text stringlengths 4 4.87k | entities list |
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目前对海绵状血管瘤的有效疗法主要是手术和激素疗法。 | [
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"entity": "激素疗法",
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若胸膜腔内同时有脓液存在则称为脓气胸（pyopneumothorax）。 | [
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... |
根据病因可分为原发性气胸和继发性气胸两大类。 | [
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原发性气胸原因不明，多发生于青少年和成人，尤其是体型高而瘦的男性。 | [
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小儿气胸多急性起病，一般在原发病的基础上突然出现烦躁、咳嗽、气急及呼吸困难等症状，或原有的呼吸困难等症状突然加重；年长儿可诉胸闷、胸痛。 | [
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"entity": "咳嗽",
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... |
张力性气胸时，由于大量气体积聚，不但肺组织受压，而且纵隔严重移位，导致腔静脉回流障碍，易引起严重的心肺功能障碍，表现烦躁、发绀、全身冷汗、脉搏细速、血压下降等休克症状，甚至出现意识不清、昏迷等。 | [
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"id": 2,
"entity": "纵隔",
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... |
典型体征为患侧胸部饱满、呼吸运动减弱或消失、叩诊呈鼓音、触觉语颤及听诊呼吸音减弱或消失，气管及纵隔移向对侧。 | [
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"id": 1,
"entity": "呼吸运动减弱或消失",
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{
"id": 2,
"entity": "叩诊呈鼓音",
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"lab... |
脓气胸者可有明显的中毒症状，体格检查患侧叩诊呈鼓音或浊音，且随体位的变化而有变化。 | [
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"entity": "体格检查",
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... |
本病常根据胸部X线所见做出诊断。 | [
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本病应与肺大疱、大叶性肺气肿、先天性含气肺囊肿等鉴别。 | [
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"id": 2,
"entity": "先天性含气肺囊肿",
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"label": ... |
少量闭合性或开放性气胸、肺压缩程度＜20%者，可让患儿卧床休息，气体大多在2～4周内被吸收。 | [
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维生素D不足将导致维生素D缺乏性佝偻病，这是一种慢性营养缺乏病，主要见于3岁以下婴幼儿。 | [
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它以维生素D缺乏导致的钙、磷代谢紊乱和骨骼的钙化障碍为主要特征。 | [
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小儿胆汁淤积、胆总管扩张、先天性胆道狭窄或闭锁、脂肪泻、胰腺炎、难治性腹泻等疾病均可影响维生素D、钙、磷的吸收而患佝偻病。 | [
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"entity": "胆总管扩张",
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"id": 2,
"entity": "先天性胆道狭窄或闭锁",
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"labe... |
8～9个月以上的患儿头颅常呈方形，前囟大及闭合延迟，严重者18个月时前囟尚未闭合。 | [
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"id": 2,
"entity": "前囟",
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患儿的肌肉韧带松弛无力，因腹部肌肉软弱而使腹部膨大，平卧时呈“蛙状腹”，因四肢肌肉无力，学会坐、站、走的年龄都较晚，因两腿无力容易跌跤。 | [
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{
"id": 2,
"entity": "腹部肌肉",
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大脑皮层功能异常，条件反射形成缓慢，患儿表情淡漠，语言发育迟缓，免疫力低下，易并发感染、贫血。 | [
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"id": 2,
"entity": "患儿表情淡漠",
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... |
反复气道吸引可能降低MAS临床危重程度，但是经反复吸引的MAS发展为依赖呼吸机治疗的情况仍比较普遍。 | [
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... |
如果自主呼吸比较强烈，有烦躁不安，也可以用SIMV+PSV或PSV模式通气，可以降低平均气道压（MAP），可以减少肺泡压力差剧烈变化导致的气胸。 | [
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"id": 2,
"entity": "肺泡",
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"label": "bod... |
Findlay等应用牛肺肺表面活性物质制剂（Survanta）随机对照治疗40例MAS得到显著临床效果。 | [
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"... |
部分患儿由于母体的自身抗体，生后即出现短暂的皮肤及血液改变和持续的心脏异常等。 | [
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{
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"entity": "心脏",
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... |
此外，患儿常伴有心内膜弹力纤维增生症和其他先天性心脏病如动脉导管未闭以及大动脉转位等。 | [
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"entity": "先天性心脏病",
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{
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"entity": "动脉导管未闭",
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"l... |
血液系统可出现暂时性的白细胞减少，于出生时即存在，可持续数日至数周。 | [
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"entity": "白细胞减少",
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... |
有时仅出现皮肤出血点，胃肠道出血偶有发生。 | [
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此外，还可有肝脏肿大、转氨酶增高和胆汁淤滞性黄疸。 | [
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... |
伴心脏损害者病死率5%～30%。 | [
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新生儿期出现严重心动过缓，应使用起搏器。 | [
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小儿口炎在婴幼儿较多见，可以单独发病，也可继发于腹泻、营养不良、急性感染和久病体弱等全身性疾病。 | [
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"entity": "营养不良",
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... |
根据致病因素分为感染性口炎和非感染性口炎。 | [
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但当内外环境发生变化，身体防御能力下降时，如感冒、发热、感染、滥用抗生素及（或）肾上腺皮质激素、化疗和放疗等，口腔内细菌增殖活跃，毒力增强，菌群关系失调，就可发病。 | [
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{
"id": 2,
"entity": "发热",
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"label": "d... |
致病菌主要包括链球菌、金黄色葡萄球菌及肺炎球菌等。 | [
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"id": 2,
"entity": "金黄色葡萄球菌",
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"label": "mic... |
涂片可见大量葡萄球菌，细菌培养可明确诊断。 | [
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"entity": "涂片可见大量葡萄球菌",
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全身症状明显，常并发有链球菌性咽炎。 | [
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苔膜涂片或细菌培养检查发现链球菌，即可确诊。 | [
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溃疡好发于牙龈和颊黏膜，形态不定，大小多在1cm左右，表浅，披以污秽的、灰白色苔膜，擦去此苔膜时，出现溢血的溃疡面，但不久又再被覆以同样的苔膜，周围黏膜有明显充血水肿，触痛明显，并有特别强烈的坏死组织臭味。 | [
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{
"id": 2,
"entity": "擦去此苔膜时，出现溢血的溃疡面",
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"end_offset": 57,
"label... |
此病确诊的依据为特殊性口臭，苔膜与小溃疡，涂片中找到大量梭形杆菌与奋森螺旋体。 | [
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"id": 1,
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"label": "sym"
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{
"id": 2,
"entity": "梭形杆菌",
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"label": ... |
全身抗感染治疗可给予广谱抗生素如青霉素、红霉素及交沙霉素等。 | [
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{
"id": 2,
"entity": "红霉素",
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"label": "dr... |
①肺动脉狭窄：肺动脉狭窄是四联症最重要的病变，狭窄范围自右心室漏斗部入口至左、右肺动脉分支。 | [
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{
"id": 2,
"entity": "四联症",
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"label": "dis... |
其中以漏斗部及肺动脉瓣复合狭窄多见，狭窄的严重程度差异颇大，严重者肺动脉闭锁，可同时伴动脉导管未闭或主动脉与肺动脉间侧支循环血管；②室间隔缺损：为大型、对位不良型室间隔缺损；③主动脉骑跨：主动脉根部粗大且顺钟向旋转右移并骑跨在室间隔缺损上，骑跨范围在15%～95%；④右心室肥厚：属继发性病变。 | [
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"id": 1,
"entity": "肺动脉闭锁",
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{
"id": 2,
"entity": "动脉导管未闭",
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"end_offset": 49,
"... |
在动脉导管关闭前，肺循环血流量减少程度较轻，青紫可不明显，随着动脉导管的关闭和漏斗部狭窄的逐渐加重，青紫日益明显，并出现杵状指（趾）。 | [
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"end_offset": 3,
"label": "bod"
},
{
"id": 1,
"entity": "青紫",
"start_offset": 22,
"end_offset": 24,
"label": "sym"
},
{
"id": 2,
"entity": "动脉",
"start_offset": 31,
"end_offset": 33,
"label": "bod"
},... |
多见于毛细血管丰富的浅表部位，如唇、指（趾）甲床、球结合膜等。 | [
{
"id": 0,
"entity": "毛细血管",
"start_offset": 3,
"end_offset": 7,
"label": "bod"
},
{
"id": 1,
"entity": "唇",
"start_offset": 16,
"end_offset": 17,
"label": "bod"
},
{
"id": 2,
"entity": "指（趾）甲床",
"start_offset": 18,
"end_offset": 24,
"label": "bod"... |
因血氧含量下降，活动耐力差，稍一活动如啼哭、情绪激动、体力劳动、寒冷等，即可出现气急及青紫加重。 | [
{
"id": 0,
"entity": "血氧含量",
"start_offset": 1,
"end_offset": 5,
"label": "ite"
},
{
"id": 1,
"entity": "啼哭",
"start_offset": 19,
"end_offset": 21,
"label": "sym"
},
{
"id": 2,
"entity": "情绪激动",
"start_offset": 22,
"end_offset": 26,
"label": "sym"
... |
纠正酸中毒，给予5%碳酸氢钠15～50ml/kg静注，以往常有缺氧发作者，可口服普萘洛尔1～2mg/（kg•d）。 | [
{
"id": 0,
"entity": "酸中毒",
"start_offset": 2,
"end_offset": 5,
"label": "dis"
},
{
"id": 1,
"entity": "碳酸氢钠",
"start_offset": 10,
"end_offset": 14,
"label": "dru"
},
{
"id": 2,
"entity": "缺氧",
"start_offset": 31,
"end_offset": 33,
"label": "sym"
... |
年龄过小的婴幼儿可先行姑息分流手术，对重症的患儿也宜先行姑息手术，待年长后一般情况改善，肺血管发育好转后，再作根治术。 | [
{
"id": 0,
"entity": "姑息分流手术",
"start_offset": 11,
"end_offset": 17,
"label": "pro"
},
{
"id": 1,
"entity": "姑息手术",
"start_offset": 28,
"end_offset": 32,
"label": "pro"
},
{
"id": 2,
"entity": "肺血管",
"start_offset": 44,
"end_offset": 47,
"label": "... |
根据出血部位的不同，可将消化道出血分为上消化道出血及下消化道出血。 | [
{
"id": 0,
"entity": "出血",
"start_offset": 2,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "消化道出血",
"start_offset": 12,
"end_offset": 17,
"label": "dis"
},
{
"id": 2,
"entity": "上消化道出血",
"start_offset": 19,
"end_offset": 25,
"label": "di... |
下消化道出血常见原因：坏死性小肠结肠炎、肠重复畸形、肠套叠以及先天性巨结肠。 | [
{
"id": 0,
"entity": "下消化道出血",
"start_offset": 0,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "坏死性小肠结肠炎",
"start_offset": 11,
"end_offset": 19,
"label": "dis"
},
{
"id": 2,
"entity": "肠重复畸形",
"start_offset": 20,
"end_offset": 25,
"label... |
下消化道：细菌性肠炎、炎症性肠道疾病、息肉及痔。 | [
{
"id": 0,
"entity": "下消化道",
"start_offset": 0,
"end_offset": 4,
"label": "bod"
},
{
"id": 1,
"entity": "细菌性肠炎",
"start_offset": 5,
"end_offset": 10,
"label": "dis"
},
{
"id": 2,
"entity": "炎症性肠道疾病",
"start_offset": 11,
"end_offset": 18,
"label": "... |
黑便代表出血来自上消化道或小肠，大便颜色呈黑色、柏油样，黑便颜色受血液在肠道内停留时间长短影响，当出血量较大、出血速度较快及肠蠕动亢进时，粪便可呈暗红色甚至鲜红色，酷似下消化道出血；相反，空、回肠出血，如出血量不多、在肠内停留时间长，也可表现为黑便。 | [
{
"id": 0,
"entity": "出血",
"start_offset": 4,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "上消化道",
"start_offset": 8,
"end_offset": 12,
"label": "bod"
},
{
"id": 2,
"entity": "小肠",
"start_offset": 13,
"end_offset": 15,
"label": "bod"
}... |
便血是指大便呈鲜红或深红褐色，出血部位多位于结肠，但是在上消化道大量出血时，由于血液有轻泻作用，会缩短排泄时间，使得大便呈鲜红色。 | [
{
"id": 0,
"entity": "大便",
"start_offset": 4,
"end_offset": 6,
"label": "bod"
},
{
"id": 1,
"entity": "结肠",
"start_offset": 22,
"end_offset": 24,
"label": "bod"
},
{
"id": 2,
"entity": "上消化道大量出血",
"start_offset": 28,
"end_offset": 36,
"label": "dis... |
如为药物引起的消化道黏膜病变应及时停用药物；维生素K缺乏出血症应补充维生素K；如门脉高压症、溃疡病合并穿孔等应及早手术治疗；血液系统疾病应给予纠正出、凝血障碍机制药，如立止血及冻干凝血酶原复合物。 | [
{
"id": 0,
"entity": "维生素K缺乏出血症",
"start_offset": 22,
"end_offset": 31,
"label": "dis"
},
{
"id": 1,
"entity": "溃疡病",
"start_offset": 46,
"end_offset": 49,
"label": "dis"
},
{
"id": 2,
"entity": "穿孔",
"start_offset": 51,
"end_offset": 53,
"label": ... |
硬化剂治疗：是目前已建立的最好的治疗食道静脉曲张破裂出血治疗方法，该方法的安全性及有效性已被证实，且费用低廉，适用范围广，操作简单。 | [
{
"id": 0,
"entity": "食道静脉曲张破裂出血",
"start_offset": 18,
"end_offset": 28,
"label": "dis"
}
] |
近年来，随着我国围产医学及新生儿重症监护技术的飞速进展，早产儿的成活率越来越高，脑瘫的发生率亦有增加趋势，早产儿脑白质损伤日益受到重视。 | [
{
"id": 0,
"entity": "脑瘫",
"start_offset": 40,
"end_offset": 42,
"label": "dis"
},
{
"id": 1,
"entity": "早产儿脑白质损伤",
"start_offset": 53,
"end_offset": 61,
"label": "dis"
}
] |
非囊性PVL是目前早产儿脑白质损伤的主要类型，可导致脑瘫和认知功能障碍，而弥漫性脑白质病变相对损伤较轻。 | [
{
"id": 0,
"entity": "非囊性PVL",
"start_offset": 0,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "脑瘫",
"start_offset": 26,
"end_offset": 28,
"label": "dis"
},
{
"id": 2,
"entity": "认知功能障碍",
"start_offset": 29,
"end_offset": 35,
"label": "s... |
新生儿期可有下肢肌张力降低、颈部伸肌张力增高、呼吸暂停和心率缓慢发作、激惹和喂养困难等，部分患儿可出现惊厥。 | [
{
"id": 0,
"entity": "下肢肌张力降低",
"start_offset": 6,
"end_offset": 13,
"label": "sym"
},
{
"id": 1,
"entity": "颈部伸肌张力增高",
"start_offset": 14,
"end_offset": 22,
"label": "sym"
},
{
"id": 2,
"entity": "呼吸暂停",
"start_offset": 23,
"end_offset": 27,
"labe... |
病变累及近三角区、枕角视放射区和颞角听放射区时常表现为视觉和听觉功能障碍。 | [
{
"id": 0,
"entity": "近三角区",
"start_offset": 4,
"end_offset": 8,
"label": "bod"
},
{
"id": 1,
"entity": "枕角视放射区",
"start_offset": 9,
"end_offset": 15,
"label": "bod"
},
{
"id": 2,
"entity": "颞角听放射区",
"start_offset": 16,
"end_offset": 22,
"label": "... |
严重弥漫性脑白质病变不仅累及运动功能，还可因皮质及皮质下神经元受损、星形胶质细胞迁移障碍，导致认知缺陷，感觉功能障碍。 | [
{
"id": 0,
"entity": "弥漫性脑白质病变",
"start_offset": 2,
"end_offset": 10,
"label": "dis"
},
{
"id": 1,
"entity": "皮质及皮质下神经元受损",
"start_offset": 22,
"end_offset": 33,
"label": "sym"
},
{
"id": 2,
"entity": "星形胶质细胞",
"start_offset": 34,
"end_offset": 40,
... |
手术完全切除是唯一的治疗方法。 | [
{
"id": 0,
"entity": "手术完全切除",
"start_offset": 0,
"end_offset": 6,
"label": "pro"
}
] |
有50%在幼儿期复发，需再手术，但从不发生转移。 | [
{
"id": 0,
"entity": "手术",
"start_offset": 13,
"end_offset": 15,
"label": "pro"
}
] |
我国有不同地区的学者通过对正常新生儿血清胆红素水平的动态监测，证实我国正常新生儿生理性黄疸时其血清胆红素峰值高于传统的诊断水平，故需要进行更大样本的前瞻性研究，才能得出我国新生儿生理性黄疸的诊断标准。 | [
{
"id": 0,
"entity": "血清胆红素",
"start_offset": 18,
"end_offset": 23,
"label": "bod"
},
{
"id": 1,
"entity": "生理性黄疸",
"start_offset": 40,
"end_offset": 45,
"label": "dis"
},
{
"id": 2,
"entity": "血清胆红素",
"start_offset": 47,
"end_offset": 52,
"label":... |
多在前额、上眼睑、鼻孔、枕等部位，压迫可褪色，不会自然消失。 | [
{
"id": 0,
"entity": "鼻孔",
"start_offset": 9,
"end_offset": 11,
"label": "bod"
},
{
"id": 1,
"entity": "枕",
"start_offset": 12,
"end_offset": 13,
"label": "bod"
}
] |
近年来，国外多采用手术治疗，如面积大，可分期手术，并可植皮。 | [
{
"id": 0,
"entity": "手术治疗",
"start_offset": 9,
"end_offset": 13,
"label": "pro"
},
{
"id": 1,
"entity": "植皮",
"start_offset": 27,
"end_offset": 29,
"label": "pro"
}
] |
好发于面、臂、手和躯干上部，压迫中央可使蜘蛛痣消失。 | [
{
"id": 0,
"entity": "面",
"start_offset": 3,
"end_offset": 4,
"label": "bod"
},
{
"id": 1,
"entity": "臂",
"start_offset": 5,
"end_offset": 6,
"label": "bod"
},
{
"id": 2,
"entity": "手",
"start_offset": 7,
"end_offset": 8,
"label": "bod"
},
{
... |
通常在生后不久出现，肿瘤常高于皮肤，鲜红色，分叶，形如草莓。 | [
{
"id": 0,
"entity": "肿瘤",
"start_offset": 10,
"end_offset": 12,
"label": "dis"
},
{
"id": 1,
"entity": "皮肤",
"start_offset": 15,
"end_offset": 17,
"label": "bod"
}
] |
好发于面、头皮和颈部。 | [
{
"id": 0,
"entity": "面",
"start_offset": 3,
"end_offset": 4,
"label": "bod"
},
{
"id": 1,
"entity": "头皮",
"start_offset": 5,
"end_offset": 7,
"label": "bod"
},
{
"id": 2,
"entity": "颈部",
"start_offset": 8,
"end_offset": 10,
"label": "bod"
}
] |
也可用手术、冷冻、硬化剂、低电压、短距离放疗等方法。 | [
{
"id": 0,
"entity": "手术",
"start_offset": 3,
"end_offset": 5,
"label": "bod"
},
{
"id": 1,
"entity": "冷冻",
"start_offset": 6,
"end_offset": 8,
"label": "pro"
},
{
"id": 2,
"entity": "硬化剂",
"start_offset": 9,
"end_offset": 12,
"label": "pro"
},
... |
临床特征为应用脂肪乳剂期间，患儿出现头痛、呕吐、贫血、血小板下降、凝血酶原时间延长、自发性出血、DIC及肝功能损害（表现为肝大、黄疸和血GPT升高）等，有作者称上述表现为脂肪超载综合征。 | [
{
"id": 0,
"entity": "头痛",
"start_offset": 18,
"end_offset": 20,
"label": "sym"
},
{
"id": 1,
"entity": "呕吐",
"start_offset": 21,
"end_offset": 23,
"label": "sym"
},
{
"id": 2,
"entity": "贫血",
"start_offset": 24,
"end_offset": 26,
"label": "sym"
... |
②禁食作用：PNAC的发生率随禁食时间的延长而增加，多数病例在PN进行2～10周后发生。 | [
{
"id": 0,
"entity": "禁食作用",
"start_offset": 1,
"end_offset": 5,
"label": "sym"
}
] |
常由b型流感嗜血杆菌引起。 | [
{
"id": 0,
"entity": "b型流感嗜血杆菌",
"start_offset": 2,
"end_offset": 10,
"label": "mic"
}
] |
喉镜检查可发现肿胀增大的樱红色会厌，杓会厌皱襞，杓状软骨和喉室带均充血水肿。 | [
{
"id": 0,
"entity": "喉镜检查",
"start_offset": 0,
"end_offset": 4,
"label": "pro"
},
{
"id": 1,
"entity": "肿胀增大的樱红色会厌",
"start_offset": 7,
"end_offset": 17,
"label": "sym"
},
{
"id": 2,
"entity": "杓会厌皱襞",
"start_offset": 18,
"end_offset": 23,
"label"... |
多数患儿存在菌血症，应立即给予肠道外抗生素治疗，如头孢噻肟、头孢曲松、氨苄西林/舒巴坦等，抗生素持续应用7～10天。 | [
{
"id": 0,
"entity": "菌血症",
"start_offset": 6,
"end_offset": 9,
"label": "dis"
},
{
"id": 1,
"entity": "肠道外抗生素",
"start_offset": 15,
"end_offset": 21,
"label": "dru"
},
{
"id": 2,
"entity": "头孢噻肟",
"start_offset": 25,
"end_offset": 29,
"label": "dr... |
除镇静、及时吸氧外，为减轻会厌部水肿，缓解呼吸困难，可立即静脉注射地塞米松等激素，必要时肾上腺素、布地奈德雾化吸入。 | [
{
"id": 0,
"entity": "镇静",
"start_offset": 1,
"end_offset": 3,
"label": "pro"
},
{
"id": 1,
"entity": "吸氧",
"start_offset": 6,
"end_offset": 8,
"label": "pro"
},
{
"id": 2,
"entity": "会厌部",
"start_offset": 13,
"end_offset": 16,
"label": "bod"
},
... |
本病常为败血症的一部分或继发于败血症，但也可作为一种局部感染而存在。 | [
{
"id": 0,
"entity": "败血症",
"start_offset": 4,
"end_offset": 7,
"label": "dis"
},
{
"id": 1,
"entity": "败血症",
"start_offset": 15,
"end_offset": 18,
"label": "dis"
}
] |
主要发生在儿童时期，是常见的危害生命的感染性疾病之一，迄今仍具有较高的死亡率与致残率。 | [
{
"id": 0,
"entity": "感染性疾病",
"start_offset": 19,
"end_offset": 24,
"label": "dis"
},
{
"id": 1,
"entity": "较高的死亡率与致残率",
"start_offset": 32,
"end_offset": 42,
"label": "sym"
}
] |
院内感染的细菌主要有克雷伯杆菌、沙门杆菌、肠杆菌、绿脓杆菌、黄质菌以及沙雷菌等。 | [
{
"id": 0,
"entity": "克雷伯杆菌",
"start_offset": 10,
"end_offset": 15,
"label": "mic"
},
{
"id": 1,
"entity": "沙门杆菌",
"start_offset": 16,
"end_offset": 20,
"label": "mic"
},
{
"id": 2,
"entity": "肠杆菌",
"start_offset": 21,
"end_offset": 24,
"label": "m... |
2006年在复旦大学附属儿童医院进行的化脑病原学流行病学研究，最后提出肺炎链球菌、B型流感嗜血杆菌及脑膜炎奈瑟菌仍是上海地区化脑儿童的主要病原菌。 | [
{
"id": 0,
"entity": "肺炎链球菌",
"start_offset": 35,
"end_offset": 40,
"label": "mic"
},
{
"id": 1,
"entity": "B型流感嗜血杆菌",
"start_offset": 41,
"end_offset": 49,
"label": "mic"
},
{
"id": 2,
"entity": "脑膜炎奈瑟菌",
"start_offset": 50,
"end_offset": 56,
"lab... |
大多数脑膜炎病例是由血行播散引起。 | [
{
"id": 0,
"entity": "脑膜炎",
"start_offset": 3,
"end_offset": 6,
"label": "dis"
}
] |
也可由脑脊膜膨出、神经管缺损、先天性窦道、胎儿头皮采血标本穿透伤或因胎内心电图监测致邻近播散所引起。 | [
{
"id": 0,
"entity": "脑脊膜膨出",
"start_offset": 3,
"end_offset": 8,
"label": "sym"
},
{
"id": 1,
"entity": "神经管缺损",
"start_offset": 9,
"end_offset": 14,
"label": "sym"
},
{
"id": 2,
"entity": "先天性窦道",
"start_offset": 15,
"end_offset": 20,
"label": "s... |
另外少数是由病原菌直接侵入脑膜引起，如肺炎链球菌脑膜炎。 | [
{
"id": 0,
"entity": "病原菌",
"start_offset": 6,
"end_offset": 9,
"label": "mic"
},
{
"id": 1,
"entity": "肺炎链球菌脑膜炎",
"start_offset": 19,
"end_offset": 27,
"label": "dis"
}
] |
特殊表现有：①神志改变：烦躁易激惹、惊跳、突然尖叫和嗜睡、神萎等；②颅内压增高：前囟紧张、饱满或隆起、骨缝分离，由于新生儿颈肌发育很差，颈项强直较少见；③惊厥：表现不典型，可仅见双眼凝视、斜视、眼球上翻及眼睑抽动，面肌小抽如吸吮状，也可阵发性青紫及呼吸暂停，一侧或局部肢体抽动；④败血症的表现如黄疸、肝大、腹胀及休克等。 | [
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},
{
"id": 1,
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"start_offset": 12,
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"label": "sym"
},
{
"id": 2,
"entity": "惊跳",
"start_offset": 18,
"end_offset": 20,
"label": "sym... |
2岁以上小儿出现①发热、头痛；②惊厥、意识改变；③脑膜刺激征或神经局灶症状，均应考虑化脑的可能。 | [
{
"id": 0,
"entity": "发热",
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},
{
"id": 1,
"entity": "头痛",
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"label": "sym"
},
{
"id": 2,
"entity": "惊厥",
"start_offset": 16,
"end_offset": 18,
"label": "sym"
}... |
临床可有以下表现：化脓性脑膜炎患儿经常规治疗后，疗效和化验结果不见好转；病情危重，频繁惊厥，出现呼吸衰竭或脑疝；脑脊液培养出少见细菌（大肠杆菌、流感杆菌，以及变形杆菌等）；颅内压增高，已排除硬脑膜下积液及化脓性脑膜炎复发者。 | [
{
"id": 0,
"entity": "化脓性脑膜炎",
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},
{
"id": 1,
"entity": "病情危重",
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"label": "sym"
},
{
"id": 2,
"entity": "频繁惊厥",
"start_offset": 41,
"end_offset": 45,
"label": "... |
确诊必须行脑室穿刺术取脑脊液 | [
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},
{
"id": 2,
"entity": "脑脊",
"start_offset": 11,
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"label": "bod"
... |
根据目前国内检出病原（肺炎链球菌、脑膜炎双球菌及流感杆菌为主），首选头孢三嗪或头孢噻肟，头孢三嗪［100mg/（kg•d），分2次］，具有广谱、高效、半衰期长、对革兰阴性杆菌作用效果好以及使用方便等优点，已成为治疗婴幼儿化脓性脑膜炎的常用药物，但其可与胆红素竞争白蛋白，有增加核黄疸的危险，在新生儿黄疸时少用。 | [
{
"id": 0,
"entity": "肺炎链球菌",
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},
{
"id": 1,
"entity": "脑膜炎双球菌",
"start_offset": 17,
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"label": "mic"
},
{
"id": 2,
"entity": "流感杆菌",
"start_offset": 24,
"end_offset": 28,
"label":... |
对其过敏者，用美罗培南替代治疗。 | [
{
"id": 0,
"entity": "美罗培南",
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"label": "dru"
}
] |
建议①流感嗜血杆菌脑膜炎推荐使用；②大于6周龄的肺炎链球菌脑膜炎患儿，权衡利弊再考虑使用；③由其他病菌引起的脑膜炎，不建议常规使用高剂量地塞米松；④部分治疗后脑膜炎，耐β内酰胺酶的肺炎链球菌脑膜炎以及小于6周龄的化脑均不宜使用糖皮质激素治疗。 | [
{
"id": 0,
"entity": "流感嗜血杆菌脑膜炎",
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},
{
"id": 1,
"entity": "肺炎链球菌脑膜炎",
"start_offset": 24,
"end_offset": 32,
"label": "dis"
},
{
"id": 2,
"entity": "脑膜炎",
"start_offset": 54,
"end_offset": 57,
"lab... |
静脉输注丙种球蛋白的不良反应有皮肤潮红、恶心、呕吐、头痛以及呼吸短促等过敏反应，通常发生在输液早期，而且与静注速度有关。 | [
{
"id": 0,
"entity": "静脉输注",
"start_offset": 0,
"end_offset": 4,
"label": "pro"
},
{
"id": 1,
"entity": "丙种球蛋白",
"start_offset": 4,
"end_offset": 9,
"label": "dru"
},
{
"id": 2,
"entity": "皮肤潮红",
"start_offset": 15,
"end_offset": 19,
"label": "sym"... |
外周血异型淋巴细胞（简称异淋）增多，脑脊液蛋白增高和血清肝酶增高。 | [
{
"id": 0,
"entity": "淋巴细胞",
"start_offset": 5,
"end_offset": 9,
"label": "bod"
},
{
"id": 1,
"entity": "异淋",
"start_offset": 12,
"end_offset": 14,
"label": "bod"
},
{
"id": 2,
"entity": "外周血异型淋巴细胞（简称异淋）增多",
"start_offset": 0,
"end_offset": 17,
"la... |
部分患儿在婴儿期出现感觉神经性耳聋和神经肌肉功能障碍，如肌张力低下、瘫痪和癫痫发作等。 | [
{
"id": 0,
"entity": "感觉神经性耳聋",
"start_offset": 10,
"end_offset": 17,
"label": "sym"
},
{
"id": 1,
"entity": "神经肌肉",
"start_offset": 18,
"end_offset": 22,
"label": "bod"
},
{
"id": 2,
"entity": "神经肌肉功能障碍",
"start_offset": 18,
"end_offset": 26,
"lab... |
HCMV还可致畸，以腹股沟疝最多见，其他如腭裂、胆道闭锁、心血管畸形和多囊肾等。 | [
{
"id": 0,
"entity": "HCMV",
"start_offset": 0,
"end_offset": 4,
"label": "mic"
},
{
"id": 1,
"entity": "畸",
"start_offset": 7,
"end_offset": 8,
"label": "dis"
},
{
"id": 2,
"entity": "腹股沟疝",
"start_offset": 10,
"end_offset": 14,
"label": "dis"
}... |
约90%有后遗症，包括智力障碍、耳聋、神经缺陷和眼部异常等。 | [
{
"id": 0,
"entity": "智力障碍",
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"label": "dis"
},
{
"id": 1,
"entity": "耳聋",
"start_offset": 16,
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"label": "dis"
},
{
"id": 2,
"entity": "神经缺陷",
"start_offset": 19,
"end_offset": 23,
"label": "dis... |
亦可有肺炎征象，甚至呼吸衰竭。 | [
{
"id": 0,
"entity": "肺炎",
"start_offset": 3,
"end_offset": 5,
"label": "dis"
},
{
"id": 1,
"entity": "肺炎征象",
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},
{
"id": 2,
"entity": "呼吸衰竭",
"start_offset": 10,
"end_offset": 14,
"label": "sym"
... |
由于HCMV致病力弱，免疫正常时无论原发或再发感染，绝大多数无症状，故在免疫正常个体应谨慎诊断HCMV疾病。 | [
{
"id": 0,
"entity": "HCMV",
"start_offset": 2,
"end_offset": 6,
"label": "mic"
},
{
"id": 1,
"entity": "原发或再发感染",
"start_offset": 18,
"end_offset": 25,
"label": "dis"
},
{
"id": 2,
"entity": "HCMV疾病",
"start_offset": 47,
"end_offset": 53,
"label":... |
在CID时，应与其他宫内感染如先天性风疹，弓形虫、梅毒螺旋体、单纯疱疹病毒等感染相鉴别。 | [
{
"id": 0,
"entity": "宫内感染",
"start_offset": 10,
"end_offset": 14,
"label": "sym"
},
{
"id": 1,
"entity": "先天性风疹",
"start_offset": 15,
"end_offset": 20,
"label": "dis"
},
{
"id": 2,
"entity": "弓形虫",
"start_offset": 21,
"end_offset": 24,
"label": "m... |
HCMV引起的传染性单核细胞增多症应与其他病原，特别是EBV引起者鉴别。 | [
{
"id": 0,
"entity": "HCMV",
"start_offset": 0,
"end_offset": 4,
"label": "mic"
},
{
"id": 1,
"entity": "传染性单核细胞增多症",
"start_offset": 7,
"end_offset": 17,
"label": "dis"
},
{
"id": 2,
"entity": "EBV",
"start_offset": 27,
"end_offset": 30,
"label": ... |
后者咽痛、渗出性咽炎和淋巴结肿大更为多见，嗜异性抗体常为阳性。 | [
{
"id": 0,
"entity": "咽痛",
"start_offset": 2,
"end_offset": 4,
"label": "sym"
},
{
"id": 1,
"entity": "渗出性咽炎",
"start_offset": 5,
"end_offset": 10,
"label": "sym"
},
{
"id": 2,
"entity": "淋巴结",
"start_offset": 11,
"end_offset": 14,
"label": "bod"
... |
常先有急性鼻咽炎病史，继而骤起高热、吞咽困难、拒食、呼吸困难、流涎、烦躁。 | [
{
"id": 0,
"entity": "急性鼻咽炎",
"start_offset": 3,
"end_offset": 8,
"label": "dis"
},
{
"id": 1,
"entity": "骤起高热",
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"label": "sym"
},
{
"id": 2,
"entity": "吞咽困难",
"start_offset": 18,
"end_offset": 22,
"label": "sy... |
哭声含糊不清；睡眠时打鼾、呼吸不畅。 | [
{
"id": 0,
"entity": "哭声含糊不清",
"start_offset": 0,
"end_offset": 6,
"label": "sym"
},
{
"id": 1,
"entity": "睡眠时打鼾、呼吸不畅",
"start_offset": 7,
"end_offset": 17,
"label": "sym"
}
] |
本病应与喉气管支气管炎引起的喉喘鸣、颈椎结核等相鉴别。 | [
{
"id": 0,
"entity": "喉气管支气管炎",
"start_offset": 4,
"end_offset": 11,
"label": "dis"
},
{
"id": 1,
"entity": "喉喘鸣",
"start_offset": 14,
"end_offset": 17,
"label": "sym"
},
{
"id": 2,
"entity": "颈椎结核",
"start_offset": 18,
"end_offset": 22,
"label": "... |
应给予适当的抗生素控制感染，首选耐酶青霉素类，亦可应用克林霉素或含β-内酰胺酶抑制剂的复合青霉素类。 | [
{
"id": 0,
"entity": "抗生素",
"start_offset": 6,
"end_offset": 9,
"label": "dru"
},
{
"id": 1,
"entity": "感染",
"start_offset": 11,
"end_offset": 13,
"label": "dis"
},
{
"id": 2,
"entity": "耐酶青霉素类",
"start_offset": 16,
"end_offset": 22,
"label": "dru"... |
脓肿成熟时应切开引流。 | [
{
"id": 0,
"entity": "脓肿",
"start_offset": 0,
"end_offset": 2,
"label": "sym"
},
{
"id": 1,
"entity": "切开引流",
"start_offset": 6,
"end_offset": 10,
"label": "pro"
}
] |
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