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表6-5常用气管导管型号及插入深度2）药物准备：肾上腺素、阿托品、麻黄碱、利多卡因、地西泮、苯巴比妥、硫喷妥钠。 | [
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"end_offset": 28,
"label": "dru"
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"id": 2,
"entity": "阿托品",
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"label": "dru"
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{
"id": 3,
"entity": "麻黄碱",
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"end_offset": 36,
"label": "dru"
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{
"id": 4,
"entity": "利多卡因",
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"end_offset": 41,
"label": "dru"
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{
"id": 5,
"entity": "地西泮",
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"end_offset": 45,
"label": "dru"
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{
"id": 6,
"entity": "苯巴比妥",
"start_offset": 46,
"end_offset": 50,
"label": "dru"
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{
"id": 7,
"entity": "硫喷妥钠",
"start_offset": 51,
"end_offset": 55,
"label": "dru"
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] |
3）其他：器械包括插管钳、牙垫、胶布，并注意给氧导管、皮囊接头、吸痰器是否完好、静脉通道是否通畅。 | [
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"entity": "插管钳",
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"end_offset": 12,
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{
"id": 1,
"entity": "牙垫",
"start_offset": 13,
"end_offset": 15,
"label": "equ"
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"id": 2,
"entity": "胶布",
"start_offset": 16,
"end_offset": 18,
"label": "equ"
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"id": 3,
"entity": "给氧导管",
"start_offset": 22,
"end_offset": 26,
"label": "equ"
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"id": 4,
"entity": "皮囊接头",
"start_offset": 27,
"end_offset": 31,
"label": "equ"
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{
"id": 5,
"entity": "吸痰器",
"start_offset": 32,
"end_offset": 35,
"label": "equ"
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{
"id": 6,
"entity": "静脉通道",
"start_offset": 40,
"end_offset": 44,
"label": "equ"
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气管插管的具体步骤见其他章节。 | [
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人工呼吸机的应用见其他章节。 | [
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3.辅助循环在保持呼吸道通畅后，应积极建立循环保证供给重要生命器官的血液。 | [
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"entity": "辅助循环",
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"label": "pro"
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"entity": "呼吸道",
"start_offset": 9,
"end_offset": 12,
"label": "bod"
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"entity": "重要生命器官",
"start_offset": 27,
"end_offset": 33,
"label": "bod"
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{
"id": 3,
"entity": "血液",
"start_offset": 34,
"end_offset": 36,
"label": "bod"
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对心脏有节律性地按压，使心内血排出进入全身的动脉系统，可分为胸外按压和胸内按压。 | [
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"entity": "胸外按压",
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"entity": "胸内按压",
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（1）胸外按压：在保持呼吸道通畅后，应积极建立循环保证供给重要生命器官的血液。 | [
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"id": 3,
"entity": "血液",
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"end_offset": 38,
"label": "bod"
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对心脏有节律性地按压，使心内血排出入全身的动脉系统。 | [
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专业人员则要求同时检查患者的脉搏搏动及观察循环的征象，时间不超过10秒。 | [
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"id": 0,
"entity": "检查患者的脉搏搏动及观察循环的征象",
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1岁以上检查颈动脉搏动，1岁以下检查肱动脉或股动脉搏动，如果无呼吸但脉搏存在，则单做人工呼吸，每2分钟要检查一次脉搏。 | [
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"id": 0,
"entity": "检查颈动脉搏动",
"start_offset": 4,
"end_offset": 11,
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{
"id": 1,
"entity": "检查肱动脉或股动脉搏动",
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"end_offset": 27,
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{
"id": 2,
"entity": "无呼吸但脉搏存在",
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"label": "sym"
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"id": 3,
"entity": "人工呼吸",
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"end_offset": 46,
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"id": 4,
"entity": "检查一次脉搏",
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"end_offset": 58,
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如果未触到脉搏或心率小于60次/分，且有体循环灌注不良表现时，即开始胸外按压。 | [
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2005指南将胸外按压更加简化，按压的技术要求见表6-6。 | [
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表6-6小儿心外按压的技术要求（2）胸内按压：小儿开胸作胸内心脏按压的机会较少。 | [
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"entity": "胸内心脏按压",
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仅在手术开胸后出现心搏骤停，当患儿有胸骨、脊柱畸形无法正确进行胸外按压等少数紧急情况下使用。 | [
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"id": 1,
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"label": "dis"
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{
"id": 2,
"entity": "胸骨",
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"entity": "脊柱",
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"entity": "脊柱畸形",
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"label": "sym"
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"id": 5,
"entity": "胸外按压",
"start_offset": 31,
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（二）进一步生命支持（ALS）经过BLS后应采取进一步生命支持，一般在医院急诊室进行，是心肺脑复苏的第二阶段，主要目的是努力恢复自主心律和自主呼吸，以保证生命体征基本稳定，其中包括心肺复苏药物的使用、严密的心脏监护和电复律。 | [
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"entity": "心肺脑复苏",
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{
"id": 6,
"entity": "心肺复苏药物的使用",
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"entity": "严密的心脏监护",
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"id": 8,
"entity": "电复律",
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"label": "pro"
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（三）延续生命支持（PLS）在保证生命体征基本稳定的基础上，积极开展脑复苏，一般在医院重症监护室里进行，主要目的是防止中枢神经系统后遗症的发生，其中包括进一步明确诊断、脑复苏、加强医疗护理、多器官功能衰竭的治疗。 | [
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"entity": "多器官功能衰竭的治疗",
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"end_offset": 105,
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【心肺复苏药物的重新评价】近年来，国内外学者对心肺复苏药物从理论到临床都进行了深入研究，提出了许多新概念和新认识，了解这些进展，对提高CPCR的成功率具有重要的意义。 | [
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（一）肾上腺素是公认CPR的首选药物，具有α、β受体兴奋作用，小剂量的肾上腺素主要兴奋β受体，扩张血管，增加心率和房室心肌收缩力；中等剂量肾上腺素兼有α和β受体兴奋作用；大剂量肾上腺素主要为α受体兴奋作用，即收缩外周血管，增高外周阻力，增高主动脉舒张压。 | [
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"entity": "α受体",
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"entity": "外周",
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"id": 13,
"entity": "主动脉",
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2005年美国CPR新指南肾上腺素均用标准剂量0.01mg/kg（1∶10000溶液，0.1ml/kg）静脉或骨髓给药，气管给药0.1mg/kg（1∶1000溶液，0.1ml/kg）；持续给药：0.1～1μg/（kg•min），心跳恢复后减量。 | [
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酸性环境可使肾上腺素药物效应减弱，肾上腺素亦不可与碱性液在同一管道输注，否则将使肾上腺素灭活影响药效。 | [
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异丙肾上腺素为单纯β受体兴奋剂，由于其直接升压效果差，对改善冠状动脉灌注不利，且增加心肌耗氧量，已不作为复苏常规用药。 | [
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"entity": "复苏",
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去甲肾上腺素虽主要兴奋α受体，但可引起周围血管强烈收缩，增加外周血管阻力和心脏后负荷，所以亦不宜选用。 | [
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{
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"end_offset": 23,
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"id": 4,
"entity": "心脏",
"start_offset": 37,
"end_offset": 39,
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（二）5%NaHCO<sub>3</sub></sub>循环一旦中止立即产生酸中毒，酸中毒可使窦房结与房室结传导减慢，导致心动过缓与心律不齐；还可直接减弱心肌收缩力。 | [
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"id": 6,
"entity": "心律不齐",
"start_offset": 66,
"end_offset": 70,
"label": "dis"
},
{
"id": 7,
"entity": "心肌",
"start_offset": 77,
"end_offset": 79,
"label": "bod"
}
] |
酸中毒可使脑微循环自动调节功能丧失，脑血管扩张，同时毛细血管通透性增强，可引起血管源性脑水肿，使颅压增高。 | [
{
"id": 0,
"entity": "酸中毒",
"start_offset": 0,
"end_offset": 3,
"label": "dis"
},
{
"id": 1,
"entity": "脑血管",
"start_offset": 18,
"end_offset": 21,
"label": "bod"
},
{
"id": 2,
"entity": "脑血管扩张",
"start_offset": 18,
"end_offset": 23,
"label": "sym"
},
{
"id": 3,
"entity": "毛细血管",
"start_offset": 26,
"end_offset": 30,
"label": "bod"
},
{
"id": 4,
"entity": "毛细血管通透性增强",
"start_offset": 26,
"end_offset": 35,
"label": "sym"
},
{
"id": 5,
"entity": "血管源性脑水肿",
"start_offset": 39,
"end_offset": 46,
"label": "dis"
},
{
"id": 6,
"entity": "颅",
"start_offset": 48,
"end_offset": 49,
"label": "bod"
},
{
"id": 7,
"entity": "颅压增高",
"start_offset": 48,
"end_offset": 52,
"label": "sym"
}
] |
酸中毒可使肝素灭活，促进弥散性血管内凝血，故多年来碳酸氢钠一直被推荐为CPCR的必要药物之一。 | [
{
"id": 0,
"entity": "酸中毒",
"start_offset": 0,
"end_offset": 3,
"label": "dis"
},
{
"id": 1,
"entity": "肝素",
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"end_offset": 7,
"label": "bod"
},
{
"id": 2,
"entity": "肝素灭活",
"start_offset": 5,
"end_offset": 9,
"label": "sym"
},
{
"id": 3,
"entity": "血管",
"start_offset": 15,
"end_offset": 17,
"label": "bod"
},
{
"id": 4,
"entity": "促进弥散性血管内凝血",
"start_offset": 10,
"end_offset": 20,
"label": "sym"
},
{
"id": 5,
"entity": "碳酸氢钠",
"start_offset": 25,
"end_offset": 29,
"label": "dru"
},
{
"id": 6,
"entity": "CPCR",
"start_offset": 35,
"end_offset": 39,
"label": "pro"
}
] |
但由于下述理由使这一传统观念受到异议：①心搏骤停后，出现的酸中毒一般为呼吸性酸中毒合并高乳酸性代酸，有效循环建立前，碳酸氢钠不易纠正这类酸中毒；②碱性液使氧离曲线左移加重组织缺氧；③大剂量碳酸氢钠还可引起或加重高钠、高渗血症，加重脑的损害；④碱血症使K<sup>+</sup>细胞内流可致心律失常。 | [
{
"id": 0,
"entity": "心搏骤停",
"start_offset": 20,
"end_offset": 24,
"label": "dis"
},
{
"id": 1,
"entity": "酸中毒",
"start_offset": 29,
"end_offset": 32,
"label": "dis"
},
{
"id": 2,
"entity": "呼吸性酸中毒",
"start_offset": 35,
"end_offset": 41,
"label": "dis"
},
{
"id": 3,
"entity": "高乳酸性代酸",
"start_offset": 43,
"end_offset": 49,
"label": "dis"
},
{
"id": 4,
"entity": "碳酸氢钠",
"start_offset": 58,
"end_offset": 62,
"label": "dru"
},
{
"id": 5,
"entity": "酸中毒",
"start_offset": 68,
"end_offset": 71,
"label": "dis"
},
{
"id": 6,
"entity": "组织缺氧",
"start_offset": 85,
"end_offset": 89,
"label": "dis"
},
{
"id": 7,
"entity": "碳酸氢钠",
"start_offset": 94,
"end_offset": 98,
"label": "dru"
},
{
"id": 8,
"entity": "高钠、高渗血症",
"start_offset": 105,
"end_offset": 112,
"label": "dis"
},
{
"id": 9,
"entity": "脑",
"start_offset": 115,
"end_offset": 116,
"label": "bod"
},
{
"id": 10,
"entity": "加重脑的损害",
"start_offset": 113,
"end_offset": 119,
"label": "sym"
},
{
"id": 11,
"entity": "碱血症",
"start_offset": 121,
"end_offset": 124,
"label": "dis"
},
{
"id": 12,
"entity": "心律失常",
"start_offset": 144,
"end_offset": 148,
"label": "sym"
}
] |
基于上述原因，目前，对于心肺复苏来讲，碳酸氢钠不是第一线药物。 | [
{
"id": 0,
"entity": "心肺复苏",
"start_offset": 12,
"end_offset": 16,
"label": "pro"
},
{
"id": 1,
"entity": "碳酸氢钠",
"start_offset": 19,
"end_offset": 23,
"label": "dru"
}
] |
迅速建立有效的通气和恢复全身灌注是处理酸中毒和低氧血症的基本措施。 | [
{
"id": 0,
"entity": "迅速建立有效的通气",
"start_offset": 0,
"end_offset": 9,
"label": "pro"
},
{
"id": 1,
"entity": "恢复全身灌注",
"start_offset": 10,
"end_offset": 16,
"label": "pro"
},
{
"id": 2,
"entity": "酸中毒",
"start_offset": 19,
"end_offset": 22,
"label": "dis"
},
{
"id": 3,
"entity": "低氧血症",
"start_offset": 23,
"end_offset": 27,
"label": "dis"
}
] |
使用碳酸氢钠前必须进行有效的通气和恢复有效的灌注，以免加重机体损害。 | [
{
"id": 0,
"entity": "碳酸氢钠",
"start_offset": 2,
"end_offset": 6,
"label": "dru"
},
{
"id": 1,
"entity": "通气",
"start_offset": 14,
"end_offset": 16,
"label": "pro"
},
{
"id": 2,
"entity": "恢复有效的灌注",
"start_offset": 17,
"end_offset": 24,
"label": "pro"
}
] |
婴儿0.5mmol/kg，儿童1.0mmol/kg（5%NaHCO<sub>3</sub>1ml=0.6mmol），快速静滴，碳酸氢钠进一步用量应根据血pH和PaCO<sub>2</sub>测定值而定，使用时应将5%NaHCO3</sub>稀释为1.4%。 | [
{
"id": 0,
"entity": "碳酸氢钠",
"start_offset": 63,
"end_offset": 67,
"label": "dru"
},
{
"id": 1,
"entity": "血pH",
"start_offset": 75,
"end_offset": 78,
"label": "ite"
},
{
"id": 2,
"entity": "PaCO<sub>2</sub>",
"start_offset": 79,
"end_offset": 95,
"label": "ite"
},
{
"id": 3,
"entity": "NaHCO3</sub>",
"start_offset": 108,
"end_offset": 120,
"label": "dru"
}
] |
（三）阿托品阿托品为胆碱酯酶拮抗剂，能降低迷走神经兴奋性。 | [
{
"id": 0,
"entity": "阿托品",
"start_offset": 3,
"end_offset": 6,
"label": "dru"
},
{
"id": 1,
"entity": "阿托品",
"start_offset": 6,
"end_offset": 9,
"label": "dru"
},
{
"id": 2,
"entity": "胆碱酯酶拮抗剂",
"start_offset": 10,
"end_offset": 17,
"label": "dru"
}
] |
适用于临床因心动过缓以及房室结的房室传导阻滞伴室率缓慢的患儿，气管插管时因咽部受到刺激，迷走神经兴奋性增高，心脏复跳后出现心动过缓的患儿均可使用。 | [
{
"id": 0,
"entity": "心动过缓",
"start_offset": 6,
"end_offset": 10,
"label": "dis"
},
{
"id": 1,
"entity": "房室结的房室传导阻滞",
"start_offset": 12,
"end_offset": 22,
"label": "dis"
},
{
"id": 2,
"entity": "室率缓慢",
"start_offset": 23,
"end_offset": 27,
"label": "dis"
},
{
"id": 3,
"entity": "气管插管",
"start_offset": 31,
"end_offset": 35,
"label": "pro"
},
{
"id": 4,
"entity": "咽部",
"start_offset": 37,
"end_offset": 39,
"label": "bod"
},
{
"id": 5,
"entity": "迷走神经",
"start_offset": 44,
"end_offset": 48,
"label": "bod"
},
{
"id": 6,
"entity": "迷走神经兴奋性增高",
"start_offset": 44,
"end_offset": 53,
"label": "sym"
},
{
"id": 7,
"entity": "心脏",
"start_offset": 54,
"end_offset": 56,
"label": "bod"
}
] |
每次0.02mg/kg静脉注射，5分钟后可重复应用，最大单一剂量1mg（青少年）、0.5mg（儿童）。 | [
{
"id": 0,
"entity": "静脉注射",
"start_offset": 11,
"end_offset": 15,
"label": "pro"
}
] |
（四）利多卡因当心脏出现多源性室性期前收缩，利多卡因为首选药物。 | [
{
"id": 0,
"entity": "利多卡因",
"start_offset": 3,
"end_offset": 7,
"label": "dru"
},
{
"id": 1,
"entity": "心脏",
"start_offset": 8,
"end_offset": 10,
"label": "bod"
},
{
"id": 2,
"entity": "利多卡因",
"start_offset": 22,
"end_offset": 26,
"label": "dru"
}
] |
它能抑制心脏自律性和室性异位性期前收缩，常用于心室纤颤。 | [
{
"id": 0,
"entity": "心脏",
"start_offset": 4,
"end_offset": 6,
"label": "bod"
},
{
"id": 1,
"entity": "心室纤颤",
"start_offset": 23,
"end_offset": 27,
"label": "dis"
}
] |
在没有或来不及作心脏监护情况下，可依据下列情况判断：原发病为心脏疾患、心脏停搏前曾有过快速性室性心律失常，一旦心脏停搏，多为心室纤颤，此时可给利多卡因。 | [
{
"id": 0,
"entity": "作心脏监护",
"start_offset": 7,
"end_offset": 12,
"label": "pro"
},
{
"id": 1,
"entity": "心脏疾患",
"start_offset": 30,
"end_offset": 34,
"label": "dis"
},
{
"id": 2,
"entity": "心脏停搏",
"start_offset": 35,
"end_offset": 39,
"label": "dis"
},
{
"id": 3,
"entity": "室性心律失常",
"start_offset": 46,
"end_offset": 52,
"label": "dis"
},
{
"id": 4,
"entity": "心脏停搏",
"start_offset": 55,
"end_offset": 59,
"label": "dis"
},
{
"id": 5,
"entity": "心室纤颤",
"start_offset": 62,
"end_offset": 66,
"label": "dis"
},
{
"id": 6,
"entity": "利多卡因",
"start_offset": 71,
"end_offset": 75,
"label": "dru"
}
] |
1mg/kg+5%GS10ml静注，5～10分钟重复，总量＜5mg/kg，当心律复转后，25～40μg/（kg•min），静脉维持6小时。 | [
{
"id": 0,
"entity": "静注",
"start_offset": 15,
"end_offset": 17,
"label": "pro"
}
] |
（五）钙剂钙剂为心肌兴奋-收缩偶联所必需，以往认为Ca2<sup>+</sup>和K<sup>+</sup>有拮抗作用，可降低高K<sup>+</sup>对心肌的抑制，可提高心肌张力和兴奋性。 | [
{
"id": 0,
"entity": "钙剂",
"start_offset": 3,
"end_offset": 5,
"label": "dru"
},
{
"id": 1,
"entity": "钙剂",
"start_offset": 5,
"end_offset": 7,
"label": "dru"
},
{
"id": 2,
"entity": "心肌",
"start_offset": 8,
"end_offset": 10,
"label": "bod"
},
{
"id": 3,
"entity": "心肌",
"start_offset": 87,
"end_offset": 89,
"label": "bod"
}
] |
从1984年后发现，Ca2<sup>+</sup>升高可使室颤变得更不易纠正，并使死亡率增加。 | [
{
"id": 0,
"entity": "室颤",
"start_offset": 29,
"end_offset": 31,
"label": "dis"
}
] |
这主要是因为缺血、缺氧时钙泵、钠泵失活，细胞外钙入细胞，导致微循环障碍、不可逆的破坏、血管痉挛、复苏后延迟性低灌流。 | [
{
"id": 0,
"entity": "缺血",
"start_offset": 6,
"end_offset": 8,
"label": "dis"
},
{
"id": 1,
"entity": "缺氧",
"start_offset": 9,
"end_offset": 11,
"label": "dis"
},
{
"id": 2,
"entity": "钙泵、钠泵失活",
"start_offset": 12,
"end_offset": 19,
"label": "sym"
},
{
"id": 3,
"entity": "细胞",
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"end_offset": 22,
"label": "bod"
},
{
"id": 4,
"entity": "细胞",
"start_offset": 25,
"end_offset": 27,
"label": "bod"
},
{
"id": 5,
"entity": "微循环障碍",
"start_offset": 30,
"end_offset": 35,
"label": "sym"
},
{
"id": 6,
"entity": "不可逆的破坏",
"start_offset": 36,
"end_offset": 42,
"label": "sym"
},
{
"id": 7,
"entity": "血管",
"start_offset": 43,
"end_offset": 45,
"label": "bod"
},
{
"id": 8,
"entity": "血管痉挛",
"start_offset": 43,
"end_offset": 47,
"label": "sym"
},
{
"id": 9,
"entity": "复苏",
"start_offset": 48,
"end_offset": 50,
"label": "pro"
},
{
"id": 10,
"entity": "延迟性低灌流",
"start_offset": 51,
"end_offset": 57,
"label": "sym"
}
] |
目前，使用指征为高钾血症、低钙血症和钙通道阻滞剂中毒。 | [
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"entity": "高钾血症",
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{
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{
"id": 2,
"entity": "钙通道阻滞剂中毒",
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"label": "dis"
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] |
（六）葡萄糖CPCR后伴高血糖的患者预后极差，而高糖血症常被忽略，其对机体的危害尚未引起临床医师重视。 | [
{
"id": 0,
"entity": "葡萄糖",
"start_offset": 3,
"end_offset": 6,
"label": "dru"
},
{
"id": 1,
"entity": "CPCR",
"start_offset": 6,
"end_offset": 10,
"label": "pro"
},
{
"id": 2,
"entity": "高血糖",
"start_offset": 12,
"end_offset": 15,
"label": "dis"
},
{
"id": 3,
"entity": "高糖血症",
"start_offset": 24,
"end_offset": 28,
"label": "dis"
}
] |
呼吸心搏骤停时，突发强烈刺激致儿茶酚胺、皮质醇、胰高糖素等分解代谢激素分泌增多，这些激素除直接刺激糖原分解、糖原异生增加外，还通过不同途径拮抗胰岛素的生物效应。 | [
{
"id": 0,
"entity": "呼吸心搏骤停",
"start_offset": 0,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "儿茶酚胺",
"start_offset": 15,
"end_offset": 19,
"label": "bod"
},
{
"id": 2,
"entity": "皮质醇",
"start_offset": 20,
"end_offset": 23,
"label": "bod"
},
{
"id": 3,
"entity": "胰高糖素",
"start_offset": 24,
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"label": "bod"
},
{
"id": 4,
"entity": "激素",
"start_offset": 33,
"end_offset": 35,
"label": "bod"
},
{
"id": 5,
"entity": "儿茶酚胺、皮质醇、胰高糖素等分解代谢激素分泌增多",
"start_offset": 15,
"end_offset": 39,
"label": "sym"
},
{
"id": 6,
"entity": "激素",
"start_offset": 42,
"end_offset": 44,
"label": "bod"
},
{
"id": 7,
"entity": "胰岛素",
"start_offset": 71,
"end_offset": 74,
"label": "bod"
}
] |
此外，在各种突发强烈刺激下，胰岛素受体数目及受体最大特异结合率可受其影响而降低，最终导致血糖升高和高糖性高渗血症。 | [
{
"id": 0,
"entity": "胰岛素受体",
"start_offset": 14,
"end_offset": 19,
"label": "bod"
},
{
"id": 1,
"entity": "受体",
"start_offset": 22,
"end_offset": 24,
"label": "bod"
},
{
"id": 2,
"entity": "血糖",
"start_offset": 44,
"end_offset": 46,
"label": "bod"
},
{
"id": 3,
"entity": "血糖升高",
"start_offset": 44,
"end_offset": 48,
"label": "sym"
},
{
"id": 4,
"entity": "高糖性高渗血症",
"start_offset": 49,
"end_offset": 56,
"label": "dis"
}
] |
由于严重缺血、缺氧，葡萄糖转为无氧酵解代谢增多，其产物乳酸增多。 | [
{
"id": 0,
"entity": "缺血",
"start_offset": 4,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "缺氧",
"start_offset": 7,
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"label": "dis"
},
{
"id": 2,
"entity": "乳酸",
"start_offset": 27,
"end_offset": 29,
"label": "bod"
}
] |
而CPCR期间输入葡萄糖必将使无氧酵解加剧，加重组织酸中毒中毒。 | [
{
"id": 0,
"entity": "CPCR",
"start_offset": 1,
"end_offset": 5,
"label": "pro"
},
{
"id": 1,
"entity": "葡萄糖",
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"label": "dru"
},
{
"id": 2,
"entity": "组织酸中毒",
"start_offset": 24,
"end_offset": 29,
"label": "dis"
}
] |
高血糖又可致血浆渗透压增高，进一步加重高渗性脑损伤。 | [
{
"id": 0,
"entity": "高血糖",
"start_offset": 0,
"end_offset": 3,
"label": "dis"
},
{
"id": 1,
"entity": "血浆",
"start_offset": 6,
"end_offset": 8,
"label": "bod"
},
{
"id": 2,
"entity": "血浆渗透压增高",
"start_offset": 6,
"end_offset": 13,
"label": "sym"
},
{
"id": 3,
"entity": "高渗性脑损伤",
"start_offset": 19,
"end_offset": 25,
"label": "dis"
}
] |
CPCR期间的高血糖多为一过性，常随CPCR的抢救成功以及外周组织胰岛素拮抗的改善逐渐缓解，处理原则为积极根治原发病和严格控制外源性葡萄糖的输入，故CPCR期间宜用无糖液或5%的低糖液，快速大量输注葡萄糖对CPCR是不利的。 | [
{
"id": 0,
"entity": "CPCR",
"start_offset": 0,
"end_offset": 4,
"label": "pro"
},
{
"id": 1,
"entity": "高血糖",
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"label": "dis"
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{
"id": 2,
"entity": "CPCR",
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"label": "pro"
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{
"id": 3,
"entity": "外周组织胰岛素",
"start_offset": 29,
"end_offset": 36,
"label": "bod"
},
{
"id": 4,
"entity": "葡萄糖",
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"end_offset": 69,
"label": "dru"
},
{
"id": 5,
"entity": "CPCR",
"start_offset": 74,
"end_offset": 78,
"label": "pro"
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{
"id": 6,
"entity": "无糖液",
"start_offset": 82,
"end_offset": 85,
"label": "dru"
},
{
"id": 7,
"entity": "低糖液",
"start_offset": 89,
"end_offset": 92,
"label": "dru"
},
{
"id": 8,
"entity": "葡萄糖",
"start_offset": 99,
"end_offset": 102,
"label": "dru"
},
{
"id": 9,
"entity": "CPCR",
"start_offset": 103,
"end_offset": 107,
"label": "pro"
}
] |
儿童的糖原储备有限，当发生心肺功能障碍时可被很快消耗殆尽，导致低血糖。 | [
{
"id": 0,
"entity": "心肺功能障碍",
"start_offset": 13,
"end_offset": 19,
"label": "dis"
},
{
"id": 1,
"entity": "低血糖",
"start_offset": 31,
"end_offset": 34,
"label": "dis"
}
] |
高血糖和低血糖均可产生脑损伤，因此对心肺功能不稳定的危重儿都应床旁监测血糖浓度。 | [
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"id": 0,
"entity": "高血糖",
"start_offset": 0,
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"label": "dis"
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{
"id": 1,
"entity": "低血糖",
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"label": "dis"
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{
"id": 2,
"entity": "脑损伤",
"start_offset": 11,
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"label": "dis"
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{
"id": 3,
"entity": "心肺功能不稳定",
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"label": "sym"
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{
"id": 4,
"entity": "监测血糖浓度",
"start_offset": 33,
"end_offset": 39,
"label": "ite"
}
] |
如发生低血糖可补葡萄糖，剂量为0.5～1g/kg或10%葡萄糖5～10ml/kg。 | [
{
"id": 0,
"entity": "低血糖",
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"end_offset": 6,
"label": "dis"
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{
"id": 1,
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{
"id": 2,
"entity": "葡萄糖",
"start_offset": 28,
"end_offset": 31,
"label": "dru"
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] |
（七）钙拮抗剂钙拮抗剂可直接抑制腺苷磷酸酶的分解，保护线粒体，降低乳酸，降低纤颤域值，不影响电复律，解除小动脉痉挛，加快血流，抑制血小板凝聚，降低血黏度，改善循环，阻止钙内流，保护缺血细胞。 | [
{
"id": 0,
"entity": "钙拮抗剂",
"start_offset": 3,
"end_offset": 7,
"label": "dru"
},
{
"id": 1,
"entity": "钙拮抗剂",
"start_offset": 7,
"end_offset": 11,
"label": "dru"
},
{
"id": 2,
"entity": "腺苷磷酸酶",
"start_offset": 16,
"end_offset": 21,
"label": "bod"
},
{
"id": 3,
"entity": "线粒体",
"start_offset": 27,
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"label": "bod"
},
{
"id": 4,
"entity": "乳酸",
"start_offset": 33,
"end_offset": 35,
"label": "bod"
},
{
"id": 5,
"entity": "纤颤",
"start_offset": 38,
"end_offset": 40,
"label": "dis"
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{
"id": 6,
"entity": "电复律",
"start_offset": 46,
"end_offset": 49,
"label": "pro"
},
{
"id": 7,
"entity": "小动脉",
"start_offset": 52,
"end_offset": 55,
"label": "bod"
},
{
"id": 8,
"entity": "小动脉痉挛",
"start_offset": 52,
"end_offset": 57,
"label": "sym"
},
{
"id": 9,
"entity": "血小板",
"start_offset": 65,
"end_offset": 68,
"label": "bod"
},
{
"id": 10,
"entity": "抑制血小板凝聚",
"start_offset": 63,
"end_offset": 70,
"label": "sym"
},
{
"id": 11,
"entity": "血",
"start_offset": 73,
"end_offset": 74,
"label": "bod"
},
{
"id": 12,
"entity": "降低血黏度",
"start_offset": 71,
"end_offset": 76,
"label": "sym"
},
{
"id": 13,
"entity": "缺血细胞",
"start_offset": 90,
"end_offset": 94,
"label": "bod"
}
] |
临床常用药物有：维拉帕米（异搏定），硝苯地平，尼莫地平。 | [
{
"id": 0,
"entity": "维拉帕米",
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"end_offset": 12,
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{
"id": 1,
"entity": "异搏定",
"start_offset": 13,
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"label": "dru"
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{
"id": 2,
"entity": "硝苯地平",
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"label": "dru"
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{
"id": 3,
"entity": "尼莫地平",
"start_offset": 23,
"end_offset": 27,
"label": "dru"
}
] |
缺点：负性心肌作用、抑制A-V传导、心律失常、扩张外周血管，故钙拮抗剂在CPCR的应用有待研究。 | [
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"id": 0,
"entity": "心肌",
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"end_offset": 7,
"label": "bod"
},
{
"id": 1,
"entity": "负性心肌作用",
"start_offset": 3,
"end_offset": 9,
"label": "sym"
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{
"id": 2,
"entity": "抑制A-V传导",
"start_offset": 10,
"end_offset": 17,
"label": "sym"
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{
"id": 3,
"entity": "心律失常",
"start_offset": 18,
"end_offset": 22,
"label": "sym"
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{
"id": 4,
"entity": "外周血管",
"start_offset": 25,
"end_offset": 29,
"label": "bod"
},
{
"id": 5,
"entity": "扩张外周血管",
"start_offset": 23,
"end_offset": 29,
"label": "sym"
},
{
"id": 6,
"entity": "钙拮抗剂",
"start_offset": 31,
"end_offset": 35,
"label": "dru"
},
{
"id": 7,
"entity": "CPCR",
"start_offset": 36,
"end_offset": 40,
"label": "pro"
}
] |
（八）呼吸兴奋剂儿科呼吸、心搏骤停的临床特点多因严重低氧血症和高碳酸血症所致，先引起呼吸骤停，继而心搏骤停，故小儿CPCR时有效的人工通气显得尤为重要。 | [
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"entity": "呼吸兴奋剂",
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"end_offset": 8,
"label": "dru"
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{
"id": 1,
"entity": "儿科",
"start_offset": 8,
"end_offset": 10,
"label": "dep"
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{
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"entity": "呼吸、心搏骤停",
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"label": "dis"
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{
"id": 3,
"entity": "低氧血症",
"start_offset": 26,
"end_offset": 30,
"label": "dis"
},
{
"id": 4,
"entity": "高碳酸血症",
"start_offset": 31,
"end_offset": 36,
"label": "dis"
},
{
"id": 5,
"entity": "呼吸骤停",
"start_offset": 42,
"end_offset": 46,
"label": "dis"
},
{
"id": 6,
"entity": "心搏骤停",
"start_offset": 49,
"end_offset": 53,
"label": "dis"
},
{
"id": 7,
"entity": "CPCR",
"start_offset": 57,
"end_offset": 61,
"label": "pro"
},
{
"id": 8,
"entity": "人工通气",
"start_offset": 65,
"end_offset": 69,
"label": "pro"
}
] |
口对口人工呼吸，一人只能坚持3分钟，因此气管内插管是首选方法，有条件应尽早使用。 | [
{
"id": 0,
"entity": "口对口人工呼吸",
"start_offset": 0,
"end_offset": 7,
"label": "pro"
},
{
"id": 1,
"entity": "气管内插管",
"start_offset": 20,
"end_offset": 25,
"label": "pro"
}
] |
目前，呼吸兴奋剂在复苏过程中已不主张使用。 | [
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"id": 0,
"entity": "呼吸兴奋剂",
"start_offset": 3,
"end_offset": 8,
"label": "dru"
},
{
"id": 1,
"entity": "复苏",
"start_offset": 9,
"end_offset": 11,
"label": "pro"
}
] |
【给药途径的选择】及时的给药和输液在CPCR十分重要，鉴于CPCR时上腔静脉系统和肺循环尚存在，故首选静脉和气管内给药。 | [
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"id": 0,
"entity": "给药",
"start_offset": 1,
"end_offset": 3,
"label": "pro"
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{
"id": 1,
"entity": "给药",
"start_offset": 12,
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"label": "pro"
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{
"id": 2,
"entity": "输液",
"start_offset": 15,
"end_offset": 17,
"label": "pro"
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{
"id": 3,
"entity": "CPCR",
"start_offset": 18,
"end_offset": 22,
"label": "pro"
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{
"id": 4,
"entity": "CPCR",
"start_offset": 29,
"end_offset": 33,
"label": "pro"
},
{
"id": 5,
"entity": "上腔静脉系统",
"start_offset": 34,
"end_offset": 40,
"label": "bod"
},
{
"id": 6,
"entity": "肺",
"start_offset": 41,
"end_offset": 42,
"label": "bod"
},
{
"id": 7,
"entity": "静脉",
"start_offset": 51,
"end_offset": 53,
"label": "bod"
},
{
"id": 8,
"entity": "气管",
"start_offset": 54,
"end_offset": 56,
"label": "bod"
},
{
"id": 9,
"entity": "给药",
"start_offset": 57,
"end_offset": 59,
"label": "pro"
}
] |
有研究表明，静脉、气管内、心内注射三种给药途径发挥的作用时间无明显差别。 | [
{
"id": 0,
"entity": "静脉",
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{
"id": 1,
"entity": "气管",
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"label": "bod"
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{
"id": 2,
"entity": "心内",
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{
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"entity": "给药",
"start_offset": 19,
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"label": "pro"
}
] |
上腔静脉系统给药最好，以中心静脉最佳（锁骨下静脉、颈内静脉），平均2分左右发挥作用。 | [
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"id": 0,
"entity": "上腔静脉系统",
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{
"id": 1,
"entity": "中心静脉",
"start_offset": 12,
"end_offset": 16,
"label": "bod"
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{
"id": 2,
"entity": "锁骨下静脉",
"start_offset": 19,
"end_offset": 24,
"label": "bod"
},
{
"id": 3,
"entity": "颈内静脉",
"start_offset": 25,
"end_offset": 29,
"label": "bod"
}
] |
但经皮静脉穿刺最快、最易。 | [
{
"id": 0,
"entity": "皮静脉穿刺",
"start_offset": 2,
"end_offset": 7,
"label": "pro"
}
] |
由于下肢末端静脉循环和回流缓慢，常不作为首选部位。 | [
{
"id": 0,
"entity": "下肢末端静脉",
"start_offset": 2,
"end_offset": 8,
"label": "bod"
}
] |
气管内给药由于发挥作用时间和静脉给药相似，在静脉通道建立困难时，气管内给药可通过肺毛细血管迅速吸收，使药物最快到达心脏。 | [
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"id": 0,
"entity": "气管内给药",
"start_offset": 0,
"end_offset": 5,
"label": "pro"
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{
"id": 1,
"entity": "静脉给药",
"start_offset": 14,
"end_offset": 18,
"label": "pro"
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{
"id": 2,
"entity": "静脉",
"start_offset": 22,
"end_offset": 24,
"label": "bod"
},
{
"id": 3,
"entity": "气管内给药",
"start_offset": 32,
"end_offset": 37,
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},
{
"id": 4,
"entity": "肺毛细血管",
"start_offset": 40,
"end_offset": 45,
"label": "bod"
},
{
"id": 5,
"entity": "心脏",
"start_offset": 57,
"end_offset": 59,
"label": "bod"
}
] |
此外，气管内给药不必中止心外按压，亦不易引起并发症。 | [
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"id": 0,
"entity": "气管内给药",
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"label": "pro"
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{
"id": 1,
"entity": "心外按压",
"start_offset": 12,
"end_offset": 16,
"label": "pro"
}
] |
肾上腺素、异丙肾上腺素、阿托品、利多卡因等均可气管内给药，采用生理盐水稀释，根据患儿年龄大小每次剂量1～5ml。 | [
{
"id": 0,
"entity": "肾上腺素",
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{
"id": 1,
"entity": "异丙肾上腺素",
"start_offset": 5,
"end_offset": 11,
"label": "dru"
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{
"id": 2,
"entity": "阿托品",
"start_offset": 12,
"end_offset": 15,
"label": "dru"
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{
"id": 3,
"entity": "利多卡因",
"start_offset": 16,
"end_offset": 20,
"label": "dru"
},
{
"id": 4,
"entity": "气管内给药",
"start_offset": 23,
"end_offset": 28,
"label": "pro"
},
{
"id": 5,
"entity": "生理盐水",
"start_offset": 31,
"end_offset": 35,
"label": "dru"
}
] |
心内注射虽然给药效果确切，但干扰胸部按压，难以准确注入心室，并可导致心肌、冠脉损伤，已不主张使用。 | [
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"id": 0,
"entity": "心内注射",
"start_offset": 0,
"end_offset": 4,
"label": "pro"
},
{
"id": 1,
"entity": "给药",
"start_offset": 6,
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"label": "pro"
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{
"id": 2,
"entity": "胸部按压",
"start_offset": 16,
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{
"id": 3,
"entity": "心室",
"start_offset": 27,
"end_offset": 29,
"label": "bod"
},
{
"id": 4,
"entity": "心肌、冠脉损伤",
"start_offset": 34,
"end_offset": 41,
"label": "dis"
}
] |
2005年新指南仍强调并推荐骨髓给药，若静脉穿刺3次失败或90秒内未能建立可靠的静脉通道，可使用骨髓给药。 | [
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"id": 0,
"entity": "骨髓给药",
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"end_offset": 18,
"label": "pro"
},
{
"id": 1,
"entity": "静脉穿刺",
"start_offset": 20,
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"label": "pro"
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{
"id": 2,
"entity": "静脉",
"start_offset": 40,
"end_offset": 42,
"label": "bod"
},
{
"id": 3,
"entity": "骨髓给药",
"start_offset": 48,
"end_offset": 52,
"label": "pro"
}
] |
【抢救时机的选择】CPCR的对象是各种原因引起的呼吸、心搏骤停患儿，经过基本生命支持和进一步生命支持后，患儿呼吸、心跳恢复，并不意味着CPCR成功，小儿脑复苏是CPCR最终达到的目的，只有脑功能得到完全恢复，才能说是CPCR成功，脑复苏不能使已死亡的脑细胞复活、再生，但能保护尚未发生不可逆损害的脑细胞，阻止其病理过程的发展。 | [
{
"id": 0,
"entity": "CPCR",
"start_offset": 9,
"end_offset": 13,
"label": "pro"
},
{
"id": 1,
"entity": "呼吸、心搏骤停",
"start_offset": 24,
"end_offset": 31,
"label": "dis"
},
{
"id": 2,
"entity": "基本生命支持",
"start_offset": 36,
"end_offset": 42,
"label": "pro"
},
{
"id": 3,
"entity": "进一步生命支持",
"start_offset": 43,
"end_offset": 50,
"label": "pro"
},
{
"id": 4,
"entity": "呼吸、心跳恢复",
"start_offset": 54,
"end_offset": 61,
"label": "sym"
},
{
"id": 5,
"entity": "CPCR",
"start_offset": 67,
"end_offset": 71,
"label": "pro"
},
{
"id": 6,
"entity": "脑复苏",
"start_offset": 76,
"end_offset": 79,
"label": "pro"
},
{
"id": 7,
"entity": "CPCR",
"start_offset": 80,
"end_offset": 84,
"label": "pro"
},
{
"id": 8,
"entity": "脑",
"start_offset": 94,
"end_offset": 95,
"label": "bod"
},
{
"id": 9,
"entity": "CPCR",
"start_offset": 108,
"end_offset": 112,
"label": "pro"
},
{
"id": 10,
"entity": "脑复苏",
"start_offset": 115,
"end_offset": 118,
"label": "pro"
},
{
"id": 11,
"entity": "脑细胞",
"start_offset": 125,
"end_offset": 128,
"label": "bod"
},
{
"id": 12,
"entity": "脑细胞",
"start_offset": 148,
"end_offset": 151,
"label": "bod"
}
] |
因此，脑功能在CPCR中是否能完全恢复，目前已作为复苏成功的首要评价标准。 | [
{
"id": 0,
"entity": "脑",
"start_offset": 3,
"end_offset": 4,
"label": "bod"
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{
"id": 1,
"entity": "CPCR",
"start_offset": 7,
"end_offset": 11,
"label": "pro"
},
{
"id": 2,
"entity": "复苏",
"start_offset": 25,
"end_offset": 27,
"label": "pro"
}
] |
心搏骤停的时间直接影响脑复苏的成功率。 | [
{
"id": 0,
"entity": "心搏骤停",
"start_offset": 0,
"end_offset": 4,
"label": "sym"
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{
"id": 1,
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"start_offset": 11,
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"label": "pro"
}
] |
一般心搏骤停10～15秒可引起缺氧晕厥脑，＞15秒可发生抽搐，30～40秒呼吸停止、瞳孔扩大，3～5分钟严重脑损害，＞10分钟无成活希望。 | [
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{
"id": 1,
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"entity": "脑损害",
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] |
因此，最关键的抢救时机是最初1～4分钟，并应及早实施脑复苏。 | [
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] |
应尽早恢复有效脑灌注，要早期给药，并且联合用药优于单一用药。 | [
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{
"id": 1,
"entity": "早期给药",
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心肺脑复苏早期成功的征象为：①瞳孔缩小和对光反射恢复；②睫毛反射出现；③肌张力增强甚至出现不自主运动；④自主呼吸恢复。 | [
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"entity": "对光反射恢复",
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"entity": "肌张力",
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"entity": "肌张力增强",
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},
{
"id": 7,
"entity": "不自主运动",
"start_offset": 45,
"end_offset": 50,
"label": "sym"
}
] |
【死亡概念的新认识】心、肺、脑复苏的患儿有4种结果：①完全恢复，不留任何后遗症；②部分恢复，但留有系统后遗症；③去大脑皮层综合征，即植物状态；④脑死亡。 | [
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{
"id": 1,
"entity": "心、肺、脑复苏",
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"entity": "脑死亡",
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] |
死亡是生命的永久丧失，但确定死亡并非简单。 | [
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长期以来，人们都把心跳和呼吸停止作为死亡的征象，然而现代医学的发展使死亡的观点发生了根本改变。 | [
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目前，通过现代医疗技术即使患者在脑神经细胞的综合功能完全丧失的情况下（脑死亡），也能维持患者脑外器官（呼吸和心跳）的生活能力。 | [
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{
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"entity": "脑外器官",
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因此，现代医学认为脑的状态是确定死亡的可靠而根本的指标。 | [
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脑死亡概念是1968年美国哈佛大学医学院首先提出的，随后世界各国都作出了不同的诊断标准。 | [
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脑死亡的现代定义是指脑神经细胞的综合功能完全的、永久的丧失，即大脑皮层、脑干的全部脑功能完全的、永久的丧失，此时不论心跳、呼吸和脊髓功能是否存在。 | [
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{
"id": 1,
"entity": "大脑皮层",
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{
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"entity": "脑干",
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{
"id": 4,
"entity": "脊髓",
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"end_offset": 66,
"label": "bod"
}
] |
在脑死亡后继续进行重症支持以维护患者脑外器官（呼吸和心跳）的生活能力是可能的，但只是毫无意义的浪费，并给国家、家庭和个人带来沉重的负担，当今国际上只有两种情况（器官移植供体捐赠者和妊娠妇女脑死亡后胎儿仍然活着）可考虑继续进行重症支持。 | [
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"entity": "重症支持",
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"label": "pro"
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{
"id": 1,
"entity": "维护患者脑外器官（呼吸和心跳）的生活能力",
"start_offset": 14,
"end_offset": 34,
"label": "pro"
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"id": 2,
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{
"id": 3,
"entity": "重症支持",
"start_offset": 112,
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"label": "pro"
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] |
我国目前尚无脑死亡标准和法规，大多参考美国哈佛大学脑死亡标准和美国国立疾病（NIR）及卒中研究所（NINDS）制定的脑死亡标准（表6-6及表6-8），对下述情况经家属同意后可考虑停止复苏：①CPCR前心跳呼吸停止15分钟以上；②心肺复苏30分钟以上心跳仍未恢复或进一步生命支持10分钟以上仍无心电活动；③已知为终末期疾病。 | [
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{
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{
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{
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},
{
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"entity": "进一步生命支持",
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] |
表6-7美国哈佛大学脑死亡标准表6-8美国国立疾病（NIR）及卒中研究所（NIND脑死亡制定的脑死亡标准植物状态是持久的意识丧失，又称无脑综合征，代表着一种生与死亡间的状脑死亡它既非脑死亡，但意识又永远不能恢复。 | [
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{
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{
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{
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{
"id": 4,
"entity": "脑死亡",
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"label": "dis"
}
] |
其表现包括：①无意识活动，不能执行指令；②保持自主呼吸和血压；③有睡眠觉醒周期；④不能理解或表达语言；⑤能自动睁眼或在刺激下睁眼；⑥丘脑下部及脑干功能基本保持；⑦可有无目的性眼球跟踪运动。 | [
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{
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{
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{
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{
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{
"id": 9,
"entity": "眼球",
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{
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"entity": "目的性眼球跟踪运动",
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"end_offset": 93,
"label": "sym"
}
] |
植物状态持续1个月以上即人们通常说的植物人。 | [
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植物人与脑死亡有本质的区别，植物状态患者其低级神经中枢的功能尚存，而高级神经中枢的功能已经丧失，而脑死亡为全脑的完全性死亡，无任何中枢的功能存在。 | [
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{
"id": 1,
"entity": "低级神经中枢",
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{
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"entity": "高级神经中枢",
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{
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{
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},
{
"id": 5,
"entity": "中枢",
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] |
确定脑死亡。 | [
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] |
确定脑死亡标准有助于决定在什么时候可宣布患儿死亡，什么时候不值得去延长一个人的生物学生命。 | [
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] |
我国目前尚无明确的关于死亡标准的法律规定，有很多工作尚待完成。 | [
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] |
第四章呼吸系统疾病的临床诊断和检查技术第一节影像诊断技术一、影像检查方法传统的胸部X线平片仍为检查胸部疾病的基本方法，以胸部平片检查为起点，也可采用其他特殊体位，如斜位、侧位、前弓位、高千伏摄影，卧位水平位、侧位水平位。 | [
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{
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{
"id": 3,
"entity": "胸部平片",
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] |
其他检查方法包括透视、食管造影、肺血管造影、支气管造影、CT和MRI等。 | [
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] |
CT可得到横断面的高质量图像，与常规技术比较，其密度分辨率高，可显示小病灶，测量CT值可决定某些组织的特性（如脂肪、钙化、液体等）。 | [
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目前CT已发展到多排CT（16排、32排等），这有利于多层面及三维的重建，现在CT应用到肺部来越普遍。 | [
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对不合作的小儿应镇静，让他（她）睡熟后再扫描，小婴儿层厚5mm，年长儿层厚10mm，对感兴趣处可选择2～3mm，甚至1mm，增强扫描可使血管和某些病灶密度增高，同时提高各种正常组织与病理组织密度差异，有利于病变的检查、病灶性质和范围的判断。 | [
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使用造影剂一般选择非离子造影剂为宜，参考剂量为1～2ml/kg。 | [
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瑞氏综合征@第十七章瑞氏综合征瑞氏综合征（Reye综合征，Reye’ssyndrome，RS），又名脑病伴内脏脂肪变性，由澳大利亚小儿病理学家Reye等于1963年首先报道，以急性脑病和肝脏脂肪变性为主要临床特征。 | [
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{
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{
"id": 8,
"entity": "肝脏脂肪变性",
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}
] |
瑞氏综合征@RS是儿科的一种危重疾患，常在前驱病毒感染后发生，服用水杨酸制剂和其发病密切相关。 | [
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"id": 0,
"entity": "瑞氏综合征",
"start_offset": 0,
"end_offset": 5,
"label": "dis"
},
{
"id": 1,
"entity": "RS",
"start_offset": 6,
"end_offset": 8,
"label": "dis"
},
{
"id": 2,
"entity": "病毒感染",
"start_offset": 23,
"end_offset": 27,
"label": "dis"
},
{
"id": 3,
"entity": "水杨酸制剂",
"start_offset": 33,
"end_offset": 38,
"label": "dru"
}
] |
瑞氏综合征@常见表现为急性颅内压增高意识障碍和惊厥等脑病症状，并出现肝功能异常、低血糖、高氨血症和其他代谢紊乱。 | [
{
"id": 0,
"entity": "瑞氏综合征",
"start_offset": 0,
"end_offset": 5,
"label": "dis"
},
{
"id": 1,
"entity": "颅内压",
"start_offset": 13,
"end_offset": 16,
"label": "ite"
},
{
"id": 2,
"entity": "急性颅内压增高",
"start_offset": 11,
"end_offset": 18,
"label": "sym"
},
{
"id": 3,
"entity": "意识障碍",
"start_offset": 18,
"end_offset": 22,
"label": "sym"
},
{
"id": 4,
"entity": "惊厥",
"start_offset": 23,
"end_offset": 25,
"label": "sym"
},
{
"id": 5,
"entity": "肝功能异常",
"start_offset": 34,
"end_offset": 39,
"label": "sym"
},
{
"id": 6,
"entity": "低血糖",
"start_offset": 40,
"end_offset": 43,
"label": "sym"
},
{
"id": 7,
"entity": "高氨血症",
"start_offset": 44,
"end_offset": 48,
"label": "sym"
}
] |
瑞氏综合征@多数病例预后不良，因严重颅内压增高及脑疝致死，或遗留严重的神经系统后遗症。 | [
{
"id": 0,
"entity": "瑞氏综合征",
"start_offset": 0,
"end_offset": 5,
"label": "dis"
},
{
"id": 1,
"entity": "严重颅内压增高",
"start_offset": 16,
"end_offset": 23,
"label": "dis"
},
{
"id": 2,
"entity": "脑疝",
"start_offset": 24,
"end_offset": 26,
"label": "dis"
},
{
"id": 3,
"entity": "神经系统后遗症",
"start_offset": 35,
"end_offset": 42,
"label": "sym"
}
] |
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