text stringlengths 4 4.87k | entities list |
|---|---|
对症治疗包括局部止痛和抗感染等。 | [
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在第二肿瘤中，AML是一种较常见的类型，主要与先前烷化剂如环磷酰胺、氮芥、马利兰等暴露有关，常发生于第一肿瘤4～5年后，可先表现为骨髓增生异常综合征（MDS）再发展为AML，但在10～12年后AML的发病机会减少。 | [
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... |
除此以外，鬼臼毒素类药物VP-16的暴露与第二肿瘤性AML的发病有关，其发病时间常较烷化剂诱发者早。 | [
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"entity": "第二肿瘤性AML",
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与ALL不同的是M3型临床有更严重的出血倾向，在治疗前及刚开始治疗时易发生DIC，而M5型齿龈浸润较多见。 | [
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{
"id": 1,
"entity": "更严重的出血倾向",
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"label": "sym"
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{
"id": 2,
"entity": "DIC",
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"end_offset": 40,
"label": "d... |
体格检查除不同程度面色苍白、出血点、紫癜外，半数以上病人有肝、脾、淋巴结不同程度肿大；皮肤、皮下组织浸润时扪及结节，眼眶部浸润时可有眼球突出，这些浸润性肿块（肿瘤部分）切面可因肿瘤细胞所含的髓过氧化酶作用而转化为绿色，因此又将其称为“绿色瘤”。 | [
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{
"id": 2,
"entity": "出血点",
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... |
外周血检查表现为红细胞、血红蛋白不同程度的下降；白细胞计数可明显升高并出现幼稚细胞，或反而减少，此时又称低增生性白血病；血小板一般均中重度减少，偶见正常者。 | [
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{
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"entity": "血红蛋白",
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起病较急，常见表现有突发头痛，呕吐，偏瘫，失语，惊厥发作，视物模糊或偏盲，感觉障碍，血压、心率及呼吸改变，意识障碍等。 | [
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"entity": "偏瘫",
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... |
血肿破入蛛网膜下腔者常有明显的脑膜刺激征。 | [
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脑室出血常表现为深昏迷，四肢软瘫，早期高热，双瞳孔缩小，去脑强直样发作。 | [
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... |
因动脉瘤以及动静脉畸形等血管异常所致者以6岁以上年长儿较多见，且有随年龄增长而逐渐增多的趋势。 | [
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常起病急剧，主要表现为血液刺激或容量增加所致的脑膜刺激征和颅内高压征，如颈项强直、剧烈头痛以及喷射性呕吐等。 | [
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"entity": "容量增加",
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半数以上病例出现意识障碍、面色苍白和惊厥发作。 | [
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{
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"entity": "惊厥发作",
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硬膜下出血所形成的血肿大多发生于大脑顶部，多数为双侧，但出血程度可不对称。 | [
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脑室周围-脑室内出血主要发生于胎龄较小的未成熟儿，源于室管膜下的生发层毛细血管破裂所致，多于生后24～48小时内发病，多数起病急骤，进行性恶化，生后不久即出现深昏迷、去脑强直与惊厥，多于数小时内死亡；但少数开始时症状亦可不典型，可有意识障碍、局限性“微小型”惊厥、眼球运动障碍以及肢体功能障碍等，症状起伏，时轻时重，多能存活，但易并发脑积水。 | [
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{
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"entity": "进行性恶化",
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... |
约10%合并其他结缔组织病，如JRA、SLE及硬皮病等，少数合并恶性肿瘤。 | [
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{
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"entity": "SLE",
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"label": "dis... |
多种感染，尤其是病毒感染，特别是柯萨奇病毒与皮肌炎发病有关。 | [
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"label": "mic"
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{
"id": 2,
"entity": "皮肌炎",
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"label": "dis"... |
10%患儿咽喉肌受累，导致吞咽困难；5%患儿面肌和眼外肌受累导致面部表情少及眼睑外翻。 | [
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{
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"entity": "面肌",
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晚期有肌肉萎缩和关节挛缩。 | [
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{
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"entity": "关节",
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皮疹轻重程度及持续时间不等。 | [
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皮疹消退后可留有色素沉着。 | [
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常继发于细菌性肺炎，亦可为吸入性或血源性感染。 | [
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"id": 2,
"entity": "血源性感染",
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外周血白细胞计数和中性粒细胞升高，结合X线后前位及侧位胸片，诊断多不困难。 | [
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{
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"entity": "X线",
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痰培养、血培养可明确病原。 | [
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怀疑金葡菌者宜首选苯唑西林或万古霉素；厌氧菌感染给予青霉素G、克林霉素、哌拉西林钠、甲硝唑等。 | [
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房颤时心房激动紊乱，节律快于房扑（300～700次/分），心室律及脉搏不规则。 | [
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"entity": "心房激动紊乱",
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房颤偶尔也可见于心房内手术后，继发于左心房室瓣关闭不全的左心房扩大，WPW综合征等。 | [
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"entity": "左心房室瓣",
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... |
治疗房颤的首选药物为洋地黄，它可使心室率恢复正常，但此时房颤通常持续（WPW综合征患儿不可应用洋地黄）。 | [
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"entity": "心室率",
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... |
此后可用Ⅰ类抗心律失常药如奎尼丁、普鲁卡因胺或直流电复律来转律。 | [
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"entity": "普鲁卡因胺",
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... |
淹溺的分类大多根据淹溺时间及缺氧程度、淹溺液体性质（淡水、海水、污水等）、出现并发症等情况而划分。 | [
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{
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... |
淹溺（near-drowning）一般指发生淹溺后存活24小时以上；溺死（drowning）指因淹溺窒息于24小时内死亡。 | [
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在意外死亡原因排位中，淹溺位居第1～2位，部分地区报道儿童淹溺发病率为10/10万，其中幼儿期发病率最高。 | [
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淹溺亦可发生在家中。 | [
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航船意外引起溺水的原因多为船只倾覆后遇险者不会游泳、寒冷、体能耗竭和缺乏救护支援和救生用品。 | [
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淹溺后气道内无吸入液体称为“干溺”。 | [
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有人推测干溺者在溺水时上呼吸道亦有水进入，但由于刺激了咽喉产生了咳嗽及吞咽反射，反射性地引起喉痉挛、声门关闭和窒息。 | [
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... |
低温对淹溺者的危害亦很大，是导致淹溺死亡的重要原因之一。 | [
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水温过低引起体温下降，低体温则可引起游泳动作失常、肌肉痉挛强直、感觉麻木以及屏气能力下降。 | [
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当中枢温度＜32℃时，可导致心律失常、低血压甚至心跳停止。 | [
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淹溺经复苏后可考虑作相应辅助检查以了解病情程度和并发症情况。 | [
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最重要的化验是血气分析。 | [
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必须的化验检查还包括全血常规、红细胞比容、血电解质、血糖（低温可引起低血糖或高血糖）、血渗透压、肝肾功能、诊断DIC的各项指标（包括凝血酶原时间、部分凝血活酶时间、血小板计数、血浆纤维蛋白原、纤维蛋白降解产物）、尿常规等。 | [
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"entity": "红细胞比容",
"start_offset": 15,
"end_offset": 20,
"label": "ite"
},
{
"id": 2,
"entity": "血电解质",
"start_offset": 21,
"end_offset": 25,
"label": "... |
对怀疑存在骨折、颈椎或头颅外伤者，可给予骨骼摄片。 | [
{
"id": 0,
"entity": "骨折",
"start_offset": 5,
"end_offset": 7,
"label": "sym"
},
{
"id": 1,
"entity": "颈椎",
"start_offset": 8,
"end_offset": 10,
"label": "bod"
},
{
"id": 2,
"entity": "头颅",
"start_offset": 11,
"end_offset": 13,
"label": "bod"
},
... |
淹溺9分钟以上和复苏时间超过25分钟者提示预后不良。 | [
{
"id": 0,
"entity": "淹溺",
"start_offset": 0,
"end_offset": 2,
"label": "dis"
}
] |
收治ICU指征为：体温低于32℃；昏迷；持续内环境紊乱；需气管插管或CPAP；心血管功能不稳定；症状体征急剧恶化。 | [
{
"id": 0,
"entity": "体温低于32℃",
"start_offset": 9,
"end_offset": 16,
"label": "sym"
},
{
"id": 1,
"entity": "昏迷",
"start_offset": 17,
"end_offset": 19,
"label": "sym"
},
{
"id": 2,
"entity": "持续内环境紊乱",
"start_offset": 20,
"end_offset": 27,
"label":... |
对支气管痉挛者可采用支气管舒张剂，如沙丁胺醇溶液雾化吸入。 | [
{
"id": 0,
"entity": "支气管",
"start_offset": 1,
"end_offset": 4,
"label": "bod"
},
{
"id": 1,
"entity": "痉挛",
"start_offset": 4,
"end_offset": 6,
"label": "sym"
},
{
"id": 2,
"entity": "支气管",
"start_offset": 10,
"end_offset": 13,
"label": "bod"
},... |
碘缺乏病除了较为典型的地方性甲状腺肿、地方性克汀病以外，尚存在大量亚临床患者。 | [
{
"id": 0,
"entity": "碘缺乏病",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "地方性甲状腺肿",
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"label": "dis"
},
{
"id": 2,
"entity": "地方性克汀病",
"start_offset": 19,
"end_offset": 25,
"label":... |
碘缺乏病是当今世界上严重的公共卫生问题之一，全世界约有10亿人生活在缺碘地区。 | [
{
"id": 0,
"entity": "碘缺乏病",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
}
] |
在我国的西安、宝鸡、石泉及蓝田等地区，饮水中的碘含量较低，甲状腺肿的发病率也较高。 | [
{
"id": 0,
"entity": "甲状腺肿",
"start_offset": 29,
"end_offset": 33,
"label": "dis"
}
] |
如碘的缺乏时发生在胚胎脑组织发育的关键时期（从妊娠开始至出生后2岁），则主要影响智力发育，并有身体发育及性发育障碍，即为克汀病。 | [
{
"id": 0,
"entity": "克汀病",
"start_offset": 60,
"end_offset": 63,
"label": "dis"
}
] |
Ⅱ度：由于甲状腺肿大，脖根明显变粗，大于本人1/3个拳头到相当于2/3个拳头，特点是“脖根粗”。 | [
{
"id": 0,
"entity": "甲状腺",
"start_offset": 5,
"end_offset": 8,
"label": "bod"
},
{
"id": 1,
"entity": "脖根",
"start_offset": 11,
"end_offset": 13,
"label": "bod"
}
] |
Ⅲ度：颈部失去正常形状，甲状腺大于本人2/3个拳头到相当于一个拳头，特点是“颈变形”。 | [
{
"id": 0,
"entity": "颈部",
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"end_offset": 5,
"label": "bod"
},
{
"id": 1,
"entity": "甲状腺",
"start_offset": 12,
"end_offset": 15,
"label": "bod"
}
] |
Ⅳ度：甲状腺大于本人一个拳头，多带有结节。 | [
{
"id": 0,
"entity": "甲状腺",
"start_offset": 3,
"end_offset": 6,
"label": "bod"
}
] |
根据甲状腺肿中是否有结节，临床上又可分为三型：①弥漫型：甲状腺均匀增大，摸不到结节；②结节型：在甲状腺上摸到一个或几个结节；③混合型：在弥漫肿大的甲状腺上，摸到一个或几个结节。 | [
{
"id": 0,
"entity": "甲状腺肿",
"start_offset": 2,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "甲状腺",
"start_offset": 28,
"end_offset": 31,
"label": "bod"
},
{
"id": 2,
"entity": "甲状腺",
"start_offset": 48,
"end_offset": 51,
"label": "bod"
... |
甲状腺如肿大明显，可压迫气管引起咳嗽和呼吸困难，压迫食管引起咽下困难，压迫喉返神经引起声音嘶哑，胸骨后甲状腺肿可使头部、颈部、上肢静脉回流受阻，表现为面部青紫、水肿。 | [
{
"id": 0,
"entity": "甲状腺",
"start_offset": 0,
"end_offset": 3,
"label": "bod"
},
{
"id": 1,
"entity": "气管",
"start_offset": 12,
"end_offset": 14,
"label": "bod"
},
{
"id": 2,
"entity": "咳嗽",
"start_offset": 16,
"end_offset": 18,
"label": "sym"
}... |
并作如下规定：如有可疑甲状腺功能低下、可疑智力低下或两者均有，只要有其中一项，则考虑为类甲状腺功能减退症。 | [
{
"id": 0,
"entity": "甲状腺",
"start_offset": 11,
"end_offset": 14,
"label": "bod"
},
{
"id": 1,
"entity": "类甲状腺功能减退症",
"start_offset": 43,
"end_offset": 52,
"label": "dis"
}
] |
应该广泛切除肿瘤，但一般不可能。 | [
{
"id": 0,
"entity": "切除肿瘤",
"start_offset": 4,
"end_offset": 8,
"label": "pro"
}
] |
术前放疗可使肿瘤体积变小，以便手术切除。 | [
{
"id": 0,
"entity": "术",
"start_offset": 0,
"end_offset": 1,
"label": "pro"
},
{
"id": 1,
"entity": "放疗",
"start_offset": 2,
"end_offset": 4,
"label": "pro"
},
{
"id": 2,
"entity": "肿瘤",
"start_offset": 6,
"end_offset": 8,
"label": "dis"
},
{
... |
术后局部复发多见，以血行转移为主，至脑、肺、肝和骨骼。 | [
{
"id": 0,
"entity": "术",
"start_offset": 0,
"end_offset": 1,
"label": "pro"
},
{
"id": 1,
"entity": "脑",
"start_offset": 18,
"end_offset": 19,
"label": "bod"
},
{
"id": 2,
"entity": "肺",
"start_offset": 20,
"end_offset": 21,
"label": "bod"
},
... |
其发生是由于大脑神经元的异常放电引起。 | [
{
"id": 0,
"entity": "大脑神经元",
"start_offset": 6,
"end_offset": 11,
"label": "bod"
}
] |
临床上多表现为突然意识丧失，全身骨骼肌群阵挛性或强直性或局限性抽搐，一般经数秒至数分钟后缓解，若惊厥时间超过30分钟或频繁惊厥中间无清醒者，称之为惊厥持续状态。 | [
{
"id": 0,
"entity": "突然意识丧失",
"start_offset": 7,
"end_offset": 13,
"label": "sym"
},
{
"id": 1,
"entity": "全身骨骼肌群阵挛性",
"start_offset": 14,
"end_offset": 23,
"label": "sym"
},
{
"id": 2,
"entity": "强直性或局限性抽搐",
"start_offset": 24,
"end_offset": 33,
... |
常有发热与感染伴随症状、颅内压增高或脑实质受损症状。 | [
{
"id": 0,
"entity": "发热",
"start_offset": 2,
"end_offset": 4,
"label": "sym"
},
{
"id": 1,
"entity": "感染",
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"label": "sym"
},
{
"id": 2,
"entity": "颅内压增高",
"start_offset": 12,
"end_offset": 17,
"label": "sym"
}... |
细菌性脑膜炎、病毒性脑膜炎及病毒性脑炎常急性起病；结核性脑膜炎多亚急性起病，但婴幼儿时期可急性起病，进展迅速，颅神经常常受累；隐球菌脑膜炎慢性起病，头痛明显并逐渐加重；脑寄生虫病特别是脑囊虫病往往以反复惊厥为主要表现。 | [
{
"id": 0,
"entity": "细菌性脑膜炎",
"start_offset": 0,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "病毒性脑膜炎",
"start_offset": 7,
"end_offset": 13,
"label": "dis"
},
{
"id": 2,
"entity": "病毒性脑炎",
"start_offset": 14,
"end_offset": 19,
"label": ... |
脑脊液及脑电图等检查异常帮助诊断，特别是脑脊液检查、病原学检测、免疫学及分子生物学检查帮助明确可能的病原。 | [
{
"id": 0,
"entity": "脑脊液",
"start_offset": 0,
"end_offset": 3,
"label": "pro"
},
{
"id": 1,
"entity": "脑电图",
"start_offset": 4,
"end_offset": 7,
"label": "pro"
},
{
"id": 2,
"entity": "脑脊液检查",
"start_offset": 20,
"end_offset": 25,
"label": "pro"
... |
热性惊厥是指婴幼儿时期发热38℃以上的惊厥，而无中枢神经系统感染、水及电解质紊乱等异常病因所致者。 | [
{
"id": 0,
"entity": "热性惊厥",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "发热38℃以上的惊厥",
"start_offset": 11,
"end_offset": 21,
"label": "sym"
},
{
"id": 2,
"entity": "水及电解质紊乱",
"start_offset": 33,
"end_offset": 40,
"lab... |
目前仍使用1983年全国小儿神经病学专题讨论会诊断标准（自贡会议）：好发年龄为4个月～3岁，复发年龄不超过5～6岁；惊厥发作在体温骤升24小时内，发作次数为1次；表现为全身性抽搐，持续时间在10～15分钟内；可伴有呼吸道或消化道等急性感染，热性惊厥也可发生在预防接种后。 | [
{
"id": 0,
"entity": "惊厥",
"start_offset": 58,
"end_offset": 60,
"label": "dis"
},
{
"id": 1,
"entity": "全身性抽搐",
"start_offset": 84,
"end_offset": 89,
"label": "sym"
},
{
"id": 2,
"entity": "呼吸道",
"start_offset": 107,
"end_offset": 110,
"label": "b... |
神经系统无异常体征，脑脊液检查无异常，脑电图2周内恢复正常，精神运动发育史正常，多有家族病史。 | [
{
"id": 0,
"entity": "脑脊液检查",
"start_offset": 10,
"end_offset": 15,
"label": "pro"
},
{
"id": 1,
"entity": "脑电图",
"start_offset": 19,
"end_offset": 22,
"label": "pro"
}
] |
以上典型发作又称之为单纯性热性惊厥。 | [
{
"id": 0,
"entity": "单纯性热性惊厥",
"start_offset": 10,
"end_offset": 17,
"label": "dis"
}
] |
部分高热惊厥临床呈不典型发作表现，称之为复杂性高热惊厥：24小时内反复多次发作；发作惊厥持续时间超过15分钟以上；发作呈局限性，或左右明显不对称。 | [
{
"id": 0,
"entity": "高热惊厥",
"start_offset": 2,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "复杂性高热惊厥",
"start_offset": 20,
"end_offset": 27,
"label": "dis"
},
{
"id": 2,
"entity": "反复多次发作",
"start_offset": 33,
"end_offset": 39,
"label":... |
惊厥的发生为脑缺氧、缺血、水肿或细菌毒素直接作用等多因素所致。 | [
{
"id": 0,
"entity": "惊厥",
"start_offset": 0,
"end_offset": 2,
"label": "dis"
},
{
"id": 1,
"entity": "脑缺氧",
"start_offset": 6,
"end_offset": 9,
"label": "sym"
},
{
"id": 2,
"entity": "缺血",
"start_offset": 10,
"end_offset": 12,
"label": "sym"
},
... |
其他还有颅内出血（产伤、窒息、外伤或维生素缺乏史），颅脑损伤（外伤史），脑血管畸形，颅内肿瘤，脑发育异常（脑积水、颅脑畸形），神经皮肤综合征，脑炎后遗症及脑水肿等。 | [
{
"id": 0,
"entity": "颅内出血",
"start_offset": 4,
"end_offset": 8,
"label": "sym"
},
{
"id": 1,
"entity": "产伤",
"start_offset": 9,
"end_offset": 11,
"label": "sym"
},
{
"id": 2,
"entity": "窒息",
"start_offset": 12,
"end_offset": 14,
"label": "sym"
}... |
积极治疗颅内感染；纠正代谢失常；对复杂性热性惊厥可预防性用药，每日口服苯巴比妥3mg/kg，或口服丙戊酸钠每日20～40mg/kg，疗程数月至1～2年，以免复发；对于癫痫患者强调规范用药。 | [
{
"id": 0,
"entity": "苯巴比妥",
"start_offset": 35,
"end_offset": 39,
"label": "dru"
},
{
"id": 1,
"entity": "丙戊酸钠",
"start_offset": 49,
"end_offset": 53,
"label": "dru"
}
] |
呈严重的慢性进行性贫血，需靠输血维持生命，血红蛋白常＜30g/L；特殊面容，表现为头大，颧骨略高，鼻梁低陷，眼距增宽，表情呆钝；肝、脾日渐增大，以脾大为主，可达盆腔。 | [
{
"id": 0,
"entity": "贫血",
"start_offset": 9,
"end_offset": 11,
"label": "dis"
},
{
"id": 1,
"entity": "输血",
"start_offset": 14,
"end_offset": 16,
"label": "pro"
},
{
"id": 2,
"entity": "血红蛋白",
"start_offset": 21,
"end_offset": 25,
"label": "bod"
... |
主要见于新生儿和小婴儿，常有以下诱因：①广谱抗生素的大量应用或联合应用；②医源性因素如气管插管、血管插管、人工呼吸机等的应用；③先天性或获得性免疫功能缺陷，如营养不良、白血病、恶性淋巴瘤、长期使用皮质激素或免疫抑制剂等。 | [
{
"id": 0,
"entity": "气管插管",
"start_offset": 43,
"end_offset": 47,
"label": "pro"
},
{
"id": 1,
"entity": "血管插管",
"start_offset": 48,
"end_offset": 52,
"label": "pro"
},
{
"id": 2,
"entity": "人工呼吸机",
"start_offset": 53,
"end_offset": 58,
"label": "... |
如致病菌株产生超广谱β-内酰胺酶（ESBL），应选用头孢霉素类、复合β-内酰胺类，严重者选用碳青霉烯类抗生素如亚胺培南。 | [
{
"id": 0,
"entity": "超广谱β-内酰胺酶",
"start_offset": 7,
"end_offset": 16,
"label": "mic"
},
{
"id": 1,
"entity": "ESBL",
"start_offset": 17,
"end_offset": 21,
"label": "mic"
},
{
"id": 2,
"entity": "头孢霉素类",
"start_offset": 26,
"end_offset": 31,
"label... |
此药可引起锥体外系不良反应，表现为动作减少、减慢和肌张力增强，有伸舌、张口困难、歪颈等，加用等量苯海索（安坦）可抵消这种不良反应。 | [
{
"id": 0,
"entity": "动作减少",
"start_offset": 17,
"end_offset": 21,
"label": "sym"
},
{
"id": 1,
"entity": "减慢",
"start_offset": 22,
"end_offset": 24,
"label": "sym"
},
{
"id": 2,
"entity": "肌张力增强",
"start_offset": 25,
"end_offset": 30,
"label": "sy... |
其他三环抗抑郁剂（丙米嗪）和可乐定也用于抽动-秽语综合征伴发注意缺陷伴多动症的治疗，特别是可乐定被视为中枢兴奋剂的一个安全替代药物。 | [
{
"id": 0,
"entity": "三环抗抑郁剂",
"start_offset": 2,
"end_offset": 8,
"label": "dru"
},
{
"id": 1,
"entity": "丙米嗪",
"start_offset": 9,
"end_offset": 12,
"label": "dru"
},
{
"id": 2,
"entity": "可乐定",
"start_offset": 14,
"end_offset": 17,
"label": "dru"... |
其他如氯米帕明（氯丙米嗪，起始剂量25mg，睡前服1次）和氟伏沙明治疗抽动-秽语综合征伴发强迫观念和行为有效的报道。 | [
{
"id": 0,
"entity": "氯米帕明",
"start_offset": 3,
"end_offset": 7,
"label": "dru"
},
{
"id": 1,
"entity": "氟伏沙明",
"start_offset": 29,
"end_offset": 33,
"label": "dru"
}
] |
不同种族CAH的发病率有很大差别。 | [
{
"id": 0,
"entity": "CAH",
"start_offset": 4,
"end_offset": 7,
"label": "dis"
}
] |
21-羟化酶缺乏症杂合子发生率约1/60。 | [
{
"id": 0,
"entity": "21-羟化酶缺乏症",
"start_offset": 0,
"end_offset": 9,
"label": "dis"
}
] |
犹太人中CAH发生率较高，达1/21。 | [
{
"id": 0,
"entity": "CAH",
"start_offset": 4,
"end_offset": 7,
"label": "dis"
}
] |
出生时外生殖器似正常，少数有轻度的阴茎增大，阴囊色素沉着。 | [
{
"id": 0,
"entity": "外生殖器",
"start_offset": 3,
"end_offset": 7,
"label": "bod"
},
{
"id": 1,
"entity": "阴茎增大",
"start_offset": 17,
"end_offset": 21,
"label": "sym"
},
{
"id": 2,
"entity": "阴囊色素沉着",
"start_offset": 22,
"end_offset": 28,
"label": "s... |
这些患儿随着年龄增大，往往2岁后出现明显的雄激素过多的体征，阴茎粗大，但由于雄激素增高并非促性腺激素分泌增加所致，故睾丸并无增大，这与真性性早熟完全不同，后者伴睾丸明显发育。 | [
{
"id": 0,
"entity": "雄激素过多",
"start_offset": 21,
"end_offset": 26,
"label": "sym"
},
{
"id": 1,
"entity": "阴茎粗大",
"start_offset": 30,
"end_offset": 34,
"label": "sym"
},
{
"id": 2,
"entity": "雄激素增高",
"start_offset": 38,
"end_offset": 43,
"label": ... |
女性可表现为阴蒂肥大，伴或不伴阴唇融合，严重者阴唇完全融合似阴囊，阴蒂肥大似阴茎，尿道开口于肥大的阴蒂下（似尿道下裂），外观似男性外生殖器但未能触及睾丸，而内生殖器仍为女性。 | [
{
"id": 0,
"entity": "阴蒂肥大",
"start_offset": 6,
"end_offset": 10,
"label": "sym"
},
{
"id": 1,
"entity": "伴或不伴阴唇融合",
"start_offset": 11,
"end_offset": 19,
"label": "sym"
},
{
"id": 2,
"entity": "阴唇完全融合似阴囊",
"start_offset": 23,
"end_offset": 32,
"la... |
患者多在生后1～4周出现失盐症状，又由于同时伴有皮质醇合成障碍，往往出现不同程度的肾上腺皮质功能不足表现，如呕吐、腹泻、脱水和严重的代谢性酸中毒，难以纠正的低血钠和高血钾症，如不及时诊治则导致血容量降低、血压下降及休克，循环功能衰竭。 | [
{
"id": 0,
"entity": "失盐",
"start_offset": 12,
"end_offset": 14,
"label": "sym"
},
{
"id": 1,
"entity": "皮质醇合成障碍",
"start_offset": 24,
"end_offset": 31,
"label": "sym"
},
{
"id": 2,
"entity": "肾上腺皮质功能不足",
"start_offset": 41,
"end_offset": 50,
"labe... |
男孩可有性早熟、生长加速及骨龄超前。 | [
{
"id": 0,
"entity": "性早熟",
"start_offset": 4,
"end_offset": 7,
"label": "sym"
},
{
"id": 1,
"entity": "生长加速",
"start_offset": 8,
"end_offset": 12,
"label": "sym"
},
{
"id": 2,
"entity": "骨龄超前",
"start_offset": 13,
"end_offset": 17,
"label": "sym"
... |
因11β-OH缺乏而导致DOC增加，可使部分患儿出现高血钠、低血钾、碱中毒及高血容量，导致高血压症状；又因皮质醇合成减少引起肾上腺雄激素水平增高，出现类似21-羟化酶缺乏的高雄激素症状和体征。 | [
{
"id": 0,
"entity": "11β-OH缺乏",
"start_offset": 1,
"end_offset": 9,
"label": "sym"
},
{
"id": 1,
"entity": "DOC",
"start_offset": 12,
"end_offset": 15,
"label": "bod"
},
{
"id": 2,
"entity": "高血钠",
"start_offset": 26,
"end_offset": 29,
"label": "s... |
因CAH是常染色体隐性遗传病，每生育一胎就有1/4概率为CAH患者，因此，对家族中有本病先证者的孕妇要在妊娠中期抽取羊水或者早期取绒毛膜抽提DNA，进行产前基因分析和诊断。 | [
{
"id": 0,
"entity": "CAH",
"start_offset": 1,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "常染色体隐性遗传病",
"start_offset": 5,
"end_offset": 14,
"label": "dis"
},
{
"id": 2,
"entity": "CAH",
"start_offset": 28,
"end_offset": 31,
"label": "d... |
以张口呼吸、持续鼻塞和流涕为特征。 | [
{
"id": 0,
"entity": "张口呼吸、持续鼻塞和流涕",
"start_offset": 1,
"end_offset": 13,
"label": "sym"
}
] |
张口呼吸以平卧时明显，睡眠时发出鼾声，严重者白天亦出现张口呼吸，口腔黏膜干燥。 | [
{
"id": 0,
"entity": "睡眠时发出鼾声",
"start_offset": 11,
"end_offset": 18,
"label": "sym"
},
{
"id": 1,
"entity": "白天亦出现张口呼吸",
"start_offset": 22,
"end_offset": 31,
"label": "sym"
},
{
"id": 2,
"entity": "口腔黏膜",
"start_offset": 32,
"end_offset": 36,
"la... |
由于长期张口呼吸，致使面骨发育障碍，上颌骨变长，腭骨高，牙列不齐，上切牙突出，缺乏表情，出现所谓“腺样体”面容。 | [
{
"id": 0,
"entity": "张口呼吸",
"start_offset": 4,
"end_offset": 8,
"label": "sym"
},
{
"id": 1,
"entity": "面骨发育障碍",
"start_offset": 11,
"end_offset": 17,
"label": "sym"
},
{
"id": 2,
"entity": "上颌骨",
"start_offset": 18,
"end_offset": 21,
"label": "bo... |
分泌物向下流并刺激呼吸道黏膜，常引起阵咳，易并发下呼吸道感染；由于咽鼓管咽口受阻，易并发非化脓性中耳炎，导致听力减退和耳鸣。 | [
{
"id": 0,
"entity": "呼吸道黏膜",
"start_offset": 9,
"end_offset": 14,
"label": "bod"
},
{
"id": 1,
"entity": "阵咳",
"start_offset": 18,
"end_offset": 20,
"label": "sym"
},
{
"id": 2,
"entity": "下呼吸道感染",
"start_offset": 24,
"end_offset": 30,
"label": "d... |
少数严重患儿张口呼吸困难，可出现三凹征、阻塞性呼吸暂停，甚至肺动脉高压。 | [
{
"id": 0,
"entity": "张口呼吸困难",
"start_offset": 6,
"end_offset": 12,
"label": "sym"
},
{
"id": 1,
"entity": "三凹征",
"start_offset": 16,
"end_offset": 19,
"label": "dis"
},
{
"id": 2,
"entity": "阻塞性呼吸暂停",
"start_offset": 20,
"end_offset": 27,
"label":... |
全身发育和营养状况较差，并有夜惊，遗尿、反应迟钝、注意力不集中等神经症状。 | [
{
"id": 0,
"entity": "全身发育和营养状况较差",
"start_offset": 0,
"end_offset": 11,
"label": "sym"
},
{
"id": 1,
"entity": "夜惊",
"start_offset": 14,
"end_offset": 16,
"label": "sym"
},
{
"id": 2,
"entity": "遗尿",
"start_offset": 17,
"end_offset": 19,
"label": ... |
患儿张口呼吸、睡眠鼾声、持续鼻塞和反复鼻窦炎应怀疑本病。 | [
{
"id": 0,
"entity": "张口呼吸",
"start_offset": 2,
"end_offset": 6,
"label": "sym"
},
{
"id": 1,
"entity": "睡眠鼾声",
"start_offset": 7,
"end_offset": 11,
"label": "sym"
},
{
"id": 2,
"entity": "持续鼻塞",
"start_offset": 12,
"end_offset": 16,
"label": "sym"... |
通过前鼻镜或纤维鼻咽镜检查，可发现鼻咽顶部和后壁表面纵行裂隙的分叶状淋巴组织。 | [
{
"id": 0,
"entity": "前鼻镜或纤维鼻咽镜检查",
"start_offset": 2,
"end_offset": 13,
"label": "pro"
},
{
"id": 1,
"entity": "鼻咽顶部",
"start_offset": 17,
"end_offset": 21,
"label": "bod"
},
{
"id": 2,
"entity": "后壁表面纵行裂隙的分叶状淋巴组织",
"start_offset": 22,
"end_offset": 3... |
但同时具有以上三方面症状的典型患者不多，尤其2岁以下婴儿往往以全身感染症状为主，仅少数患儿有栓塞症状和（或）心脏杂音。 | [
{
"id": 0,
"entity": "全身感染",
"start_offset": 31,
"end_offset": 35,
"label": "sym"
},
{
"id": 1,
"entity": "栓塞",
"start_offset": 46,
"end_offset": 48,
"label": "sym"
},
{
"id": 2,
"entity": "心脏杂音",
"start_offset": 54,
"end_offset": 58,
"label": "sym... |
内脏栓塞可出现脾大、腹痛、血尿、便血，有时脾大很显著；肺栓塞可出现胸痛、咳嗽、咯血、肺部啰音等；脑动脉栓塞则有头痛、呕吐、偏瘫、失语、抽搐甚至昏迷等。 | [
{
"id": 0,
"entity": "内脏栓塞",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "脾大",
"start_offset": 7,
"end_offset": 9,
"label": "sym"
},
{
"id": 2,
"entity": "腹痛",
"start_offset": 10,
"end_offset": 12,
"label": "sym"
},... |
治疗不满意或对青霉素过敏者选用头孢菌素类或万古霉素：40～60mg/（kg•d），分2～3次静脉滴注，疗程6～8周。 | [
{
"id": 0,
"entity": "青霉素",
"start_offset": 7,
"end_offset": 10,
"label": "dru"
},
{
"id": 1,
"entity": "头孢菌素类",
"start_offset": 15,
"end_offset": 20,
"label": "dru"
},
{
"id": 2,
"entity": "万古霉素",
"start_offset": 21,
"end_offset": 25,
"label": "dr... |
③革兰阴性杆菌或大肠杆菌：选用氨苄西林300mg/（kg•d），分4次，每6小时1次静脉滴注，疗程4～6周，或用头孢氧哌唑或头孢噻肟三嗪200mg/（kg•d），分4次，每6小时1次静脉滴注，疗程4～6周，加用庆大霉素2周。 | [
{
"id": 0,
"entity": "革兰阴性杆菌",
"start_offset": 1,
"end_offset": 7,
"label": "mic"
},
{
"id": 1,
"entity": "大肠杆菌",
"start_offset": 8,
"end_offset": 12,
"label": "mic"
},
{
"id": 2,
"entity": "氨苄西林",
"start_offset": 15,
"end_offset": 19,
"label": "dr... |
绿脓杆菌感染可加用羟苄青霉素200～400mg/（kg•d），分4次，每6小时1次静脉滴注。 | [
{
"id": 0,
"entity": "绿脓杆菌感染",
"start_offset": 0,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "羟苄青霉素",
"start_offset": 9,
"end_offset": 14,
"label": "dru"
}
] |
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