text stringlengths 4 4.87k | entities list |
|---|---|
一般停药3～6个月后，因LAM作用消除而病情复发，将LAM与IFN-α联合应用，可更早获得疗效。 | [
{
"id": 0,
"entity": "LAM",
"start_offset": 12,
"end_offset": 15,
"label": "dru"
},
{
"id": 1,
"entity": "LAM",
"start_offset": 26,
"end_offset": 29,
"label": "dru"
}
] |
3.其他药物①阿地福韦（adefovir，ADV）用于治疗LAM耐药的HBV变异株感染。 | [
{
"id": 0,
"entity": "阿地福韦",
"start_offset": 7,
"end_offset": 11,
"label": "dru"
},
{
"id": 1,
"entity": "adefovir",
"start_offset": 12,
"end_offset": 20,
"label": "dru"
},
{
"id": 2,
"entity": "ADV",
"start_offset": 21,
"end_offset": 24,
"label": "dru"
},
{
"id": 3,
"entity": "LAM",
"start_offset": 29,
"end_offset": 32,
"label": "dru"
},
{
"id": 4,
"entity": "HBV变异株感染",
"start_offset": 35,
"end_offset": 43,
"label": "dis"
}
] |
②胸腺素α1</sub>（Tα1</sub>）通过诱导和促进细胞免疫而清除病毒，其不良反应极小，12～16岁儿童1.6mg皮下注射，每周2次，共6个月。 | [
{
"id": 0,
"entity": "胸腺素α1",
"start_offset": 1,
"end_offset": 6,
"label": "dru"
},
{
"id": 1,
"entity": "细胞",
"start_offset": 30,
"end_offset": 32,
"label": "bod"
},
{
"id": 2,
"entity": "病毒",
"start_offset": 37,
"end_offset": 39,
"label": "mic"
},
{
"id": 3,
"entity": "皮下注射",
"start_offset": 61,
"end_offset": 65,
"label": "pro"
}
] |
患者能很好耐受，适于对IFN和LAM不能耐受者和重型肝炎，可用于联合治疗。 | [
{
"id": 0,
"entity": "IFN",
"start_offset": 11,
"end_offset": 14,
"label": "dru"
},
{
"id": 1,
"entity": "LAM",
"start_offset": 15,
"end_offset": 18,
"label": "dru"
},
{
"id": 2,
"entity": "重型肝炎",
"start_offset": 24,
"end_offset": 28,
"label": "dis"
}
] |
4.肝移植国外对慢性失代偿性乙肝患者采用肝移植和LAM联合治疗（移植后持续服用LAM），5年存活率可达95%以上。 | [
{
"id": 0,
"entity": "肝移植",
"start_offset": 2,
"end_offset": 5,
"label": "pro"
},
{
"id": 1,
"entity": "慢性失代偿性乙肝",
"start_offset": 8,
"end_offset": 16,
"label": "dis"
},
{
"id": 2,
"entity": "肝移植",
"start_offset": 20,
"end_offset": 23,
"label": "pro"
},
{
"id": 3,
"entity": "LAM联合治疗",
"start_offset": 24,
"end_offset": 31,
"label": "pro"
}
] |
六、幼年性纤维瘤病幼年性纤维瘤病又称硬纤维瘤，是一种局部侵袭性纤维瘤，1838年Muller初次报道。 | [
{
"id": 0,
"entity": "幼年性纤维瘤病",
"start_offset": 2,
"end_offset": 9,
"label": "dis"
},
{
"id": 1,
"entity": "幼年性纤维瘤病",
"start_offset": 9,
"end_offset": 16,
"label": "dis"
},
{
"id": 2,
"entity": "硬纤维瘤",
"start_offset": 18,
"end_offset": 22,
"label": "dis"
},
{
"id": 3,
"entity": "局部侵袭性纤维瘤",
"start_offset": 26,
"end_offset": 34,
"label": "dis"
}
] |
有人认为本病是先天性肿瘤，也有人认为与雌性激素有关，还有人认为与遗传缺陷有关，总之，发病机制尚不完全清楚。 | [
{
"id": 0,
"entity": "肿瘤",
"start_offset": 10,
"end_offset": 12,
"label": "dis"
},
{
"id": 1,
"entity": "雌性激素",
"start_offset": 19,
"end_offset": 23,
"label": "bod"
},
{
"id": 2,
"entity": "遗传缺陷",
"start_offset": 32,
"end_offset": 36,
"label": "dis"
}
] |
镜下肿瘤为梭形的成熟成纤维细胞组成，被或多或少的胶原梭包围，可见成纤维细胞的核仁，但无明显的有丝分裂。 | [
{
"id": 0,
"entity": "镜",
"start_offset": 0,
"end_offset": 1,
"label": "equ"
},
{
"id": 1,
"entity": "肿瘤",
"start_offset": 2,
"end_offset": 4,
"label": "dis"
},
{
"id": 2,
"entity": "纤维细胞",
"start_offset": 11,
"end_offset": 15,
"label": "bod"
},
{
"id": 3,
"entity": "胶原梭",
"start_offset": 24,
"end_offset": 27,
"label": "bod"
},
{
"id": 4,
"entity": "成纤维细胞",
"start_offset": 32,
"end_offset": 37,
"label": "bod"
}
] |
不同部位的肿瘤表现不同。 | [
{
"id": 0,
"entity": "肿瘤",
"start_offset": 5,
"end_offset": 7,
"label": "dis"
}
] |
肿瘤表面皮肤正常，不与肿瘤黏附，可活动。 | [
{
"id": 0,
"entity": "肿瘤",
"start_offset": 0,
"end_offset": 2,
"label": "dis"
},
{
"id": 1,
"entity": "皮肤",
"start_offset": 4,
"end_offset": 6,
"label": "bod"
},
{
"id": 2,
"entity": "肿瘤",
"start_offset": 11,
"end_offset": 13,
"label": "dis"
}
] |
多在腹直肌前鞘的后面，与后鞘融合，且与腹横肌紧密附着。 | [
{
"id": 0,
"entity": "腹直肌前鞘",
"start_offset": 2,
"end_offset": 7,
"label": "bod"
},
{
"id": 1,
"entity": "后鞘",
"start_offset": 12,
"end_offset": 14,
"label": "bod"
}
] |
肿瘤质地非常坚硬，无痛，边界不清楚，无全身症状。 | [
{
"id": 0,
"entity": "肿瘤",
"start_offset": 0,
"end_offset": 2,
"label": "dis"
}
] |
手术切除是主要的治疗方法。 | [
{
"id": 0,
"entity": "手术切除",
"start_offset": 0,
"end_offset": 4,
"label": "pro"
}
] |
切除要彻底，一般要切除包括肿瘤边缘1～2cm正常组织，因为如有残留必定复发。 | [
{
"id": 0,
"entity": "肿瘤",
"start_offset": 13,
"end_offset": 15,
"label": "dis"
},
{
"id": 1,
"entity": "组织",
"start_offset": 24,
"end_offset": 26,
"label": "bod"
}
] |
本瘤的复发率为50%～70%，应该争取再次手术切除，而且对复发病例，应加以放疗，对所有病例应长期随访。 | [
{
"id": 0,
"entity": "手术切除",
"start_offset": 21,
"end_offset": 25,
"label": "pro"
}
] |
四、腹膜透析的并发症（一）与技术有关的并发症主要为透析管道故障，多发生于插管后40天以内，40天后的并发症多为腹膜炎引起。 | [
{
"id": 0,
"entity": "腹膜透析",
"start_offset": 2,
"end_offset": 6,
"label": "pro"
},
{
"id": 1,
"entity": "透析管道故障",
"start_offset": 25,
"end_offset": 31,
"label": "dis"
},
{
"id": 2,
"entity": "腹膜炎",
"start_offset": 55,
"end_offset": 58,
"label": "dis"
}
] |
1.透析液外漏透析液沿管道自皮肤出口或皮肤切口漏出。 | [
{
"id": 0,
"entity": "透析液",
"start_offset": 2,
"end_offset": 5,
"label": "dru"
},
{
"id": 1,
"entity": "透析液",
"start_offset": 7,
"end_offset": 10,
"label": "dru"
},
{
"id": 2,
"entity": "皮肤",
"start_offset": 14,
"end_offset": 16,
"label": "bod"
},
{
"id": 3,
"entity": "皮肤",
"start_offset": 19,
"end_offset": 21,
"label": "bod"
}
] |
多因腹膜切口过大以及缝合不严所致，腹壁松弛、应用糖皮质激素药物期间易于发生。 | [
{
"id": 0,
"entity": "腹膜",
"start_offset": 2,
"end_offset": 4,
"label": "bod"
},
{
"id": 1,
"entity": "腹壁",
"start_offset": 17,
"end_offset": 19,
"label": "bod"
},
{
"id": 2,
"entity": "糖皮质激素",
"start_offset": 24,
"end_offset": 29,
"label": "dru"
}
] |
插管术中严密缝合腹膜，术后5～14天才开始透析可以避免。 | [
{
"id": 0,
"entity": "插管术",
"start_offset": 0,
"end_offset": 3,
"label": "pro"
},
{
"id": 1,
"entity": "腹膜",
"start_offset": 8,
"end_offset": 10,
"label": "bod"
},
{
"id": 2,
"entity": "透析",
"start_offset": 21,
"end_offset": 23,
"label": "pro"
}
] |
一旦漏液发生后应排空透析液，停止透析1～2天，防止延迟愈合的因素如腹肌过度活动，一般休息数日后漏液自行停止。 | [
{
"id": 0,
"entity": "透析液",
"start_offset": 10,
"end_offset": 13,
"label": "dru"
},
{
"id": 1,
"entity": "透析",
"start_offset": 16,
"end_offset": 18,
"label": "pro"
},
{
"id": 2,
"entity": "腹肌",
"start_offset": 33,
"end_offset": 35,
"label": "bod"
}
] |
2.透析液引流不畅原因有：透析管端移位、漂浮，表现为单向阻滞；腹膜炎后形成纤维蛋白块，堵塞管道，透析液出入不畅，以排出不畅为主；腹膜粘连透析管周围形成包裹，表现为输入透析液不久患者即感腹痛，X线造影可确诊；腹腔内进入空气、肠胀气以及便秘等亦可导致透析液引流不畅。 | [
{
"id": 0,
"entity": "透析液",
"start_offset": 2,
"end_offset": 5,
"label": "dru"
},
{
"id": 1,
"entity": "透析管",
"start_offset": 13,
"end_offset": 16,
"label": "equ"
},
{
"id": 2,
"entity": "腹膜炎",
"start_offset": 31,
"end_offset": 34,
"label": "dis"
},
{
"id": 3,
"entity": "纤维蛋白块",
"start_offset": 37,
"end_offset": 42,
"label": "bod"
},
{
"id": 4,
"entity": "透析液",
"start_offset": 48,
"end_offset": 51,
"label": "dru"
},
{
"id": 5,
"entity": "腹膜",
"start_offset": 64,
"end_offset": 66,
"label": "bod"
},
{
"id": 6,
"entity": "腹膜粘连",
"start_offset": 64,
"end_offset": 68,
"label": "sym"
},
{
"id": 7,
"entity": "透析管",
"start_offset": 68,
"end_offset": 71,
"label": "equ"
},
{
"id": 8,
"entity": "透析液",
"start_offset": 83,
"end_offset": 86,
"label": "dru"
},
{
"id": 9,
"entity": "腹痛",
"start_offset": 92,
"end_offset": 94,
"label": "sym"
},
{
"id": 10,
"entity": "腹腔",
"start_offset": 103,
"end_offset": 105,
"label": "bod"
},
{
"id": 11,
"entity": "肠胀气",
"start_offset": 111,
"end_offset": 114,
"label": "sym"
},
{
"id": 12,
"entity": "便秘",
"start_offset": 116,
"end_offset": 118,
"label": "sym"
},
{
"id": 13,
"entity": "透析液",
"start_offset": 123,
"end_offset": 126,
"label": "dru"
}
] |
应根据临床表现，结合X线检查，明确导致引流不畅的原因，分别处理。 | [
{
"id": 0,
"entity": "X线检查",
"start_offset": 10,
"end_offset": 14,
"label": "pro"
}
] |
遇到凝块堵塞，可用加有肝素以及尿激酶的生理盐水冲洗，应用尼龙丝线或细探针疏导。 | [
{
"id": 0,
"entity": "有肝素以及尿激酶的生理盐水",
"start_offset": 10,
"end_offset": 23,
"label": "dru"
},
{
"id": 1,
"entity": "尼龙丝线",
"start_offset": 28,
"end_offset": 32,
"label": "equ"
},
{
"id": 2,
"entity": "细探针",
"start_offset": 33,
"end_offset": 36,
"label": "equ"
}
] |
此外，腹部按摩以及灌肠可收效。 | [
{
"id": 0,
"entity": "腹部",
"start_offset": 3,
"end_offset": 5,
"label": "bod"
},
{
"id": 1,
"entity": "灌肠",
"start_offset": 9,
"end_offset": 11,
"label": "pro"
}
] |
若上述措施无效，则需要更换透析管。 | [
{
"id": 0,
"entity": "透析管",
"start_offset": 13,
"end_offset": 16,
"label": "equ"
}
] |
（二）透析引起的继发性并发症1.腹膜炎儿童腹膜透析最常见的并发症是腹膜炎，其发生率为每13.4病人月发作一次，是导致腹透失败的常见原因。 | [
{
"id": 0,
"entity": "透析",
"start_offset": 3,
"end_offset": 5,
"label": "pro"
},
{
"id": 1,
"entity": "腹膜炎",
"start_offset": 16,
"end_offset": 19,
"label": "dis"
},
{
"id": 2,
"entity": "腹膜透析",
"start_offset": 21,
"end_offset": 25,
"label": "pro"
},
{
"id": 3,
"entity": "腹膜炎",
"start_offset": 33,
"end_offset": 36,
"label": "dis"
},
{
"id": 4,
"entity": "腹透",
"start_offset": 58,
"end_offset": 60,
"label": "pro"
}
] |
但最近由于先进的连接系统和自动腹膜透析机的使用，使儿童腹膜炎的发生大为减少，报道已减至30～50个病人月发生一次。 | [
{
"id": 0,
"entity": "自动腹膜透析机",
"start_offset": 13,
"end_offset": 20,
"label": "equ"
},
{
"id": 1,
"entity": "腹膜炎",
"start_offset": 27,
"end_offset": 30,
"label": "dis"
}
] |
儿童腹膜炎最常见的细菌为革兰阳性球菌，达60%～70%，如金黄色葡萄球菌，其次是表皮葡萄球菌。 | [
{
"id": 0,
"entity": "儿童腹膜炎",
"start_offset": 0,
"end_offset": 5,
"label": "dis"
},
{
"id": 1,
"entity": "革兰阳性球菌",
"start_offset": 12,
"end_offset": 18,
"label": "mic"
},
{
"id": 2,
"entity": "金黄色葡萄球菌",
"start_offset": 29,
"end_offset": 36,
"label": "mic"
},
{
"id": 3,
"entity": "表皮葡萄球菌",
"start_offset": 40,
"end_offset": 46,
"label": "mic"
}
] |
革兰阴性杆菌约占20%～30%，真菌感染约占3%～5%。 | [
{
"id": 0,
"entity": "革兰阴性杆菌",
"start_offset": 0,
"end_offset": 6,
"label": "mic"
},
{
"id": 1,
"entity": "真菌",
"start_offset": 16,
"end_offset": 18,
"label": "mic"
}
] |
当腹透液白细胞总数＞100/ml，多形核大于50%，要考虑腹膜炎的诊断。 | [
{
"id": 0,
"entity": "腹透液",
"start_offset": 1,
"end_offset": 4,
"label": "dru"
},
{
"id": 1,
"entity": "腹膜炎",
"start_offset": 29,
"end_offset": 32,
"label": "dis"
}
] |
体温升高常为最早表现，随之出现腹透液混浊、腹痛，同时伴有消化道症状如恶心、呕吐。 | [
{
"id": 0,
"entity": "腹透液",
"start_offset": 15,
"end_offset": 18,
"label": "dru"
},
{
"id": 1,
"entity": "腹痛",
"start_offset": 21,
"end_offset": 23,
"label": "sym"
},
{
"id": 2,
"entity": "恶心",
"start_offset": 34,
"end_offset": 36,
"label": "sym"
},
{
"id": 3,
"entity": "呕吐",
"start_offset": 37,
"end_offset": 39,
"label": "sym"
}
] |
腹透液革兰染色和细菌培养可协助诊断并提供抗生素治疗选择依据。 | [
{
"id": 0,
"entity": "腹透液革兰染色",
"start_offset": 0,
"end_offset": 7,
"label": "pro"
},
{
"id": 1,
"entity": "细菌培养",
"start_offset": 8,
"end_offset": 12,
"label": "pro"
},
{
"id": 2,
"entity": "抗生素",
"start_offset": 20,
"end_offset": 23,
"label": "dru"
}
] |
由于患儿的腹膜表面积大，通透性高，腹腔内给抗生素能快速经腹膜吸收，局部药物浓度高。 | [
{
"id": 0,
"entity": "腹膜",
"start_offset": 5,
"end_offset": 7,
"label": "bod"
},
{
"id": 1,
"entity": "腹腔",
"start_offset": 17,
"end_offset": 19,
"label": "bod"
},
{
"id": 2,
"entity": "抗生素",
"start_offset": 21,
"end_offset": 24,
"label": "dru"
},
{
"id": 3,
"entity": "腹膜",
"start_offset": 28,
"end_offset": 30,
"label": "bod"
}
] |
但＜2岁婴儿，是需作血培养除外有无败血症并及时给予全身抗生素治疗，抗生素治疗时间一般为培养阴性后再持续7天，总疗程约14～21天。 | [
{
"id": 0,
"entity": "血培养",
"start_offset": 10,
"end_offset": 13,
"label": "pro"
},
{
"id": 1,
"entity": "败血症",
"start_offset": 17,
"end_offset": 20,
"label": "dis"
},
{
"id": 2,
"entity": "全身抗生素治疗",
"start_offset": 25,
"end_offset": 32,
"label": "pro"
},
{
"id": 3,
"entity": "抗生素治疗",
"start_offset": 33,
"end_offset": 38,
"label": "pro"
}
] |
真菌性腹膜炎的抗真菌治疗效果较差，若应用两性霉素B或5-氟胞嘧啶等药物治疗10天后无效，可考虑拔除腹透管，拔管后继续抗真菌治疗10天。 | [
{
"id": 0,
"entity": "真菌性腹膜炎",
"start_offset": 0,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "抗真菌治疗",
"start_offset": 7,
"end_offset": 12,
"label": "pro"
},
{
"id": 2,
"entity": "两性霉素B",
"start_offset": 20,
"end_offset": 25,
"label": "dru"
},
{
"id": 3,
"entity": "5-氟胞嘧啶",
"start_offset": 26,
"end_offset": 32,
"label": "dru"
},
{
"id": 4,
"entity": "腹透管",
"start_offset": 49,
"end_offset": 52,
"label": "equ"
},
{
"id": 5,
"entity": "抗真菌治疗",
"start_offset": 58,
"end_offset": 63,
"label": "pro"
}
] |
2.腹透管外口及腹透管皮下隧道感染为儿童腹透常见并发症之一，腹透管外口感染表现为外口充血、皮肤炎症以及有脓性分泌物。 | [
{
"id": 0,
"entity": "腹透管",
"start_offset": 2,
"end_offset": 5,
"label": "equ"
},
{
"id": 1,
"entity": "腹透管",
"start_offset": 8,
"end_offset": 11,
"label": "equ"
},
{
"id": 2,
"entity": "腹透",
"start_offset": 20,
"end_offset": 22,
"label": "pro"
},
{
"id": 3,
"entity": "腹透管",
"start_offset": 30,
"end_offset": 33,
"label": "equ"
},
{
"id": 4,
"entity": "外口充血",
"start_offset": 40,
"end_offset": 44,
"label": "sym"
},
{
"id": 5,
"entity": "皮肤炎症",
"start_offset": 45,
"end_offset": 49,
"label": "sym"
},
{
"id": 6,
"entity": "有脓性分泌物",
"start_offset": 51,
"end_offset": 57,
"label": "sym"
}
] |
分泌物培养阴性不能否定感染，培养阳性而无炎症时则可以否定感染的存在。 | [
{
"id": 0,
"entity": "分泌物培养",
"start_offset": 0,
"end_offset": 5,
"label": "pro"
},
{
"id": 1,
"entity": "感染",
"start_offset": 11,
"end_offset": 13,
"label": "dis"
},
{
"id": 2,
"entity": "炎症",
"start_offset": 20,
"end_offset": 22,
"label": "dis"
}
] |
感染可以单独存在，但常常伴有皮下隧道感染。 | [
{
"id": 0,
"entity": "感染",
"start_offset": 0,
"end_offset": 2,
"label": "dis"
},
{
"id": 1,
"entity": "皮下隧道感染",
"start_offset": 14,
"end_offset": 20,
"label": "dis"
}
] |
皮下隧道感染表现为炎症累及涤纶套，皮肤充血，隧道沿途触痛、周围有蜂窝织炎。 | [
{
"id": 0,
"entity": "皮下隧道感染",
"start_offset": 0,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "炎症累及涤纶套",
"start_offset": 9,
"end_offset": 16,
"label": "sym"
},
{
"id": 2,
"entity": "皮肤充血",
"start_offset": 17,
"end_offset": 21,
"label": "sym"
}
] |
当有以下指征时，要考虑拔除PD管：真菌性腹膜炎；伴PD管皮肤出口或皮下隧道感染，治疗无效；同一病菌引起反复发作的腹膜炎。 | [
{
"id": 0,
"entity": "PD管",
"start_offset": 13,
"end_offset": 16,
"label": "equ"
},
{
"id": 1,
"entity": "真菌性腹膜炎",
"start_offset": 17,
"end_offset": 23,
"label": "dis"
},
{
"id": 2,
"entity": "伴PD管皮肤出口或皮下隧道感染",
"start_offset": 24,
"end_offset": 39,
"label": "dis"
},
{
"id": 3,
"entity": "腹膜炎",
"start_offset": 56,
"end_offset": 59,
"label": "dis"
}
] |
拔除PD管后若有必要，可在1～3周后重新置管。 | [
{
"id": 0,
"entity": "PD管",
"start_offset": 2,
"end_offset": 5,
"label": "equ"
}
] |
3.非感染性并发症随着PD感染性并发症的逐渐减少，非感染性并发症日益受到重视。 | [
{
"id": 0,
"entity": "非感染性并发症",
"start_offset": 2,
"end_offset": 9,
"label": "dis"
},
{
"id": 1,
"entity": "PD感染性并发症",
"start_offset": 11,
"end_offset": 19,
"label": "dis"
},
{
"id": 2,
"entity": "非感染性并发症",
"start_offset": 25,
"end_offset": 32,
"label": "dis"
}
] |
其发生主要与腹内压升高、长期透析对腹膜的非生理性影响和对全身代谢的影响有关：①蛋白质和氨基酸、维生素的丢失。 | [
{
"id": 0,
"entity": "腹内压",
"start_offset": 6,
"end_offset": 9,
"label": "ite"
},
{
"id": 1,
"entity": "透析",
"start_offset": 14,
"end_offset": 16,
"label": "pro"
},
{
"id": 2,
"entity": "腹膜",
"start_offset": 17,
"end_offset": 19,
"label": "bod"
},
{
"id": 3,
"entity": "蛋白质",
"start_offset": 39,
"end_offset": 42,
"label": "bod"
},
{
"id": 4,
"entity": "氨基酸",
"start_offset": 43,
"end_offset": 46,
"label": "bod"
},
{
"id": 5,
"entity": "维生素",
"start_offset": 47,
"end_offset": 50,
"label": "bod"
}
] |
PD中难免要丢失体内的营养物质，蛋白质丢失的多少与血清蛋白质浓度、体表面积以及腹膜的通透性有关。 | [
{
"id": 0,
"entity": "PD",
"start_offset": 0,
"end_offset": 2,
"label": "pro"
},
{
"id": 1,
"entity": "蛋白质",
"start_offset": 16,
"end_offset": 19,
"label": "bod"
},
{
"id": 2,
"entity": "血清蛋白质浓度",
"start_offset": 25,
"end_offset": 32,
"label": "ite"
},
{
"id": 3,
"entity": "体表",
"start_offset": 33,
"end_offset": 35,
"label": "bod"
},
{
"id": 4,
"entity": "腹膜",
"start_offset": 39,
"end_offset": 41,
"label": "bod"
}
] |
在CAPD开始2周内，每日经透析液丢失蛋白质15～20g，以后丢失量减少，平均每日丢失5～11g，其中以白蛋白为主。 | [
{
"id": 0,
"entity": "CAPD",
"start_offset": 1,
"end_offset": 5,
"label": "pro"
},
{
"id": 1,
"entity": "透析液",
"start_offset": 14,
"end_offset": 17,
"label": "dru"
},
{
"id": 2,
"entity": "蛋白质",
"start_offset": 19,
"end_offset": 22,
"label": "bod"
},
{
"id": 3,
"entity": "白蛋白",
"start_offset": 52,
"end_offset": 55,
"label": "bod"
}
] |
IPD每日丢失10～44g蛋白质。 | [
{
"id": 0,
"entity": "IPD",
"start_offset": 0,
"end_offset": 3,
"label": "pro"
},
{
"id": 1,
"entity": "蛋白质",
"start_offset": 13,
"end_offset": 16,
"label": "bod"
}
] |
发生腹膜炎时蛋白质丢失量可增加1～30倍；增加透析次数、提高透析液的渗透压及发热时蛋白质丢失量也增多：氨基酸丢失量每日约2g，丢失种类与血中氨基酸成分相似，80%为非必需氨基酸。 | [
{
"id": 0,
"entity": "腹膜炎",
"start_offset": 2,
"end_offset": 5,
"label": "dis"
},
{
"id": 1,
"entity": "蛋白质",
"start_offset": 6,
"end_offset": 9,
"label": "bod"
},
{
"id": 2,
"entity": "透析",
"start_offset": 23,
"end_offset": 25,
"label": "pro"
},
{
"id": 3,
"entity": "透析液",
"start_offset": 30,
"end_offset": 33,
"label": "dru"
},
{
"id": 4,
"entity": "发热",
"start_offset": 38,
"end_offset": 40,
"label": "sym"
},
{
"id": 5,
"entity": "蛋白质",
"start_offset": 41,
"end_offset": 44,
"label": "bod"
},
{
"id": 6,
"entity": "氨基酸",
"start_offset": 51,
"end_offset": 54,
"label": "bod"
},
{
"id": 7,
"entity": "血",
"start_offset": 68,
"end_offset": 69,
"label": "bod"
},
{
"id": 8,
"entity": "氨基酸",
"start_offset": 70,
"end_offset": 73,
"label": "bod"
},
{
"id": 9,
"entity": "非必需氨基酸",
"start_offset": 82,
"end_offset": 88,
"label": "bod"
}
] |
每日随透析液丢失大量维生素，主要是水溶性维生素，若不注意补充，在透析2～3个月后可以出现维生素缺乏的表现。 | [
{
"id": 0,
"entity": "透析液",
"start_offset": 3,
"end_offset": 6,
"label": "dru"
},
{
"id": 1,
"entity": "维生素",
"start_offset": 10,
"end_offset": 13,
"label": "bod"
},
{
"id": 2,
"entity": "水溶性维生素",
"start_offset": 17,
"end_offset": 23,
"label": "bod"
},
{
"id": 3,
"entity": "维生素",
"start_offset": 44,
"end_offset": 47,
"label": "bod"
}
] |
有感染时可能需要另外补充蛋白质，如血浆和白蛋白。 | [
{
"id": 0,
"entity": "感染",
"start_offset": 1,
"end_offset": 3,
"label": "dis"
},
{
"id": 1,
"entity": "蛋白质",
"start_offset": 12,
"end_offset": 15,
"label": "bod"
},
{
"id": 2,
"entity": "血浆",
"start_offset": 17,
"end_offset": 19,
"label": "dru"
},
{
"id": 3,
"entity": "白蛋白",
"start_offset": 20,
"end_offset": 23,
"label": "dru"
}
] |
在透析液中加入氨基酸可以补充氨基酸的丢失。 | [
{
"id": 0,
"entity": "透析液",
"start_offset": 1,
"end_offset": 4,
"label": "dru"
},
{
"id": 1,
"entity": "氨基酸",
"start_offset": 7,
"end_offset": 10,
"label": "bod"
},
{
"id": 2,
"entity": "氨基酸",
"start_offset": 14,
"end_offset": 17,
"label": "bod"
}
] |
②高血糖、高血脂与肥胖。 | [
{
"id": 0,
"entity": "高血糖、高血脂与肥胖",
"start_offset": 1,
"end_offset": 11,
"label": "sym"
}
] |
PD中经腹膜吸收的葡萄糖每日约120～200g。 | [
{
"id": 0,
"entity": "PD",
"start_offset": 0,
"end_offset": 2,
"label": "pro"
},
{
"id": 1,
"entity": "腹膜",
"start_offset": 4,
"end_offset": 6,
"label": "bod"
},
{
"id": 2,
"entity": "葡萄糖",
"start_offset": 9,
"end_offset": 12,
"label": "bod"
}
] |
透析液渗透压越高，吸收的葡萄糖量越多。 | [
{
"id": 0,
"entity": "透析液",
"start_offset": 0,
"end_offset": 3,
"label": "dru"
},
{
"id": 1,
"entity": "葡萄糖",
"start_offset": 12,
"end_offset": 15,
"label": "bod"
}
] |
若长期用较高浓度的葡萄糖液，可能会发生高血糖，甚至高渗性昏迷以及糖尿病。 | [
{
"id": 0,
"entity": "葡萄糖液",
"start_offset": 9,
"end_offset": 13,
"label": "dru"
},
{
"id": 1,
"entity": "高血糖",
"start_offset": 19,
"end_offset": 22,
"label": "sym"
},
{
"id": 2,
"entity": "高渗性昏迷",
"start_offset": 25,
"end_offset": 30,
"label": "sym"
},
{
"id": 3,
"entity": "糖尿病",
"start_offset": 32,
"end_offset": 35,
"label": "dis"
}
] |
部分患者体重逐渐增加，血清甘油三酯以及胆固醇升高。 | [
{
"id": 0,
"entity": "血清甘油三酯",
"start_offset": 11,
"end_offset": 17,
"label": "bod"
},
{
"id": 1,
"entity": "胆固醇",
"start_offset": 19,
"end_offset": 22,
"label": "bod"
}
] |
③水、电解质及酸碱失衡。 | [
{
"id": 0,
"entity": "水、电解质及酸碱失衡",
"start_offset": 1,
"end_offset": 11,
"label": "sym"
}
] |
PD患者很容易发生水代谢失衡。 | [
{
"id": 0,
"entity": "PD",
"start_offset": 0,
"end_offset": 2,
"label": "pro"
},
{
"id": 1,
"entity": "水代谢失衡",
"start_offset": 9,
"end_offset": 14,
"label": "sym"
}
] |
若患者每日体重增加0.5kg，明显水肿，甚至出现肺水肿及脑水肿，提示体内水分过多，宜提高透析液渗透压，加强超滤；若患者显著口渴，短期内体重下降，乏力，发生体位性低血压，提示体内缺水，此时宜减少透析液中的葡萄糖用量，应用生理盐水或血浆扩容。 | [
{
"id": 0,
"entity": "水肿",
"start_offset": 17,
"end_offset": 19,
"label": "sym"
},
{
"id": 1,
"entity": "肺水肿",
"start_offset": 24,
"end_offset": 27,
"label": "sym"
},
{
"id": 2,
"entity": "脑水肿",
"start_offset": 28,
"end_offset": 31,
"label": "sym"
},
{
"id": 3,
"entity": "水分",
"start_offset": 36,
"end_offset": 38,
"label": "bod"
},
{
"id": 4,
"entity": "透析液",
"start_offset": 44,
"end_offset": 47,
"label": "dru"
},
{
"id": 5,
"entity": "口渴",
"start_offset": 61,
"end_offset": 63,
"label": "sym"
},
{
"id": 6,
"entity": "短期内体重下降",
"start_offset": 64,
"end_offset": 71,
"label": "sym"
},
{
"id": 7,
"entity": "乏力",
"start_offset": 72,
"end_offset": 74,
"label": "sym"
},
{
"id": 8,
"entity": "发生体位性低血压",
"start_offset": 75,
"end_offset": 83,
"label": "sym"
},
{
"id": 9,
"entity": "水",
"start_offset": 89,
"end_offset": 90,
"label": "bod"
},
{
"id": 10,
"entity": "透析液",
"start_offset": 96,
"end_offset": 99,
"label": "dru"
},
{
"id": 11,
"entity": "葡萄糖",
"start_offset": 101,
"end_offset": 104,
"label": "dru"
},
{
"id": 12,
"entity": "生理盐水",
"start_offset": 109,
"end_offset": 113,
"label": "dru"
},
{
"id": 13,
"entity": "血浆",
"start_offset": 114,
"end_offset": 116,
"label": "dru"
}
] |
血中钠、钾、镁和碳酸氢根浓度过高或过低时，应调整透析液中的相应离子浓度来纠正。 | [
{
"id": 0,
"entity": "血",
"start_offset": 0,
"end_offset": 1,
"label": "bod"
},
{
"id": 1,
"entity": "钠",
"start_offset": 2,
"end_offset": 3,
"label": "bod"
},
{
"id": 2,
"entity": "钾",
"start_offset": 4,
"end_offset": 5,
"label": "bod"
},
{
"id": 3,
"entity": "镁",
"start_offset": 6,
"end_offset": 7,
"label": "bod"
},
{
"id": 4,
"entity": "碳酸氢根",
"start_offset": 8,
"end_offset": 12,
"label": "bod"
},
{
"id": 5,
"entity": "透析液",
"start_offset": 24,
"end_offset": 27,
"label": "dru"
}
] |
④呼吸系统并发症。 | [
{
"id": 0,
"entity": "呼吸系统",
"start_offset": 1,
"end_offset": 5,
"label": "bod"
}
] |
由于腹腔内存有大量透析液，横膈抬高，肺底萎陷，分泌物易积蓄，患者可能发生呼吸系统并发症，包括支气管炎、肺炎、肺不张以及胸腔积液。 | [
{
"id": 0,
"entity": "腹腔",
"start_offset": 2,
"end_offset": 4,
"label": "bod"
},
{
"id": 1,
"entity": "透析液",
"start_offset": 9,
"end_offset": 12,
"label": "dru"
},
{
"id": 2,
"entity": "横膈抬高",
"start_offset": 13,
"end_offset": 17,
"label": "sym"
},
{
"id": 3,
"entity": "肺底萎陷",
"start_offset": 18,
"end_offset": 22,
"label": "sym"
},
{
"id": 4,
"entity": "分泌物",
"start_offset": 23,
"end_offset": 26,
"label": "bod"
},
{
"id": 5,
"entity": "呼吸系统",
"start_offset": 36,
"end_offset": 40,
"label": "bod"
},
{
"id": 6,
"entity": "支气管炎",
"start_offset": 46,
"end_offset": 50,
"label": "dis"
},
{
"id": 7,
"entity": "肺炎",
"start_offset": 51,
"end_offset": 53,
"label": "dis"
},
{
"id": 8,
"entity": "肺不张",
"start_offset": 54,
"end_offset": 57,
"label": "dis"
},
{
"id": 9,
"entity": "胸腔积液",
"start_offset": 59,
"end_offset": 63,
"label": "dis"
}
] |
⑤疝气：包括腹壁切口疝、脐疝、腹股沟疝和膈疝等，因腹内压增高所致。 | [
{
"id": 0,
"entity": "疝气",
"start_offset": 1,
"end_offset": 3,
"label": "dis"
},
{
"id": 1,
"entity": "腹壁切口疝",
"start_offset": 6,
"end_offset": 11,
"label": "dis"
},
{
"id": 2,
"entity": "脐疝",
"start_offset": 12,
"end_offset": 14,
"label": "dis"
},
{
"id": 3,
"entity": "腹股沟疝",
"start_offset": 15,
"end_offset": 19,
"label": "dis"
},
{
"id": 4,
"entity": "膈疝",
"start_offset": 20,
"end_offset": 22,
"label": "dis"
},
{
"id": 5,
"entity": "腹内压",
"start_offset": 25,
"end_offset": 28,
"label": "ite"
}
] |
腹肌软弱者较易发生，常需手术修补。 | [
{
"id": 0,
"entity": "腹肌",
"start_offset": 0,
"end_offset": 2,
"label": "bod"
},
{
"id": 1,
"entity": "手术",
"start_offset": 12,
"end_offset": 14,
"label": "pro"
}
] |
⑥其他可有腹痛 | [
{
"id": 0,
"entity": "腹痛",
"start_offset": 5,
"end_offset": 7,
"label": "sym"
}
] |
第十章心律失常第一节概况儿童心律失常可以是一过性的或永久性的；可以是先天性的（心脏结构可正常或异常）或后天获得性的（风湿热，心肌炎）；可以由毒素（白喉毒素）、可卡因、茶碱或一些抗心律失常药物引起；也可以是先天性心脏病外科手术后的后遗症。 | [
{
"id": 0,
"entity": "心律失常",
"start_offset": 3,
"end_offset": 7,
"label": "dis"
},
{
"id": 1,
"entity": "心律失常",
"start_offset": 14,
"end_offset": 18,
"label": "dis"
},
{
"id": 2,
"entity": "心脏",
"start_offset": 39,
"end_offset": 41,
"label": "bod"
},
{
"id": 3,
"entity": "风湿热",
"start_offset": 58,
"end_offset": 61,
"label": "dis"
},
{
"id": 4,
"entity": "心肌炎",
"start_offset": 62,
"end_offset": 65,
"label": "dis"
},
{
"id": 5,
"entity": "毒素",
"start_offset": 70,
"end_offset": 72,
"label": "mic"
},
{
"id": 6,
"entity": "白喉毒素",
"start_offset": 73,
"end_offset": 77,
"label": "mic"
},
{
"id": 7,
"entity": "可卡因",
"start_offset": 79,
"end_offset": 82,
"label": "dru"
},
{
"id": 8,
"entity": "茶碱",
"start_offset": 83,
"end_offset": 85,
"label": "dru"
},
{
"id": 9,
"entity": "心律失常",
"start_offset": 89,
"end_offset": 93,
"label": "dis"
},
{
"id": 10,
"entity": "先天性心脏病外科手术",
"start_offset": 102,
"end_offset": 112,
"label": "pro"
}
] |
心律失常的主要危险是严重心动过速或心动过缓，导致心输出量下降，或发展成更严重的心律失常，如心室颤动。 | [
{
"id": 0,
"entity": "心律失常",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "心动过速",
"start_offset": 12,
"end_offset": 16,
"label": "sym"
},
{
"id": 2,
"entity": "心动过缓",
"start_offset": 17,
"end_offset": 21,
"label": "sym"
},
{
"id": 3,
"entity": "心输出量下降",
"start_offset": 24,
"end_offset": 30,
"label": "sym"
},
{
"id": 4,
"entity": "心律失常",
"start_offset": 39,
"end_offset": 43,
"label": "dis"
},
{
"id": 5,
"entity": "心室颤动",
"start_offset": 45,
"end_offset": 49,
"label": "dis"
}
] |
晕厥本身在某些情况下也很危险，如发生在游泳或驾车时。 | [
{
"id": 0,
"entity": "晕厥",
"start_offset": 0,
"end_offset": 2,
"label": "sym"
}
] |
当一个患有心律失常的患儿就诊时，首先需确定这种心律失常是否有可能发展成威胁生命的心动过速或心动过缓。 | [
{
"id": 0,
"entity": "心律失常",
"start_offset": 5,
"end_offset": 9,
"label": "dis"
},
{
"id": 1,
"entity": "心律失常",
"start_offset": 23,
"end_offset": 27,
"label": "dis"
},
{
"id": 2,
"entity": "心动过速",
"start_offset": 40,
"end_offset": 44,
"label": "sym"
},
{
"id": 3,
"entity": "心动过缓",
"start_offset": 45,
"end_offset": 49,
"label": "sym"
}
] |
一些心律异常（如单纯性房性期前收缩和室性期前收缩）在无心脏疾患的儿童常见，在绝大多数情况下并不给这些患儿带来生命的危险。 | [
{
"id": 0,
"entity": "心律异常",
"start_offset": 2,
"end_offset": 6,
"label": "sym"
},
{
"id": 1,
"entity": "室性期前收缩",
"start_offset": 18,
"end_offset": 24,
"label": "sym"
},
{
"id": 2,
"entity": "心脏",
"start_offset": 27,
"end_offset": 29,
"label": "bod"
}
] |
成人抗心律失常药物的种类不断增加，但许多药物在儿科的应用并未广泛研究。 | [
{
"id": 0,
"entity": "心律失常",
"start_offset": 3,
"end_offset": 7,
"label": "dis"
}
] |
儿童抗心律失常药物的给予次数、顺应性、副作用及不同的反应性仍是有待解决的问题。 | [
{
"id": 0,
"entity": "心律失常",
"start_offset": 3,
"end_offset": 7,
"label": "dis"
}
] |
当患儿患快速性心律失常且耐药时，可予经导管射频消融或外科治疗。 | [
{
"id": 0,
"entity": "快速性心律失常",
"start_offset": 4,
"end_offset": 11,
"label": "dis"
},
{
"id": 1,
"entity": "经导管射频消融",
"start_offset": 18,
"end_offset": 25,
"label": "pro"
},
{
"id": 2,
"entity": "外科治疗",
"start_offset": 26,
"end_offset": 30,
"label": "pro"
}
] |
现今的起搏器体积很小，已可用于早产儿。 | [
{
"id": 0,
"entity": "起搏器",
"start_offset": 3,
"end_offset": 6,
"label": "equ"
}
] |
在高危恶性室性心律失常患儿，可安装自动植入式电复律除颤器（AICDs）。 | [
{
"id": 0,
"entity": "高危恶性室性心律失常",
"start_offset": 1,
"end_offset": 11,
"label": "dis"
},
{
"id": 1,
"entity": "安装自动植入式电复律除颤器",
"start_offset": 15,
"end_offset": 28,
"label": "pro"
},
{
"id": 2,
"entity": "AICDs",
"start_offset": 29,
"end_offset": 34,
"label": "equ"
}
] |
表9-9为儿科常用抗心律失常药物的剂量及注意事项，表9-9为美国心脏病学会/美国心脏协会（ACC/AHA）1998年更新的小儿及青少年永久心脏起搏的特殊指征，可供参考。 | [
{
"id": 0,
"entity": "儿科",
"start_offset": 5,
"end_offset": 7,
"label": "dep"
},
{
"id": 1,
"entity": "心脏病",
"start_offset": 32,
"end_offset": 35,
"label": "dis"
},
{
"id": 2,
"entity": "心脏",
"start_offset": 40,
"end_offset": 42,
"label": "bod"
},
{
"id": 3,
"entity": "心脏起搏",
"start_offset": 69,
"end_offset": 73,
"label": "ite"
}
] |
表9-13儿科常用抗心律失常药物的剂量及注意事项续表注：CNS—中枢神经系统，bid—一天二次，tid—一天三次，PO—口服，IV—静脉应用。 | [
{
"id": 0,
"entity": "儿科",
"start_offset": 5,
"end_offset": 7,
"label": "dep"
},
{
"id": 1,
"entity": "心律失常",
"start_offset": 10,
"end_offset": 14,
"label": "dis"
},
{
"id": 2,
"entity": "中枢神经系统",
"start_offset": 32,
"end_offset": 38,
"label": "bod"
},
{
"id": 3,
"entity": "静脉",
"start_offset": 66,
"end_offset": 68,
"label": "bod"
}
] |
表9-14小儿与青少年永久心脏起搏的指征注：表中第一类为无争议的起搏指征，第二类为有争议的起搏指征，其中二a类为倾向于植入起搏器，二b类为倾向于不植入起搏器，第三类为无需起搏治疗的心律失常。 | [
{
"id": 0,
"entity": "心脏起搏",
"start_offset": 13,
"end_offset": 17,
"label": "ite"
},
{
"id": 1,
"entity": "起搏",
"start_offset": 32,
"end_offset": 34,
"label": "ite"
},
{
"id": 2,
"entity": "起搏",
"start_offset": 45,
"end_offset": 47,
"label": "ite"
},
{
"id": 3,
"entity": "起搏器",
"start_offset": 61,
"end_offset": 64,
"label": "equ"
},
{
"id": 4,
"entity": "起搏器",
"start_offset": 75,
"end_offset": 78,
"label": "equ"
},
{
"id": 5,
"entity": "心律失常",
"start_offset": 90,
"end_offset": 94,
"label": "dis"
}
] |
小儿病例不包含A级部分原因是儿科患儿数较少。 | [
{
"id": 0,
"entity": "儿科",
"start_offset": 14,
"end_offset": 16,
"label": "dep"
}
] |
四、低度恶性胶质瘤低度恶性胶质瘤（glioma）指生长缓慢，非侵袭性，组织学表现相对良性的肿瘤，相当于Kernohan分类法中的Ⅰ、Ⅱ级肿瘤。 | [
{
"id": 0,
"entity": "低度恶性胶质瘤",
"start_offset": 2,
"end_offset": 9,
"label": "dis"
},
{
"id": 1,
"entity": "低度恶性胶质瘤",
"start_offset": 9,
"end_offset": 16,
"label": "dis"
},
{
"id": 2,
"entity": "glioma",
"start_offset": 17,
"end_offset": 23,
"label": "dis"
},
{
"id": 3,
"entity": "肿瘤",
"start_offset": 45,
"end_offset": 47,
"label": "dis"
}
] |
包括星形细胞瘤、少突胶质细胞瘤、以上两种瘤细胞的混合型肿瘤及神经元和胶质细胞的混合型肿瘤。 | [
{
"id": 0,
"entity": "星形细胞瘤",
"start_offset": 2,
"end_offset": 7,
"label": "dis"
},
{
"id": 1,
"entity": "少突胶质细胞瘤",
"start_offset": 8,
"end_offset": 15,
"label": "dis"
},
{
"id": 2,
"entity": "瘤细胞",
"start_offset": 20,
"end_offset": 23,
"label": "bod"
},
{
"id": 3,
"entity": "混合型肿瘤",
"start_offset": 24,
"end_offset": 29,
"label": "dis"
},
{
"id": 4,
"entity": "神经元和胶质细胞的混合型肿瘤",
"start_offset": 30,
"end_offset": 44,
"label": "dis"
}
] |
儿童幕上肿瘤35%为低度胶质瘤，1/3～1/2的肿瘤位于大脑半球，其余位于间脑中央深部（丘脑、下丘脑、三脑室）及基底节。 | [
{
"id": 0,
"entity": "儿童幕上肿瘤",
"start_offset": 0,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "低度胶质瘤",
"start_offset": 10,
"end_offset": 15,
"label": "dis"
},
{
"id": 2,
"entity": "肿瘤",
"start_offset": 24,
"end_offset": 26,
"label": "dis"
},
{
"id": 3,
"entity": "脑半球",
"start_offset": 29,
"end_offset": 32,
"label": "bod"
},
{
"id": 4,
"entity": "间脑中央",
"start_offset": 37,
"end_offset": 41,
"label": "bod"
},
{
"id": 5,
"entity": "丘脑",
"start_offset": 44,
"end_offset": 46,
"label": "bod"
},
{
"id": 6,
"entity": "下丘脑",
"start_offset": 47,
"end_offset": 50,
"label": "bod"
},
{
"id": 7,
"entity": "三脑室",
"start_offset": 51,
"end_offset": 54,
"label": "bod"
},
{
"id": 8,
"entity": "基底节",
"start_offset": 56,
"end_offset": 59,
"label": "bod"
}
] |
低度胶质瘤在儿童幕下肿瘤中占10%～20%，主要为纤维型星形细胞瘤，平均发病年龄为6.5～9岁。 | [
{
"id": 0,
"entity": "低度胶质瘤",
"start_offset": 0,
"end_offset": 5,
"label": "dis"
},
{
"id": 1,
"entity": "儿童幕下肿瘤",
"start_offset": 6,
"end_offset": 12,
"label": "dis"
},
{
"id": 2,
"entity": "纤维型星形细胞瘤",
"start_offset": 25,
"end_offset": 33,
"label": "dis"
}
] |
临床表现常见症状有颅内高压（约75%）、癫痫不同部位的神经损害症状如偏瘫、失语、神经内分泌异常、视神经萎缩症状等检查CT及MRI可显示肿瘤部位、大小、血运是否丰富等。 | [
{
"id": 0,
"entity": "有颅内高压",
"start_offset": 8,
"end_offset": 13,
"label": "sym"
},
{
"id": 1,
"entity": "癫痫",
"start_offset": 20,
"end_offset": 22,
"label": "dis"
},
{
"id": 2,
"entity": "癫痫",
"start_offset": 20,
"end_offset": 22,
"label": "sym"
},
{
"id": 3,
"entity": "神经损害",
"start_offset": 27,
"end_offset": 31,
"label": "dis"
},
{
"id": 4,
"entity": "偏瘫",
"start_offset": 34,
"end_offset": 36,
"label": "dis"
},
{
"id": 5,
"entity": "失语",
"start_offset": 37,
"end_offset": 39,
"label": "dis"
},
{
"id": 6,
"entity": "神经内分泌异常",
"start_offset": 40,
"end_offset": 47,
"label": "dis"
},
{
"id": 7,
"entity": "视神经萎缩",
"start_offset": 48,
"end_offset": 53,
"label": "dis"
},
{
"id": 8,
"entity": "不同部位的神经损害症状如偏瘫、失语、神经内分泌异常、视神经萎缩症状等",
"start_offset": 22,
"end_offset": 56,
"label": "sym"
},
{
"id": 9,
"entity": "检查CT",
"start_offset": 56,
"end_offset": 60,
"label": "pro"
},
{
"id": 10,
"entity": "MRI",
"start_offset": 61,
"end_offset": 64,
"label": "pro"
},
{
"id": 11,
"entity": "肿瘤",
"start_offset": 67,
"end_offset": 69,
"label": "dis"
}
] |
手术是治疗的主要手段，要求在安全的前提下尽量完整切除肿瘤。 | [
{
"id": 0,
"entity": "手术",
"start_offset": 0,
"end_offset": 2,
"label": "pro"
},
{
"id": 1,
"entity": "肿瘤",
"start_offset": 26,
"end_offset": 28,
"label": "dis"
}
] |
统计肿瘤全切除病例，有报道7年存活率达80%，而次全切除的病例，7年存活率仅达15%～50%。 | [
{
"id": 0,
"entity": "肿瘤",
"start_offset": 2,
"end_offset": 4,
"label": "dis"
}
] |
放疗适用于进展性或复发性肿瘤，且仅需做局部放疗即可；全切除肿瘤不需放疗；不全切除肿瘤是否需要放疗尚有争议，多数学者认为应有再次手术或先化疗。 | [
{
"id": 0,
"entity": "放疗",
"start_offset": 0,
"end_offset": 2,
"label": "pro"
},
{
"id": 1,
"entity": "肿瘤",
"start_offset": 12,
"end_offset": 14,
"label": "dis"
},
{
"id": 2,
"entity": "局部放疗",
"start_offset": 19,
"end_offset": 23,
"label": "pro"
},
{
"id": 3,
"entity": "肿瘤",
"start_offset": 29,
"end_offset": 31,
"label": "dis"
},
{
"id": 4,
"entity": "放疗",
"start_offset": 33,
"end_offset": 35,
"label": "pro"
},
{
"id": 5,
"entity": "肿瘤",
"start_offset": 40,
"end_offset": 42,
"label": "dis"
},
{
"id": 6,
"entity": "放疗",
"start_offset": 46,
"end_offset": 48,
"label": "pro"
},
{
"id": 7,
"entity": "手术",
"start_offset": 63,
"end_offset": 65,
"label": "pro"
},
{
"id": 8,
"entity": "化疗",
"start_offset": 67,
"end_offset": 69,
"label": "pro"
}
] |
报道105例儿童纤维细胞型星形细胞瘤，20年生存率达79%。 | [
{
"id": 0,
"entity": "儿童纤维细胞型星形细胞瘤",
"start_offset": 6,
"end_offset": 18,
"label": "dis"
}
] |
位于脑干、间脑及脊髓肿瘤的预后相对较差。 | [
{
"id": 0,
"entity": "脑干、间脑及脊髓肿瘤",
"start_offset": 2,
"end_offset": 12,
"label": "dis"
}
] |
二、腹膜透析置管术及相关并发症（一）腹膜透析管的选择质量好的腹透管是成功进行腹膜透析的基础。 | [
{
"id": 0,
"entity": "腹膜透析置管术",
"start_offset": 2,
"end_offset": 9,
"label": "pro"
},
{
"id": 1,
"entity": "腹膜透析管",
"start_offset": 18,
"end_offset": 23,
"label": "equ"
},
{
"id": 2,
"entity": "腹透管",
"start_offset": 30,
"end_offset": 33,
"label": "equ"
},
{
"id": 3,
"entity": "腹膜透析",
"start_offset": 38,
"end_offset": 42,
"label": "pro"
}
] |
儿童和婴幼儿腹透管应随其年龄、身高和体重而选择，通常比成人腹透管更短，更小，还有新生儿专用管。 | [
{
"id": 0,
"entity": "腹透管",
"start_offset": 6,
"end_offset": 9,
"label": "equ"
},
{
"id": 1,
"entity": "腹透管",
"start_offset": 29,
"end_offset": 32,
"label": "equ"
}
] |
插入腹腔内透析管长度约相当于患儿脐至耻骨联合的距离，6岁以上、体重＞30kg的儿童，可以应用成人型透析管。 | [
{
"id": 0,
"entity": "腹腔",
"start_offset": 2,
"end_offset": 4,
"label": "bod"
},
{
"id": 1,
"entity": "透析管",
"start_offset": 5,
"end_offset": 8,
"label": "equ"
},
{
"id": 2,
"entity": "脐",
"start_offset": 16,
"end_offset": 17,
"label": "bod"
},
{
"id": 3,
"entity": "耻骨",
"start_offset": 18,
"end_offset": 20,
"label": "bod"
},
{
"id": 4,
"entity": "成人型透析管",
"start_offset": 46,
"end_offset": 52,
"label": "equ"
}
] |
目前全世界范围内使用最广的仍是Tenckhoff透析管。 | [
{
"id": 0,
"entity": "Tenckhoff透析管",
"start_offset": 15,
"end_offset": 27,
"label": "equ"
}
] |
早期使用的Tenckhoff透析管均为直管，但考虑到减少注入腹透液疼痛及腹透液流出梗阻等问题，目前多倾向于使用弯曲Tenckhoff透析管。 | [
{
"id": 0,
"entity": "Tenckhoff透析管",
"start_offset": 5,
"end_offset": 17,
"label": "equ"
},
{
"id": 1,
"entity": "腹透液",
"start_offset": 30,
"end_offset": 33,
"label": "dru"
},
{
"id": 2,
"entity": "疼痛",
"start_offset": 33,
"end_offset": 35,
"label": "sym"
},
{
"id": 3,
"entity": "腹透液流出梗阻",
"start_offset": 36,
"end_offset": 43,
"label": "sym"
},
{
"id": 4,
"entity": "弯曲Tenckhoff透析管",
"start_offset": 55,
"end_offset": 69,
"label": "equ"
}
] |
据北美儿童肾移植合作研究组的观察结果显示415根直管有49根发生原发性流出梗阻（12%），而741根Tenckhoff弯管只有45根发生原发性流出梗阻（6%）。 | [
{
"id": 0,
"entity": "肾移植",
"start_offset": 5,
"end_offset": 8,
"label": "pro"
},
{
"id": 1,
"entity": "原发性流出梗阻",
"start_offset": 32,
"end_offset": 39,
"label": "sym"
},
{
"id": 2,
"entity": "Tenckhoff弯管",
"start_offset": 50,
"end_offset": 61,
"label": "equ"
},
{
"id": 3,
"entity": "原发性流出梗阻",
"start_offset": 68,
"end_offset": 75,
"label": "sym"
}
] |
Tenckhoff导管有单涤纶套和双涤纶套，临床观察已证实双涤纶套透析管在减少腹膜炎的发生率及延长植管后第一次发作腹膜炎的时间方面的确优于单涤纶套导管。 | [
{
"id": 0,
"entity": "Tenckhoff导管",
"start_offset": 0,
"end_offset": 11,
"label": "equ"
},
{
"id": 1,
"entity": "单涤纶套",
"start_offset": 12,
"end_offset": 16,
"label": "equ"
},
{
"id": 2,
"entity": "双涤纶套",
"start_offset": 17,
"end_offset": 21,
"label": "equ"
},
{
"id": 3,
"entity": "双涤纶套透析管",
"start_offset": 29,
"end_offset": 36,
"label": "equ"
},
{
"id": 4,
"entity": "腹膜炎",
"start_offset": 39,
"end_offset": 42,
"label": "dis"
},
{
"id": 5,
"entity": "植管",
"start_offset": 49,
"end_offset": 51,
"label": "pro"
},
{
"id": 6,
"entity": "腹膜炎",
"start_offset": 57,
"end_offset": 60,
"label": "dis"
},
{
"id": 7,
"entity": "单涤纶套导管",
"start_offset": 69,
"end_offset": 75,
"label": "equ"
}
] |
（二）透析管置入术因穿刺植入法的并发症较多，小儿腹膜透析管的安置多主张采用手术植入法，特别在新生儿期。 | [
{
"id": 0,
"entity": "透析管置入术",
"start_offset": 3,
"end_offset": 9,
"label": "pro"
},
{
"id": 1,
"entity": "穿刺植入法",
"start_offset": 10,
"end_offset": 15,
"label": "pro"
},
{
"id": 2,
"entity": "腹膜透析管",
"start_offset": 24,
"end_offset": 29,
"label": "equ"
},
{
"id": 3,
"entity": "手术植入法",
"start_offset": 37,
"end_offset": 42,
"label": "pro"
}
] |
手术植入法可准确地将导管放入小儿骨盆内，由于儿童难以配合，手术常于全麻下进行。 | [
{
"id": 0,
"entity": "手术植入法",
"start_offset": 0,
"end_offset": 5,
"label": "pro"
},
{
"id": 1,
"entity": "导管",
"start_offset": 10,
"end_offset": 12,
"label": "equ"
},
{
"id": 2,
"entity": "骨盆",
"start_offset": 16,
"end_offset": 18,
"label": "bod"
},
{
"id": 3,
"entity": "手术",
"start_offset": 29,
"end_offset": 31,
"label": "pro"
},
{
"id": 4,
"entity": "全麻",
"start_offset": 33,
"end_offset": 35,
"label": "pro"
}
] |
切口常选择在脐与耻骨联合的连线上1/3处，可行正中或正中旁经腹直肌切口，也可选择麦氏切口，以经腹直肌旁正中切口最为常用。 | [
{
"id": 0,
"entity": "脐",
"start_offset": 6,
"end_offset": 7,
"label": "bod"
},
{
"id": 1,
"entity": "耻骨",
"start_offset": 8,
"end_offset": 10,
"label": "bod"
},
{
"id": 2,
"entity": "腹直肌",
"start_offset": 30,
"end_offset": 33,
"label": "bod"
},
{
"id": 3,
"entity": "麦氏切口",
"start_offset": 40,
"end_offset": 44,
"label": "pro"
},
{
"id": 4,
"entity": "腹直肌",
"start_offset": 47,
"end_offset": 50,
"label": "bod"
}
] |
Rinadi报道意大利20个透析中心的347次患儿腹膜透析管置管手术，136次采用正中切口，占39.2%，211次采用正中旁经腹直肌切口，占60.8%。 | [
{
"id": 0,
"entity": "透析",
"start_offset": 14,
"end_offset": 16,
"label": "pro"
},
{
"id": 1,
"entity": "腹膜透析管置管手术",
"start_offset": 25,
"end_offset": 34,
"label": "pro"
},
{
"id": 2,
"entity": "腹直肌",
"start_offset": 63,
"end_offset": 66,
"label": "bod"
}
] |
按常规消毒、铺巾，切开皮肤，分离腹壁各层组织，暴露腹膜作0.5～0.8cm切口，将腹透管在导丝引导下紧贴腹膜后壁送入膀胱直肠窝，婴幼儿盆腔较浅，插入腹腔内透析管长度约相当于脐至耻骨联合的距离。 | [
{
"id": 0,
"entity": "消毒",
"start_offset": 3,
"end_offset": 5,
"label": "pro"
},
{
"id": 1,
"entity": "皮肤",
"start_offset": 11,
"end_offset": 13,
"label": "bod"
},
{
"id": 2,
"entity": "腹壁",
"start_offset": 16,
"end_offset": 18,
"label": "bod"
},
{
"id": 3,
"entity": "组织",
"start_offset": 20,
"end_offset": 22,
"label": "bod"
},
{
"id": 4,
"entity": "腹膜",
"start_offset": 25,
"end_offset": 27,
"label": "bod"
},
{
"id": 5,
"entity": "腹透管",
"start_offset": 41,
"end_offset": 44,
"label": "equ"
},
{
"id": 6,
"entity": "腹膜",
"start_offset": 52,
"end_offset": 54,
"label": "bod"
},
{
"id": 7,
"entity": "膀胱直肠窝",
"start_offset": 58,
"end_offset": 63,
"label": "bod"
},
{
"id": 8,
"entity": "盆腔",
"start_offset": 67,
"end_offset": 69,
"label": "bod"
},
{
"id": 9,
"entity": "腹腔",
"start_offset": 74,
"end_offset": 76,
"label": "bod"
},
{
"id": 10,
"entity": "透析管",
"start_offset": 77,
"end_offset": 80,
"label": "equ"
},
{
"id": 11,
"entity": "脐",
"start_offset": 86,
"end_offset": 87,
"label": "bod"
},
{
"id": 12,
"entity": "耻骨",
"start_offset": 88,
"end_offset": 90,
"label": "bod"
}
] |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.