持续数小时至数日，2次发作间期有长达数周至数日的完全无症状间隙期",
"start_offset": 25,
"end_offset": 81,
"label": "sym"
}
] |
双侧肺发育不全或不发育常无法存活，生后迅速出现严重呼吸困难和呼吸衰竭。 | [
{
"id": 0,
"entity": "双侧肺发育不全或不发育",
"start_offset": 0,
"end_offset": 11,
"label": "dis"
},
{
"id": 1,
"entity": "无法存活",
"start_offset": 12,
"end_offset": 16,
"label": "sym"
},
{
"id": 2,
"entity": "迅速出现严重呼吸困难和呼吸衰竭",
"start_offset": 19,
"end_offset": 34,
"label": "sym"
}
] |
单侧肺发育不全或不发育以左侧多见，特异症状少，仅1/3患儿生前得到诊断；部分于新生儿期出现肺活量不足表现，常伴有持续肺动脉高压。 | [
{
"id": 0,
"entity": "单侧肺发育不全或不发育",
"start_offset": 0,
"end_offset": 11,
"label": "dis"
},
{
"id": 1,
"entity": "肺活量不足",
"start_offset": 45,
"end_offset": 50,
"label": "sym"
},
{
"id": 2,
"entity": "持续肺动脉高压",
"start_offset": 56,
"end_offset": 63,
"label": "sym"
}
] |
体格检查显示患侧肺部叩诊浊音，呼吸音减低，尤以腋下及肺底部为明显，气管和心脏向患侧移位。 | [
{
"id": 0,
"entity": "体格检查",
"start_offset": 0,
"end_offset": 4,
"label": "ite"
},
{
"id": 1,
"entity": "患侧肺部叩诊浊音",
"start_offset": 6,
"end_offset": 14,
"label": "sym"
},
{
"id": 2,
"entity": "呼吸音减低",
"start_offset": 15,
"end_offset": 20,
"label": "sym"
}
] |
支气管镜及支气管造影检查可确定诊断。 | [
{
"id": 0,
"entity": "支气管镜",
"start_offset": 0,
"end_offset": 4,
"label": "ite"
},
{
"id": 1,
"entity": "支气管造影检查",
"start_offset": 5,
"end_offset": 12,
"label": "ite"
}
] |
CT和MRI可准确反映气道整体情况和血管解剖畸形。 | [
{
"id": 0,
"entity": "CT",
"start_offset": 0,
"end_offset": 2,
"label": "ite"
},
{
"id": 1,
"entity": "MRI",
"start_offset": 3,
"end_offset": 6,
"label": "ite"
},
{
"id": 2,
"entity": "气道",
"start_offset": 11,
"end_offset": 13,
"label": "bod"
},
{
"id": 3,
"entity": "血管",
"start_offset": 18,
"end_offset": 20,
"label": "bod"
}
] |
可出现过度兴奋、喊叫乃至全身惊厥等神经系统表现。 | [
{
"id": 0,
"entity": "过度兴奋",
"start_offset": 3,
"end_offset": 7,
"label": "sym"
},
{
"id": 1,
"entity": "喊叫",
"start_offset": 8,
"end_offset": 10,
"label": "sym"
},
{
"id": 2,
"entity": "全身惊厥",
"start_offset": 12,
"end_offset": 16,
"label": "sym"
},
{
"id": 3,
"entity": "神经系统",
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"end_offset": 21,
"label": "bod"
},
{
"id": 4,
"entity": "神经系统表现",
"start_offset": 17,
"end_offset": 23,
"label": "sym"
}
] |
可先后出现肾小管性蛋白尿，全氨基酸尤以赖氨酸和酸氨酸明显，还可出现高磷尿症而致血磷降低，引起抗维生素D性佝偻病或骨质疏松，肾小管性酸中毒也较常见，而糖尿往往不明显，多无低血钾以及多尿，即使有也表现轻微。 | [
{
"id": 0,
"entity": "肾小管性蛋白尿",
"start_offset": 5,
"end_offset": 12,
"label": "sym"
},
{
"id": 1,
"entity": "全氨基酸",
"start_offset": 13,
"end_offset": 17,
"label": "bod"
},
{
"id": 2,
"entity": "赖氨酸",
"start_offset": 19,
"end_offset": 22,
"label": "bod"
},
{
"id": 3,
"entity": "酸氨酸",
"start_offset": 23,
"end_offset": 26,
"label": "bod"
},
{
"id": 4,
"entity": "高磷尿症",
"start_offset": 33,
"end_offset": 37,
"label": "dis"
},
{
"id": 5,
"entity": "血磷降低",
"start_offset": 39,
"end_offset": 43,
"label": "sym"
},
{
"id": 6,
"entity": "抗维生素D性佝偻病",
"start_offset": 46,
"end_offset": 55,
"label": "dis"
},
{
"id": 7,
"entity": "骨质疏松",
"start_offset": 56,
"end_offset": 60,
"label": "dis"
},
{
"id": 8,
"entity": "肾小管性酸中毒",
"start_offset": 61,
"end_offset": 68,
"label": "dis"
},
{
"id": 9,
"entity": "糖尿",
"start_offset": 74,
"end_offset": 76,
"label": "sym"
},
{
"id": 10,
"entity": "无低血钾以及多尿",
"start_offset": 83,
"end_offset": 91,
"label": "sym"
}
] |
有高钙尿症者还需口服氢氯噻嗪，降低尿钙，以免形成肾脏钙化及肾结石。 | [
{
"id": 0,
"entity": "高钙尿症",
"start_offset": 1,
"end_offset": 5,
"label": "dis"
},
{
"id": 1,
"entity": "氢氯噻嗪",
"start_offset": 10,
"end_offset": 14,
"label": "dru"
},
{
"id": 2,
"entity": "降低尿钙",
"start_offset": 15,
"end_offset": 19,
"label": "sym"
},
{
"id": 3,
"entity": "肾脏钙化",
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"end_offset": 28,
"label": "dis"
},
{
"id": 4,
"entity": "肾结石",
"start_offset": 29,
"end_offset": 32,
"label": "dis"
}
] |
幽门螺杆菌是慢性活动性胃炎的主要致病因素，是消化性溃疡发病的重要因素。 | [
{
"id": 0,
"entity": "幽门螺杆菌",
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"end_offset": 5,
"label": "mic"
},
{
"id": 1,
"entity": "慢性活动性胃炎",
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"label": "dis"
},
{
"id": 2,
"entity": "消化性溃疡",
"start_offset": 22,
"end_offset": 27,
"label": "dis"
}
] |
幽门螺杆菌的长期感染也与胃腺癌和胃黏膜相关淋巴组织（MALT）淋巴瘤的发生相关。 | [
{
"id": 0,
"entity": "幽门螺杆菌",
"start_offset": 0,
"end_offset": 5,
"label": "mic"
},
{
"id": 1,
"entity": "胃腺癌",
"start_offset": 12,
"end_offset": 15,
"label": "dis"
},
{
"id": 2,
"entity": "胃黏膜相关淋巴组织（MALT）淋巴瘤",
"start_offset": 16,
"end_offset": 34,
"label": "dis"
}
] |
临床研究发现，根除幽门螺杆菌可明显降低消化性溃疡病的复发率，还可使胃MALT淋巴瘤病程发生逆转，甚至消失；并可改善一部分慢性胃炎患者的顽固性消化不良症状。 | [
{
"id": 0,
"entity": "幽门螺杆菌",
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"end_offset": 14,
"label": "mic"
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{
"id": 1,
"entity": "消化性溃疡病",
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"end_offset": 25,
"label": "dis"
},
{
"id": 2,
"entity": "胃MALT淋巴瘤",
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"end_offset": 41,
"label": "dis"
},
{
"id": 3,
"entity": "慢性胃炎",
"start_offset": 60,
"end_offset": 64,
"label": "dis"
},
{
"id": 4,
"entity": "顽固性消化不良",
"start_offset": 67,
"end_offset": 74,
"label": "dis"
}
] |
在西方发达国家地区儿童与青少年中一般很少有幽门螺杆菌定植，与此相反的是在发展中国家幽门螺杆菌感染率较高，10岁即有一半感染幽门螺杆菌。 | [
{
"id": 0,
"entity": "幽门螺杆菌",
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"label": "mic"
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{
"id": 1,
"entity": "幽门螺杆菌",
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"label": "mic"
},
{
"id": 2,
"entity": "幽门螺杆菌",
"start_offset": 61,
"end_offset": 66,
"label": "mic"
}
] |
此外最近报道在人的一生中儿童期较成人期容易获得幽门螺杆菌感染，出生较早的较出生迟的个体具有更容易获得幽门螺杆菌感染的危险。 | [
{
"id": 0,
"entity": "幽门螺杆菌感染",
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"end_offset": 30,
"label": "dis"
},
{
"id": 1,
"entity": "幽门螺杆菌感染",
"start_offset": 50,
"end_offset": 57,
"label": "dis"
}
] |
但幽门螺杆菌是怎样从人到人之间的传播尚不清楚，目前较多的依据是支持口-口与粪-口途径传播。 | [
{
"id": 0,
"entity": "幽门螺杆菌",
"start_offset": 1,
"end_offset": 6,
"label": "mic"
},
{
"id": 1,
"entity": "口-口",
"start_offset": 33,
"end_offset": 36,
"label": "bod"
},
{
"id": 2,
"entity": "粪-口",
"start_offset": 37,
"end_offset": 40,
"label": "bod"
}
] |
有人提出母亲喂小孩饭前的咀嚼食物或吃饭时共用一个饭碗可能是发展中国家幽门螺杆菌感染的传播机制。 | [
{
"id": 0,
"entity": "幽门螺杆菌感染",
"start_offset": 34,
"end_offset": 41,
"label": "dis"
}
] |
有不少文献提示，儿童幽门螺杆菌可以导致铁的缺乏，若在补充铁剂同时给予根除幽门螺杆菌治疗甚至是单独采用根除方案，病情即可恢复。 | [
{
"id": 0,
"entity": "幽门螺杆菌",
"start_offset": 10,
"end_offset": 15,
"label": "mic"
},
{
"id": 1,
"entity": "铁剂",
"start_offset": 28,
"end_offset": 30,
"label": "dru"
},
{
"id": 2,
"entity": "幽门螺杆菌",
"start_offset": 36,
"end_offset": 41,
"label": "mic"
}
] |
欧洲幽门螺杆菌研究小组宣布的MaastrichtⅢ共识提出，对所有缺铁性贫血患者在检查完其他原因外应行幽门螺杆菌检测和根除治疗。 | [
{
"id": 0,
"entity": "幽门螺杆菌",
"start_offset": 2,
"end_offset": 7,
"label": "mic"
},
{
"id": 1,
"entity": "缺铁性贫血",
"start_offset": 33,
"end_offset": 38,
"label": "dis"
},
{
"id": 2,
"entity": "幽门螺杆菌检测",
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"end_offset": 58,
"label": "pro"
},
{
"id": 3,
"entity": "根除治疗",
"start_offset": 59,
"end_offset": 63,
"label": "pro"
}
] |
幽门螺杆菌感染缺铁性贫血发病机制目前尚不清楚，可能是影响了铁的吸收，或增加了铁的消耗及流失，导致铁的储备不够。 | [
{
"id": 0,
"entity": "幽门螺杆菌感染",
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"end_offset": 7,
"label": "dis"
},
{
"id": 1,
"entity": "缺铁性贫血",
"start_offset": 7,
"end_offset": 12,
"label": "dis"
}
] |
此外，还可提供细菌的药物敏感试验，指导临床选用药物，尤其是治疗失败者或生活在幽门螺杆菌耐药性很高的国家与地区。 | [
{
"id": 0,
"entity": "药物敏感试验",
"start_offset": 10,
"end_offset": 16,
"label": "pro"
},
{
"id": 1,
"entity": "幽门螺杆菌",
"start_offset": 38,
"end_offset": 43,
"label": "mic"
}
] |
除常规的组织学检查外，还有免疫化学和免疫荧光方法，但需使用免疫荧光镜和免疫抗体，多用于实验室研究。 | [
{
"id": 0,
"entity": "组织学检查",
"start_offset": 4,
"end_offset": 9,
"label": "pro"
},
{
"id": 1,
"entity": "免疫化学",
"start_offset": 13,
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"label": "pro"
},
{
"id": 2,
"entity": "免疫荧光方法",
"start_offset": 18,
"end_offset": 24,
"label": "pro"
}
] |
福建三强生化有限公司生产的CPUT试剂盒属于这种方法，可半定量指示幽门螺杆菌感染的程度（+、++、+++、++++）。 | [
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] |
呼气试验具有快速、可靠、安全及无痛苦的优点，适合大规模流行病学调查，表明目前是否有幽门螺杆菌感染，优于血清学检查。 | [
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管儿童是幽门螺杆菌的易感人群，已有的资料也显示中国儿童人群中幽门螺杆菌感染率很高，感染后所造成的结局相差有悬殊；因根除治疗困难以及抗生素的长期应用会产生不良反应等因素的存在，所以对所有幽门螺杆菌感染者都给予根除治疗显然是不可能也不现实的。 | [
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中国儿科消化学组制定的共识，对儿童目前主要用于幽门螺杆菌感染性胃炎和消化性溃疡，胃MALT患儿以及消化不良症状严重且反复发生幽门螺杆菌的患儿。 | [
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急性胰腺炎在儿童中少见，其发病原因多种多样，临床上常有急性发作的上腹部剧痛伴恶心、呕吐及血尿淀粉酶增高，疾病初期常易被忽视或误诊。 | [
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轻型胰腺炎多见，仅有轻度的胰腺功能障碍，去除发作的病因后多不会再有发作，病情呈自限性，一般病程在1～2周，胰腺的形态和功能亦恢复正常。 | [
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重型胰腺炎少见，有器官衰竭或坏死、脓肿、假性囊肿等局部并发症存在，病情急重，病死率高。 | [
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成人急性胰腺炎的病因主要是胆石症及酗酒。 | [
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其中流行性腮腺炎病毒引起的胰腺炎是较常见的。 | [
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在亚洲地区寄生虫感染也是一种多见的原因，如蛔虫及肝吸虫引起的上行性感染、梗阻可导致急性胰腺炎的发生。 | [
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细菌感染如沙门菌、痢疾杆菌、弯曲菌及钩端螺旋体感染可伴急性胰腺炎，但多是由于其毒素引起。 | [
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此类疾病因血管炎累及胰腺和其他脏器的血管，引起血管壁的炎症、坏死、血栓形成而致坏死性胰腺炎。 | [
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患者常在幼年开始发生典型的急性胰腺炎，以后转为慢性反复发作，逐渐导致胰腺的钙化、糖尿病和脂肪泻。 | [
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急性水肿型胰腺炎通常呈自限性，预后一般较好。 | [
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急性坏死性胰腺炎在儿童少见。 | [
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用于评估成人胰腺炎严重性的体系通常不适用于儿科患者。 | [
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剧烈腹痛是胰腺炎的主要症状，但小儿有时仅表现为阵发性哭闹，而小婴儿可无腹痛，仅有反应差及面色灰等表现。 | [
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典型胰腺炎往往左上腹痛，而小儿腹痛常为全腹性甚至伴明显肌卫，易并发腹膜炎。 | [
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有文献报道急性胰腺炎如具有以下症状之一者即应拟诊急性坏死性胰腺炎：①急性胰腺炎经内科治疗4～72小时，病情无改善或加重，表现为高热、末梢血白细胞计数明显增高及脏器功能衰竭（肾衰竭及休克肺等）；②腹胀明显，肠鸣音减弱或出现麻痹性肠梗阻；③出现腹水，尤其是血性腹水，其淀粉酶升高；④发生休克。 | [
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75%急性胰腺炎患者血清淀粉酶增高达正常的3倍并持续数日，一般在症状发作后2～12小时即增高，24小时最高峰，48小时后高峰下降而尿淀粉酶升高，尿淀粉酶可持续1～2周。 | [
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1）禁食：急性胰腺炎的患者应绝对禁食，直到腹痛消失可开始进少量流质。 | [
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脂肪乳剂有利于补充代谢需要，有利于重型胰腺炎的恢复，故现主张可予以适量的脂肪乳剂。 | [
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在成人的急性坏死性胰腺炎的治疗中，许多专家学者强调要晚期手术，但国内儿科较多主张一旦确诊为急性坏死性胰腺炎时，即应做手术治疗。 | [
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1/3病例可有先天性心血管畸形。 | [
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发育明显落后，2岁时才会坐，4岁时才会走，出现一种痉挛性步态。 | [
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患儿通常有臀位难产史，临床症状大多开始于生后2天之内，以后很快出现脑干受压症状，如木僵、昏迷、脑神经异常、呼吸暂停、心动过缓或角弓反张等。 | [
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{
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"entity": "角弓反张",
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小脑出血的诊断主要靠临床医师高度警惕，确诊可通过CT或MRI，有时头颅超声也可证实小脑出血，但阴性结果不能排除本病。 | [
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带菌妇女所分娩的婴儿约有1%～2%发生早发GBS感染。 | [
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极低出生体重儿GBS感染的发病率为8‰。 | [
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早发GBS感染的发病率受一些产科危险因素的影响，如早产、低出生体重（体重≤2500g）、胎膜早破（＞18小时）、母亲有产褥期发热、母亲分娩时为阴道GBS带菌者和母亲有绒毛膜羊膜炎或子宫内膜炎等均可增加感染的发生率。 | [
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"entity": "子宫内膜炎",
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主要（90%）由GBSⅢ型引起。 | [
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晚发GBS感染骨髓炎的病理生理改变不典型，可以由早发的无症状的菌血症引起，很少有全身症状。 | [
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脑膜炎的发生率低于10%，可以有惊厥、嗜睡、昏迷、前囟隆起等表现。 | [
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晚发GBS感染主要临床表现为脑膜炎。 | [
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常见隐匿起病，最初可表现为发热、昏睡、呕吐、囟门饱满等。 | [
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化脓性关节炎常累及髋、膝、踝关节，症状可持续数天。 | [
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{
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"entity": "踝关节",
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GBS蜂窝组织炎或淋巴结炎常不对称，可累及面部或下颌部，腹股沟、阴囊和髌骨前也可受累。 | [
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{
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{
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"entity": "髌骨",
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细菌学检查是诊断GBS感染的基本手段，依靠从血液、脑脊液或感染病灶（如骨、关节、脓肿液等）中分离出病原菌即可诊断。 | [
{
"id": 0,
"entity": "细菌学检查",
"start_offset": 0,
"end_offset": 5,
"label": "pro"
},
{
"id": 1,
"entity": "GBS感染",
"start_offset": 8,
"end_offset": 13,
"label": "dis"
},
{
"id": 2,
"entity": "血液",
"start_offset": 22,
"end_offset": 24,
"label": "bod"
},
{
"id": 3,
"entity": "脑脊液",
"start_offset": 25,
"end_offset": 28,
"label": "bod"
},
{
"id": 4,
"entity": "骨",
"start_offset": 35,
"end_offset": 36,
"label": "bod"
},
{
"id": 5,
"entity": "关节",
"start_offset": 37,
"end_offset": 39,
"label": "bod"
},
{
"id": 6,
"entity": "脓肿液",
"start_offset": 40,
"end_offset": 43,
"label": "bod"
}
] |
快速抗原检测的方法可以从体液中直接检测GBS抗原，常用的方法有乳胶凝集试验（LA）、协同凝集试验（COA）、对流免疫电泳（CIE）等，其敏感性比培养低，但对于产前已应用了抗生素治疗的母亲或婴儿及非菌血症、败血症的检测是非常有用的。 | [
{
"id": 0,
"entity": "快速抗原检测",
"start_offset": 0,
"end_offset": 6,
"label": "pro"
},
{
"id": 1,
"entity": "GBS",
"start_offset": 19,
"end_offset": 22,
"label": "mic"
},
{
"id": 2,
"entity": "乳胶凝集试验",
"start_offset": 31,
"end_offset": 37,
"label": "pro"
},
{
"id": 3,
"entity": "LA",
"start_offset": 38,
"end_offset": 40,
"label": "pro"
},
{
"id": 4,
"entity": "协同凝集试验",
"start_offset": 42,
"end_offset": 48,
"label": "pro"
},
{
"id": 5,
"entity": "COA",
"start_offset": 49,
"end_offset": 52,
"label": "pro"
},
{
"id": 6,
"entity": "对流免疫电泳",
"start_offset": 54,
"end_offset": 60,
"label": "pro"
},
{
"id": 7,
"entity": "CIE",
"start_offset": 61,
"end_offset": 64,
"label": "pro"
},
{
"id": 8,
"entity": "抗生素治疗",
"start_offset": 85,
"end_offset": 90,
"label": "pro"
},
{
"id": 9,
"entity": "菌血症",
"start_offset": 98,
"end_offset": 101,
"label": "dis"
},
{
"id": 10,
"entity": "败血症",
"start_offset": 102,
"end_offset": 105,
"label": "dis"
}
] |
但抗原检测可以有假阳性，因此抗原检测的阳性结果只能提示可能有GBS感染，同时应结合感染的临床表现来综合判断。 | [
{
"id": 0,
"entity": "抗原检测",
"start_offset": 1,
"end_offset": 5,
"label": "pro"
},
{
"id": 1,
"entity": "抗原检测",
"start_offset": 14,
"end_offset": 18,
"label": "pro"
},
{
"id": 2,
"entity": "GBS感染",
"start_offset": 30,
"end_offset": 35,
"label": "pro"
}
] |
对青霉素耐药，可选择氨苄西林、氨基糖苷类或头孢类抗生素。 | [
{
"id": 0,
"entity": "青霉素",
"start_offset": 1,
"end_offset": 4,
"label": "dru"
},
{
"id": 1,
"entity": "氨苄西林",
"start_offset": 10,
"end_offset": 14,
"label": "dru"
},
{
"id": 2,
"entity": "氨基糖苷类",
"start_offset": 15,
"end_offset": 20,
"label": "dru"
},
{
"id": 3,
"entity": "头孢类抗生素",
"start_offset": 21,
"end_offset": 27,
"label": "dru"
}
] |
脑膜炎的治疗应用大剂量的青霉素，也可用氨苄西林加庆大霉素，疗程2～3周。 | [
{
"id": 0,
"entity": "脑膜炎",
"start_offset": 0,
"end_offset": 3,
"label": "dis"
},
{
"id": 1,
"entity": "青霉素",
"start_offset": 12,
"end_offset": 15,
"label": "dru"
},
{
"id": 2,
"entity": "氨苄西林",
"start_offset": 19,
"end_offset": 23,
"label": "dru"
},
{
"id": 3,
"entity": "庆大霉素",
"start_offset": 24,
"end_offset": 28,
"label": "dru"
}
] |
支持治疗、治疗休克、纠正通气不良、控制颅内高压对于改善GBS感染的预后尤为重要。 | [
{
"id": 0,
"entity": "支持治疗",
"start_offset": 0,
"end_offset": 4,
"label": "pro"
},
{
"id": 1,
"entity": "纠正通气不良",
"start_offset": 10,
"end_offset": 16,
"label": "pro"
},
{
"id": 2,
"entity": "控制颅内高压",
"start_offset": 17,
"end_offset": 23,
"label": "pro"
},
{
"id": 3,
"entity": "GBS感染",
"start_offset": 27,
"end_offset": 32,
"label": "dis"
}
] |
辅助应用静脉注射免疫球蛋白（IVIG）可增加吞噬细胞的杀菌力，应用500～800mg/kg的剂量，对于新生儿败血症是安全的。 | [
{
"id": 0,
"entity": "静脉注射免疫球蛋白",
"start_offset": 4,
"end_offset": 13,
"label": "pro"
},
{
"id": 1,
"entity": "IVIG",
"start_offset": 14,
"end_offset": 18,
"label": "pro"
},
{
"id": 2,
"entity": "吞噬细胞",
"start_offset": 22,
"end_offset": 26,
"label": "bod"
},
{
"id": 3,
"entity": "新生儿败血症",
"start_offset": 51,
"end_offset": 57,
"label": "dis"
}
] |
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