text stringlengths 4 4.87k | entities list |
|---|---|
在正常情况下，当细胞内DNA增加到两倍（4n）时才发生细胞分裂。 | [
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叶酸和维生素B12</sub>缺乏时，DNA合成发生障碍，幼红细胞分裂延迟，而血红蛋白则仍然在继续合成，这样，幼红细胞血红蛋白合成越来越多，体积越来越大，而DNA含量却始终未能达到细胞分裂所必需的要求，使幼红细胞发生巨幼变。 | [
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"entity": "幼红细胞",
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"entity": "血红蛋白",
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"entity": "幼红细胞",
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"entity": "血红蛋白",
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"entity": "幼红细胞",
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这种巨幼红细胞很容易在骨髓内破坏，造成无效造血。 | [
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叶酸和维生素B12</sub>缺乏对细胞分裂的影响不仅见于红系，也见于粒系和巨核细胞系。 | [
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"entity": "巨核细胞系",
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晚幼粒和杆状核粒细胞体积大、核肿胀、结构疏松，核分叶过多，可多至5叶以上。 | [
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由于粒细胞生存期短，故这种变化先于红系，可作为叶酸或维生素B12</sub>缺乏早期诊断的依据。 | [
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巨核细胞的体积也增大，核分叶过多，血小板生成障碍，可见巨大血小板。 | [
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维生素B12</sub>缺乏时，除可出现血液系统改变外，尚可影响神经精神系统。 | [
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这是由于维生素B12</sub>缺乏可引起神经系统有鞘神经纤维脂质代谢障碍。 | [
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有鞘神经纤维的鞘中含有丰富的鞘磷脂，脂质代谢过程中的中间代谢产物为甲基丙二酸，后者在维生素B12</sub>的参与下，转变成琥珀酸进而进入三羧酸循环。 | [
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"entity": "三羧酸",
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维生素B12</sub>缺乏时，甲基丙二酸不能转变成琥珀酸而使甲基丙二酸在神经鞘中堆积，破坏了神经鞘的形成，从而出现神经精神症状。 | [
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"entity": "神经精神",
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全身症状轻重和贫血不一定成正比。 | [
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常有舌面光滑、厌食、恶心、呕吐、腹泻，偶有吞咽困难、声音嘶哑。 | [
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由于髓外造血的关系，肝、脾可出现不同程度的肿大，与发病年龄有关，年龄越小，肝、脾大就越明显。 | [
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白细胞减少者易患细菌性感染。 | [
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维生素B12</sub>缺乏时，除也有上述表现外，尚可出现明显的神经精神症状。 | [
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【实验室检查】（一）外周血象红细胞数较血红蛋白量降低得更明显。 | [
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早期血红蛋白尚在正常范围时，红细胞数就可已经明显减少。 | [
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红细胞体积增大，可有轻度大小不等，以大细胞为主。 | [
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红细胞内血红蛋白充盈度良好，中央淡染区缩小。 | [
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平均红细胞体积（MCV）及平均红细胞血红蛋白含量（MCH）均大于正常，但平均红细胞血红蛋白浓度（MCHC）则在正常范围，说明此种贫血为单纯大细胞性贫血。 | [
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"entity": "单纯大细胞性贫血",
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粒细胞体积增大、数量减少、核染色质疏松，核分叶较多，多者可达5叶以上，如核分叶5叶以上的细胞超过5%则有诊断价值。 | [
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血小板数可减少、体积增大，出血时间延长。 | [
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（二）骨髓象骨髓细胞大多代偿性增生旺盛，也有增生正常或增生低下者，但均有红细胞巨幼变，胞体大、核染色质松、胞质嗜酸性强，核、浆发育不平衡，胞核的发育落后于胞质。 | [
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"entity": "胞质嗜酸性强",
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"entity": "核",
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"entity": "浆",
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"entity": "核、浆发育不平衡",
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"entity": "胞核",
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"entity": "胞核的发育落后于胞质",
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粒细胞体大、核分叶多、核右移，巨核细胞核分叶过多、胞质中颗粒减少，骨髓中血小板也较大。 | [
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"start_offset": 0,
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"label": "sym"
},
{
"id": 2,
"entity": "核分叶",
"start_offset": 6,
"end_offset": 9,
"label": "bod"
},
{
"id": 3,
"entity": "核分叶多",
"start_offset": 6,
"end_offset": 10,
"label": "sym"
},
{
"id": 4,
"entity": "核",
"start_offset": 11,
"end_offset": 12,
"label": "bod"
},
{
"id": 5,
"entity": "核右移",
"start_offset": 11,
"end_offset": 14,
"label": "sym"
},
{
"id": 6,
"entity": "巨核细胞核分叶",
"start_offset": 15,
"end_offset": 22,
"label": "bod"
},
{
"id": 7,
"entity": "巨核细胞核分叶过多",
"start_offset": 15,
"end_offset": 24,
"label": "sym"
},
{
"id": 8,
"entity": "胞质",
"start_offset": 25,
"end_offset": 27,
"label": "bod"
},
{
"id": 9,
"entity": "胞质中颗粒减少",
"start_offset": 25,
"end_offset": 32,
"label": "sym"
},
{
"id": 10,
"entity": "骨髓中血小板",
"start_offset": 33,
"end_offset": 39,
"label": "bod"
},
{
"id": 11,
"entity": "骨髓中血小板也较大",
"start_offset": 33,
"end_offset": 42,
"label": "sym"
}
] |
（三）血浆叶酸及维生素B12</sub>定量测定叶酸或维生素B12</sub>减少或两者皆减少。 | [
{
"id": 0,
"entity": "血浆",
"start_offset": 3,
"end_offset": 5,
"label": "bod"
},
{
"id": 1,
"entity": "叶酸",
"start_offset": 5,
"end_offset": 7,
"label": "dru"
},
{
"id": 2,
"entity": "维生素B12",
"start_offset": 8,
"end_offset": 14,
"label": "dru"
},
{
"id": 3,
"entity": "叶酸",
"start_offset": 24,
"end_offset": 26,
"label": "dru"
},
{
"id": 4,
"entity": "维生素B12",
"start_offset": 27,
"end_offset": 33,
"label": "dru"
}
] |
当血浆叶酸含量＜3μg/L（67nmol/L）和（或）血浆维生素B12</sub>含量＜100ng/L时有助于确诊。 | [
{
"id": 0,
"entity": "血浆",
"start_offset": 1,
"end_offset": 3,
"label": "bod"
},
{
"id": 1,
"entity": "叶酸",
"start_offset": 3,
"end_offset": 5,
"label": "dru"
},
{
"id": 2,
"entity": "血浆",
"start_offset": 27,
"end_offset": 29,
"label": "bod"
},
{
"id": 3,
"entity": "维生素B12",
"start_offset": 29,
"end_offset": 35,
"label": "dru"
}
] |
（四）胃酸测定患儿胃酸常降低，经治疗后可恢复。 | [
{
"id": 0,
"entity": "胃酸",
"start_offset": 3,
"end_offset": 5,
"label": "bod"
},
{
"id": 1,
"entity": "胃酸",
"start_offset": 9,
"end_offset": 11,
"label": "bod"
}
] |
为鉴别维生素B12</sub>缺乏抑或内因子缺乏，可采用51</sup>Cr标记的维生素B12</sub>进行Schilling试验。 | [
{
"id": 0,
"entity": "维生素B12",
"start_offset": 3,
"end_offset": 9,
"label": "dru"
},
{
"id": 1,
"entity": "维生素B12",
"start_offset": 41,
"end_offset": 47,
"label": "dru"
},
{
"id": 2,
"entity": "Schilling试验",
"start_offset": 55,
"end_offset": 66,
"label": "pro"
}
] |
巨幼红细胞性贫血应与红白血病、先天性脑发育不全症鉴别，红白血病时恶性巨幼红细胞中糖原染色（PAS）呈现巨大PAS阳性颗粒，而巨幼红细胞性贫血时却无此种表现；先天性脑发育不全的智力障碍发生于出生时，而巨幼红细胞性贫血者的智力下降是继发的，出生时智力正常，不难鉴别。 | [
{
"id": 0,
"entity": "巨幼红细胞性贫血",
"start_offset": 0,
"end_offset": 8,
"label": "dis"
},
{
"id": 1,
"entity": "红白血病",
"start_offset": 10,
"end_offset": 14,
"label": "dis"
},
{
"id": 2,
"entity": "先天性脑发育不全症",
"start_offset": 15,
"end_offset": 24,
"label": "dis"
},
{
"id": 3,
"entity": "红白血病",
"start_offset": 27,
"end_offset": 31,
"label": "dis"
},
{
"id": 4,
"entity": "恶性巨幼红细胞",
"start_offset": 32,
"end_offset": 39,
"label": "bod"
},
{
"id": 5,
"entity": "糖原染色",
"start_offset": 40,
"end_offset": 44,
"label": "bod"
},
{
"id": 6,
"entity": "PAS",
"start_offset": 45,
"end_offset": 48,
"label": "bod"
},
{
"id": 7,
"entity": "巨大PAS阳性颗粒",
"start_offset": 51,
"end_offset": 60,
"label": "sym"
},
{
"id": 8,
"entity": "巨幼红细胞性贫血",
"start_offset": 62,
"end_offset": 70,
"label": "dis"
},
{
"id": 9,
"entity": "先天性脑发育不全",
"start_offset": 78,
"end_offset": 86,
"label": "dis"
},
{
"id": 10,
"entity": "智力障碍",
"start_offset": 87,
"end_offset": 91,
"label": "sym"
},
{
"id": 11,
"entity": "巨幼红细胞性贫血者",
"start_offset": 99,
"end_offset": 108,
"label": "dis"
},
{
"id": 12,
"entity": "智力下降",
"start_offset": 109,
"end_offset": 113,
"label": "sym"
}
] |
对于不能根治的先天性缺陷，只能采用补充或替代疗法。 | [
{
"id": 0,
"entity": "先天性缺陷",
"start_offset": 7,
"end_offset": 12,
"label": "dis"
}
] |
叶酸不能改善维生素B12</sub>缺乏引起的神经症状，故在无明显神经症状的巨幼红细胞性贫血可用叶酸进行治疗。 | [
{
"id": 0,
"entity": "叶酸",
"start_offset": 0,
"end_offset": 2,
"label": "dru"
},
{
"id": 1,
"entity": "维生素B12",
"start_offset": 6,
"end_offset": 12,
"label": "dru"
},
{
"id": 2,
"entity": "巨幼红细胞性贫血",
"start_offset": 38,
"end_offset": 46,
"label": "dis"
},
{
"id": 3,
"entity": "叶酸",
"start_offset": 48,
"end_offset": 50,
"label": "dru"
}
] |
每日口服叶酸5～15mg，维生素C300mg；后者可加强前者的疗效。 | [
{
"id": 0,
"entity": "叶酸",
"start_offset": 4,
"end_offset": 6,
"label": "dru"
},
{
"id": 1,
"entity": "维生素C",
"start_offset": 13,
"end_offset": 17,
"label": "dru"
}
] |
营养因素引起的维生素B12</sub>缺乏者，可给予维生素B12</sub>每3日肌肉注射0.1mg，共2～3周。 | [
{
"id": 0,
"entity": "维生素B12",
"start_offset": 7,
"end_offset": 13,
"label": "dru"
},
{
"id": 1,
"entity": "维生素B12",
"start_offset": 26,
"end_offset": 32,
"label": "dru"
},
{
"id": 2,
"entity": "肌肉注射",
"start_offset": 41,
"end_offset": 45,
"label": "pro"
}
] |
其他原因引起或病情严重者可每月1次，每次1mg，待血象正常后，减量维持。 | [
{
"id": 0,
"entity": "血象",
"start_offset": 25,
"end_offset": 27,
"label": "ite"
}
] |
为改善神经系统症状，可适当加用维生素B6</sub>。 | [
{
"id": 0,
"entity": "神经系统",
"start_offset": 3,
"end_offset": 7,
"label": "bod"
},
{
"id": 1,
"entity": "维生素B6",
"start_offset": 15,
"end_offset": 20,
"label": "dru"
}
] |
严重贫血已引起心功能不全者，应小量多次输血，以减少慢性缺氧。 | [
{
"id": 0,
"entity": "严重贫血",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "心功能不全",
"start_offset": 7,
"end_offset": 12,
"label": "sym"
},
{
"id": 2,
"entity": "输血",
"start_offset": 19,
"end_offset": 21,
"label": "pro"
},
{
"id": 3,
"entity": "慢性缺氧",
"start_offset": 25,
"end_offset": 29,
"label": "sym"
}
] |
输血时点滴速度要缓慢。 | [
{
"id": 0,
"entity": "输血",
"start_offset": 0,
"end_offset": 2,
"label": "pro"
}
] |
如有原发病应积极治疗。 | [
{
"id": 0,
"entity": "原发病",
"start_offset": 2,
"end_offset": 5,
"label": "dis"
}
] |
第三章极低出生体重儿的特点及护理极低出生体重儿（verylowbirthweightinfant，VLBW）是指出生体重小于1500g的新生儿，其中绝大部分为早产儿，胎龄小于32周。 | [
{
"id": 0,
"entity": "极低出生体重儿",
"start_offset": 4,
"end_offset": 11,
"label": "dis"
},
{
"id": 1,
"entity": "极低出生体重儿",
"start_offset": 17,
"end_offset": 24,
"label": "dis"
},
{
"id": 2,
"entity": "verylowbirthweightinfant",
"start_offset": 25,
"end_offset": 49,
"label": "dis"
},
{
"id": 3,
"entity": "VLBW",
"start_offset": 50,
"end_offset": 54,
"label": "dis"
},
{
"id": 4,
"entity": "体重",
"start_offset": 59,
"end_offset": 61,
"label": "ite"
},
{
"id": 5,
"entity": "出生体重小于1500g",
"start_offset": 57,
"end_offset": 68,
"label": "sym"
}
] |
VLBW的死亡数占新生儿死亡数的很大一部分，而且，即使存活也容易出现神经系统发育的障碍。 | [
{
"id": 0,
"entity": "VLBW",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "神经系统",
"start_offset": 34,
"end_offset": 38,
"label": "bod"
},
{
"id": 2,
"entity": "神经系统发育的障碍",
"start_offset": 34,
"end_offset": 43,
"label": "sym"
}
] |
美国1981—1997年VLBW的发生率为1.1%～1.4%，国内20世纪80年代的资料与之相近。 | [
{
"id": 0,
"entity": "VLBW",
"start_offset": 12,
"end_offset": 16,
"label": "dis"
}
] |
一、生理特点（一）呼吸系统VLBW呼吸中枢的发育、呼吸器官的发育和相关因子的产生均不完善，很容易发生呼吸暂停和低氧血症的发生。 | [
{
"id": 0,
"entity": "呼吸系统",
"start_offset": 9,
"end_offset": 13,
"label": "bod"
},
{
"id": 1,
"entity": "VLBW",
"start_offset": 13,
"end_offset": 17,
"label": "dis"
},
{
"id": 2,
"entity": "呼吸中枢",
"start_offset": 17,
"end_offset": 21,
"label": "bod"
},
{
"id": 3,
"entity": "呼吸器官",
"start_offset": 25,
"end_offset": 29,
"label": "bod"
},
{
"id": 4,
"entity": "呼吸中枢的发育、呼吸器官的发育和相关因子的产生均不完善",
"start_offset": 17,
"end_offset": 44,
"label": "sym"
},
{
"id": 5,
"entity": "呼吸暂停",
"start_offset": 50,
"end_offset": 54,
"label": "sym"
},
{
"id": 6,
"entity": "低氧血症",
"start_offset": 55,
"end_offset": 59,
"label": "dis"
}
] |
VLBW的胸壁薄、呼吸肌发育差、小支气管的软骨少，肺泡发育未完成，导致其功能残气量低，肺顺应性差，通气/血流比严重失调；同时，由于其气道的管径小，造成气道阻力高、有效通气量减少。 | [
{
"id": 0,
"entity": "VLBW",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "胸壁",
"start_offset": 5,
"end_offset": 7,
"label": "bod"
},
{
"id": 2,
"entity": "胸壁薄",
"start_offset": 5,
"end_offset": 8,
"label": "sym"
},
{
"id": 3,
"entity": "呼吸肌",
"start_offset": 9,
"end_offset": 12,
"label": "bod"
},
{
"id": 4,
"entity": "呼吸肌发育差",
"start_offset": 9,
"end_offset": 15,
"label": "sym"
},
{
"id": 5,
"entity": "小支气管",
"start_offset": 16,
"end_offset": 20,
"label": "bod"
},
{
"id": 6,
"entity": "软骨",
"start_offset": 21,
"end_offset": 23,
"label": "bod"
},
{
"id": 7,
"entity": "小支气管的软骨少",
"start_offset": 16,
"end_offset": 24,
"label": "sym"
},
{
"id": 8,
"entity": "肺泡",
"start_offset": 25,
"end_offset": 27,
"label": "bod"
},
{
"id": 9,
"entity": "肺泡发育未完成",
"start_offset": 25,
"end_offset": 32,
"label": "sym"
},
{
"id": 10,
"entity": "功能残气量低",
"start_offset": 36,
"end_offset": 42,
"label": "sym"
},
{
"id": 11,
"entity": "肺",
"start_offset": 43,
"end_offset": 44,
"label": "bod"
},
{
"id": 12,
"entity": "肺顺应性差",
"start_offset": 43,
"end_offset": 48,
"label": "sym"
},
{
"id": 13,
"entity": "通气/血流比",
"start_offset": 49,
"end_offset": 55,
"label": "ite"
},
{
"id": 14,
"entity": "通气/血流比严重失调",
"start_offset": 49,
"end_offset": 59,
"label": "sym"
},
{
"id": 15,
"entity": "气道",
"start_offset": 66,
"end_offset": 68,
"label": "bod"
},
{
"id": 16,
"entity": "气道的管径小",
"start_offset": 66,
"end_offset": 72,
"label": "sym"
},
{
"id": 17,
"entity": "气道",
"start_offset": 75,
"end_offset": 77,
"label": "bod"
},
{
"id": 18,
"entity": "气道阻力高、有效通气量减少",
"start_offset": 75,
"end_offset": 88,
"label": "sym"
}
] |
对于胎龄小于32周的VLBW，其肺泡Ⅱ型上皮细胞及其功能的发育尚未完善，缺乏产生肺表面活性物质的能力或数量极少，导致新生儿呼吸窘迫综合征的发生率增高。 | [
{
"id": 0,
"entity": "VLBW",
"start_offset": 10,
"end_offset": 14,
"label": "dis"
},
{
"id": 1,
"entity": "肺泡Ⅱ型上皮细胞",
"start_offset": 16,
"end_offset": 24,
"label": "bod"
},
{
"id": 2,
"entity": "肺泡Ⅱ型上皮细胞及其功能的发育尚未完善",
"start_offset": 16,
"end_offset": 35,
"label": "sym"
},
{
"id": 3,
"entity": "肺表面活性物质",
"start_offset": 40,
"end_offset": 47,
"label": "bod"
},
{
"id": 4,
"entity": "缺乏产生肺表面活性物质的能力或数量极少",
"start_offset": 36,
"end_offset": 55,
"label": "sym"
},
{
"id": 5,
"entity": "呼吸窘迫综合征",
"start_offset": 61,
"end_offset": 68,
"label": "dis"
}
] |
（二）循环系统胎龄小的VLBW的心肌纤维胶原含量低而且缺乏张力，心肌处于一种低反应状态，表现为收缩期的收缩力和舒张期张力均较低，对于维持心功能不利。 | [
{
"id": 0,
"entity": "循环系统",
"start_offset": 3,
"end_offset": 7,
"label": "bod"
},
{
"id": 1,
"entity": "VLBW",
"start_offset": 11,
"end_offset": 15,
"label": "dis"
},
{
"id": 2,
"entity": "心肌纤维胶原",
"start_offset": 16,
"end_offset": 22,
"label": "bod"
},
{
"id": 3,
"entity": "心肌纤维胶原含量低而且缺乏张力",
"start_offset": 16,
"end_offset": 31,
"label": "sym"
},
{
"id": 4,
"entity": "心肌",
"start_offset": 32,
"end_offset": 34,
"label": "bod"
},
{
"id": 5,
"entity": "心肌处于一种低反应状态",
"start_offset": 32,
"end_offset": 43,
"label": "sym"
},
{
"id": 6,
"entity": "收缩期的收缩力和舒张期张力均较低",
"start_offset": 47,
"end_offset": 63,
"label": "sym"
},
{
"id": 7,
"entity": "心功能",
"start_offset": 68,
"end_offset": 71,
"label": "ite"
}
] |
VLBW发育尚未达到适应外界生活的需要，因而出生后容易发生潜水反射，即全身血流重新分布，以保证重要脏器心、脑、肾上腺的血液供应。 | [
{
"id": 0,
"entity": "VLBW",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "心",
"start_offset": 51,
"end_offset": 52,
"label": "bod"
},
{
"id": 2,
"entity": "脑",
"start_offset": 53,
"end_offset": 54,
"label": "bod"
},
{
"id": 3,
"entity": "肾上腺",
"start_offset": 55,
"end_offset": 58,
"label": "bod"
},
{
"id": 4,
"entity": "血液",
"start_offset": 59,
"end_offset": 61,
"label": "bod"
}
] |
神经系统对心血管的调节为副交感神经占优势，在对VLBW进行口、鼻腔操作时容易引起迷走神经反射亢进，发生缓脉等情况。 | [
{
"id": 0,
"entity": "神经系统",
"start_offset": 0,
"end_offset": 4,
"label": "bod"
},
{
"id": 1,
"entity": "心血管",
"start_offset": 5,
"end_offset": 8,
"label": "bod"
},
{
"id": 2,
"entity": "副交感神经",
"start_offset": 12,
"end_offset": 17,
"label": "bod"
},
{
"id": 3,
"entity": "VLBW",
"start_offset": 23,
"end_offset": 27,
"label": "dis"
},
{
"id": 4,
"entity": "口",
"start_offset": 29,
"end_offset": 30,
"label": "bod"
},
{
"id": 5,
"entity": "鼻腔",
"start_offset": 31,
"end_offset": 33,
"label": "bod"
},
{
"id": 6,
"entity": "迷走神经",
"start_offset": 40,
"end_offset": 44,
"label": "bod"
},
{
"id": 7,
"entity": "迷走神经反射亢进",
"start_offset": 40,
"end_offset": 48,
"label": "sym"
},
{
"id": 8,
"entity": "缓脉",
"start_offset": 51,
"end_offset": 53,
"label": "sym"
}
] |
对血压自身调节能力的发育尚未完善，如躯体血压的变动直接可影响脑血压的变化。 | [
{
"id": 0,
"entity": "血压",
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{
"id": 1,
"entity": "血压",
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},
{
"id": 2,
"entity": "脑血压",
"start_offset": 30,
"end_offset": 33,
"label": "ite"
}
] |
另外，对于部分重度宫内发育迟缓的VLBW，生后即可发生心功能不全，并在生后2～3天开始恶化，发病后1～2天达高峰，如能度过这一高峰期，则存活率增高。 | [
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"id": 0,
"entity": "重度宫内发育迟缓",
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{
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{
"id": 2,
"entity": "心功能",
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] |
在部分死亡病例的尸解中发现心肌纤维与相应胎龄比较明显地更细。 | [
{
"id": 0,
"entity": "心肌纤维",
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"end_offset": 17,
"label": "bod"
}
] |
（三）中枢神经系统因发育不完善致反射和协调功能差；四肢肌张力明显低下。 | [
{
"id": 0,
"entity": "中枢神经系统",
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{
"id": 1,
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{
"id": 2,
"entity": "四肢",
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{
"id": 3,
"entity": "四肢肌张力明显低下",
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"end_offset": 34,
"label": "sym"
}
] |
脑血管结构从软脑膜开始，沿很长的小动脉向侧脑室方向行进，终止于深部白质的脑室脚间动脉，与从侧脑室开始向深部白质行进的较短脑室动脉形成终末供血区。 | [
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"entity": "脑血管",
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{
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{
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{
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{
"id": 4,
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{
"id": 5,
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{
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"entity": "侧脑室",
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{
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},
{
"id": 8,
"entity": "较短脑室动脉",
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"label": "bod"
}
] |
这一部位容易受低血压或低血流所伴的缺血性变化的影响，造成脑室周围白质软化症的发生。 | [
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{
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{
"id": 3,
"entity": "白质软化症",
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"label": "dis"
}
] |
（四）泌尿系统VLBW的肾功能差，肾小球滤过率较低；肾脏浓缩功能亦差，肾小管对葡萄糖的重吸收阈值低，给予高浓度葡萄糖补液可以造成高血糖和渗透性利尿。 | [
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"entity": "泌尿系统",
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{
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"entity": "肾功能",
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"entity": "肾功能差",
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{
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"entity": "肾小球",
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{
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"entity": "肾小球滤过率较低",
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{
"id": 6,
"entity": "肾脏",
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},
{
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"entity": "肾脏浓缩功能亦差",
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},
{
"id": 8,
"entity": "肾小管",
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"label": "bod"
},
{
"id": 9,
"entity": "葡萄糖",
"start_offset": 39,
"end_offset": 42,
"label": "bod"
},
{
"id": 10,
"entity": "肾小管对葡萄糖的重吸收阈值低",
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"end_offset": 49,
"label": "sym"
},
{
"id": 11,
"entity": "高浓度葡萄糖补液",
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"end_offset": 60,
"label": "dru"
},
{
"id": 12,
"entity": "高血糖",
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"end_offset": 67,
"label": "dis"
},
{
"id": 13,
"entity": "渗透性利尿",
"start_offset": 68,
"end_offset": 73,
"label": "dis"
}
] |
新生儿少尿的定义为＜1ml/（kg•h），但是对于VLBW在尿量＜2ml/（kg•h）时也要考虑少尿的存在。 | [
{
"id": 0,
"entity": "少尿",
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"end_offset": 5,
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{
"id": 1,
"entity": "VLBW",
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{
"id": 2,
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{
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"entity": "尿量＜2ml/（kg•h）",
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},
{
"id": 4,
"entity": "少尿",
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"end_offset": 50,
"label": "sym"
}
] |
（五）消化系统小肠的自律性活动从胎龄6～7个月已经开始，但尚无输送能力，肠道输送能力实际是从胎龄34周开始的。 | [
{
"id": 0,
"entity": "消化系统",
"start_offset": 3,
"end_offset": 7,
"label": "bod"
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{
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"label": "bod"
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{
"id": 2,
"entity": "肠道",
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"label": "bod"
}
] |
VLBW的消化器官未能正常活动是因为：肠道神经丛处于未成熟阶段，加上低血糖及其他刺激，使交感神经的兴奋性增高；潜水反射使进入肠道的血流减少，导致肠道活动能力低下；母亲的某些用药，如控制妊高征的硫酸镁可以使乙酰胆碱释放减少，并使神经-肌紧张反射功能低下。 | [
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"entity": "VLBW",
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{
"id": 1,
"entity": "消化器官",
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"label": "bod"
},
{
"id": 2,
"entity": "肠道神经丛",
"start_offset": 19,
"end_offset": 24,
"label": "bod"
},
{
"id": 3,
"entity": "低血糖",
"start_offset": 34,
"end_offset": 37,
"label": "dis"
},
{
"id": 4,
"entity": "交感神经",
"start_offset": 44,
"end_offset": 48,
"label": "bod"
},
{
"id": 5,
"entity": "交感神经的兴奋性增高",
"start_offset": 44,
"end_offset": 54,
"label": "sym"
},
{
"id": 6,
"entity": "肠道",
"start_offset": 62,
"end_offset": 64,
"label": "bod"
},
{
"id": 7,
"entity": "肠道活动能力低下",
"start_offset": 72,
"end_offset": 80,
"label": "sym"
},
{
"id": 8,
"entity": "妊高征",
"start_offset": 92,
"end_offset": 95,
"label": "dis"
},
{
"id": 9,
"entity": "硫酸镁",
"start_offset": 96,
"end_offset": 99,
"label": "dru"
},
{
"id": 10,
"entity": "乙酰胆碱",
"start_offset": 102,
"end_offset": 106,
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},
{
"id": 11,
"entity": "神经-肌",
"start_offset": 113,
"end_offset": 117,
"label": "bod"
},
{
"id": 12,
"entity": "神经-肌紧张反射功能低下",
"start_offset": 113,
"end_offset": 125,
"label": "sym"
}
] |
无论是潜水反射造成的缺氧，或是肠道喂养后发生的缺氧（开始肠道喂养后，肠道本身对氧的需求增加，而肠道血流量未明显增加，造成一种肠道组织的低氧状态），都是发生NEC的危险因素。 | [
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{
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{
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{
"id": 5,
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{
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"entity": "肠道血流量未明显增加",
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{
"id": 7,
"entity": "肠道组织",
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"label": "bod"
},
{
"id": 8,
"entity": "NEC",
"start_offset": 77,
"end_offset": 80,
"label": "dis"
}
] |
感染对发生NEC的影响与肠道的局部防御能力有关。 | [
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"entity": "NEC",
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{
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}
] |
VLBW的胆汁酸分泌量很少，其胆汁酸池也很小，容易造成胆汁排出困难，形成胆汁淤积症。 | [
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"id": 0,
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{
"id": 1,
"entity": "胆汁酸",
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{
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"entity": "胆汁酸池",
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{
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"entity": "胆汁",
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"entity": "胆汁排出困难",
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},
{
"id": 5,
"entity": "胆汁淤积症",
"start_offset": 36,
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"label": "dis"
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] |
VLBW在出生前体内已经有蛋白分解酶的活性存在，尽管其浓度与成人比还是处于明显的低水平；胎龄24周已经具备对氨基酸等的转运能力。 | [
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"id": 0,
"entity": "VLBW",
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{
"id": 1,
"entity": "蛋白分解酶",
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},
{
"id": 2,
"entity": "氨基酸",
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}
] |
胎龄25周时唾液腺已经开始分泌能消化脂肪的脂酶，同时人乳中存在的胆盐刺激脂酶（bilesaltstimulatinglipase，BSSL）能促使脂肪酸分解和消化脂肪。 | [
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"entity": "唾液腺",
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{
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{
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"entity": "脂酶",
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{
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"entity": "人乳",
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{
"id": 4,
"entity": "胆盐",
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"label": "bod"
},
{
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"entity": "脂酶",
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{
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"entity": "bilesaltstimulatinglipase",
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{
"id": 7,
"entity": "BSSL",
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},
{
"id": 8,
"entity": "脂肪酸",
"start_offset": 73,
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"label": "bod"
},
{
"id": 9,
"entity": "脂肪",
"start_offset": 81,
"end_offset": 83,
"label": "bod"
}
] |
小肠黏膜绒毛膜刷状缘有活性双糖分解酶在胎龄10～12周已经出现，在26～34周时几乎达到成人的水平；乳糖酶、β-葡萄糖苷酶的活性在胎龄24周才开始增加；但缺乏消化多糖体所需要的淀粉酶，母乳中抗胃酸的淀粉酶直接到达小肠，可以帮助消化多糖体。 | [
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"id": 0,
"entity": "小肠黏膜绒毛膜刷状缘",
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{
"id": 1,
"entity": "活性双糖分解酶",
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{
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"entity": "乳糖酶",
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{
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"entity": "淀粉酶",
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{
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"entity": "胃酸",
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},
{
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"entity": "淀粉酶",
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"label": "mic"
},
{
"id": 8,
"entity": "小肠",
"start_offset": 106,
"end_offset": 108,
"label": "bod"
}
] |
（六）水、电解质和酸碱平衡VLBW的体表面积相对较大，不显性失水量较大，体重＜1000g新生儿的不显性失水几乎是1500g新生儿的2倍。 | [
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"entity": "VLBW",
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{
"id": 1,
"entity": "体表面积相对较大",
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{
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"entity": "不显性失水量较大",
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{
"id": 3,
"entity": "体重",
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},
{
"id": 4,
"entity": "体重＜1000g",
"start_offset": 36,
"end_offset": 44,
"label": "sym"
}
] |
出生后3天内，由于不显性失水的增加以及排尿和使用含钠盐溶液，可以造成高钠血症的出现。 | [
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{
"id": 1,
"entity": "高钠血症",
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] |
而对于出生3天后的VLBW，由于其肾小管重吸收功能差，尿中排钠量高，母乳中钠含量随出生后天数的增加而相应地持续减少，如加上利尿剂的使用，可以造成低钠血症。 | [
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"id": 0,
"entity": "VLBW",
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{
"id": 1,
"entity": "肾小管",
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{
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"entity": "肾小管重吸收功能差",
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{
"id": 3,
"entity": "尿",
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{
"id": 4,
"entity": "尿中排钠量高",
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{
"id": 5,
"entity": "母乳",
"start_offset": 34,
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},
{
"id": 6,
"entity": "利尿剂",
"start_offset": 61,
"end_offset": 64,
"label": "dru"
},
{
"id": 7,
"entity": "低钠血症",
"start_offset": 72,
"end_offset": 76,
"label": "dis"
}
] |
酸中毒往往发生在生后初期，主要与缺氧有关，通过改善氧供和呼吸循环的功能可以及时纠正；生后2周以后发生的晚发性代谢性酸中毒，可能与蛋白质负荷高、尿酸化能力低（肾小管分泌H<sup>+</sup>功能差）和排出阈值低有关。 | [
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"entity": "酸中毒",
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{
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{
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"entity": "晚发性代谢性酸中毒",
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{
"id": 3,
"entity": "蛋白质",
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"label": "bod"
},
{
"id": 4,
"entity": "蛋白质负荷高",
"start_offset": 64,
"end_offset": 70,
"label": "sym"
},
{
"id": 5,
"entity": "尿",
"start_offset": 71,
"end_offset": 72,
"label": "bod"
},
{
"id": 6,
"entity": "尿酸化能力低",
"start_offset": 71,
"end_offset": 77,
"label": "sym"
},
{
"id": 7,
"entity": "肾小管",
"start_offset": 78,
"end_offset": 81,
"label": "bod"
},
{
"id": 8,
"entity": "肾小管分泌H<sup>+</sup>功能差",
"start_offset": 78,
"end_offset": 99,
"label": "sym"
},
{
"id": 9,
"entity": "排出阈值低",
"start_offset": 101,
"end_offset": 106,
"label": "sym"
}
] |
代谢性碱中毒的发生，可能与排钠钾性利尿剂的持续使用有关，造成肾小管对钠钾的重吸收障碍，同时利尿剂抑制了对氯离子的重吸收，则发生低氯性代谢性碱中毒。 | [
{
"id": 0,
"entity": "代谢性碱中毒",
"start_offset": 0,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "排钠钾性利尿剂",
"start_offset": 13,
"end_offset": 20,
"label": "dru"
},
{
"id": 2,
"entity": "肾小管",
"start_offset": 30,
"end_offset": 33,
"label": "bod"
},
{
"id": 3,
"entity": "肾小管对钠钾的重吸收障碍",
"start_offset": 30,
"end_offset": 42,
"label": "sym"
},
{
"id": 4,
"entity": "利尿剂",
"start_offset": 45,
"end_offset": 48,
"label": "dru"
},
{
"id": 5,
"entity": "低氯性代谢性碱中毒",
"start_offset": 63,
"end_offset": 72,
"label": "dis"
}
] |
低血钙的发生可能无临床症状，血钙最低可＜3mmol/L，一般在7天后可自行纠正。 | [
{
"id": 0,
"entity": "低血钙",
"start_offset": 0,
"end_offset": 3,
"label": "dis"
},
{
"id": 1,
"entity": "血钙",
"start_offset": 14,
"end_offset": 16,
"label": "ite"
},
{
"id": 2,
"entity": "血钙最低可＜3mmol/L",
"start_offset": 14,
"end_offset": 27,
"label": "sym"
}
] |
（七）代谢VLBW的基础代谢率比足月新生儿低，但是其糖原、脂肪的储存量很少，能量的摄取能力极差。 | [
{
"id": 0,
"entity": "VLBW",
"start_offset": 5,
"end_offset": 9,
"label": "dis"
},
{
"id": 1,
"entity": "糖原",
"start_offset": 26,
"end_offset": 28,
"label": "bod"
},
{
"id": 2,
"entity": "脂肪",
"start_offset": 29,
"end_offset": 31,
"label": "bod"
},
{
"id": 3,
"entity": "糖原、脂肪的储存量很少",
"start_offset": 26,
"end_offset": 37,
"label": "sym"
},
{
"id": 4,
"entity": "能量的摄取能力极差",
"start_offset": 38,
"end_offset": 47,
"label": "sym"
}
] |
同时，高血糖会造成肝细胞对胰岛素的反应低下。 | [
{
"id": 0,
"entity": "高血糖",
"start_offset": 3,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "肝细胞",
"start_offset": 9,
"end_offset": 12,
"label": "bod"
},
{
"id": 2,
"entity": "胰岛素",
"start_offset": 13,
"end_offset": 16,
"label": "dru"
}
] |
VLBW发生低血糖情况较少见。 | [
{
"id": 0,
"entity": "VLBW",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "低血糖",
"start_offset": 6,
"end_offset": 9,
"label": "dis"
}
] |
VLBW本身血清蛋白含量低，同时能量供应不足的情况下，蛋白质被用于能量供应，造成负氮平衡。 | [
{
"id": 0,
"entity": "VLBW",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "血清蛋白",
"start_offset": 6,
"end_offset": 10,
"label": "bod"
},
{
"id": 2,
"entity": "蛋白质",
"start_offset": 27,
"end_offset": 30,
"label": "bod"
}
] |
VLBW的卡泥汀合成能力低，对脂肪酸的分解不利。 | [
{
"id": 0,
"entity": "VLBW",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "卡泥汀",
"start_offset": 5,
"end_offset": 8,
"label": "bod"
},
{
"id": 2,
"entity": "脂肪酸",
"start_offset": 15,
"end_offset": 18,
"label": "bod"
}
] |
对静脉给予的脂肪利用度小，容易造成一过性高脂血症。 | [
{
"id": 0,
"entity": "静脉",
"start_offset": 1,
"end_offset": 3,
"label": "pro"
},
{
"id": 1,
"entity": "脂肪",
"start_offset": 6,
"end_offset": 8,
"label": "bod"
},
{
"id": 2,
"entity": "一过性高脂血症",
"start_offset": 17,
"end_offset": 24,
"label": "dis"
}
] |
脂肪吸收率低，容易影响脂溶性维生素的吸收。 | [
{
"id": 0,
"entity": "脂肪",
"start_offset": 0,
"end_offset": 2,
"label": "bod"
},
{
"id": 1,
"entity": "脂肪吸收率低",
"start_offset": 0,
"end_offset": 6,
"label": "sym"
}
] |
胎龄小于36周的新生儿难以从肠道吸收锌，容易存在锌缺乏。 | [
{
"id": 0,
"entity": "肠道",
"start_offset": 14,
"end_offset": 16,
"label": "bod"
},
{
"id": 1,
"entity": "锌缺乏",
"start_offset": 24,
"end_offset": 27,
"label": "sym"
}
] |
VLBW的体温调节能力低，通常需要37～38℃的环境温度（包括暖箱温度）方能维持其肛门温度为37℃，否则容易出现低体温。 | [
{
"id": 0,
"entity": "VLBW",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "体温调节能力低",
"start_offset": 5,
"end_offset": 12,
"label": "sym"
},
{
"id": 2,
"entity": "暖箱",
"start_offset": 31,
"end_offset": 33,
"label": "equ"
},
{
"id": 3,
"entity": "肛门",
"start_offset": 41,
"end_offset": 43,
"label": "bod"
}
] |
同时，由于汗腺功能发育不完善，环境温度过高，容易产生发热。 | [
{
"id": 0,
"entity": "汗腺",
"start_offset": 5,
"end_offset": 7,
"label": "bod"
},
{
"id": 1,
"entity": "发热",
"start_offset": 26,
"end_offset": 28,
"label": "sym"
}
] |
（八）其他感染是造成VLBW死亡的重要原因，主要与免疫功能发育不完善有关，包括从母体获得的特异性免疫球蛋白量少于足月新生儿。 | [
{
"id": 0,
"entity": "感染",
"start_offset": 5,
"end_offset": 7,
"label": "dis"
},
{
"id": 1,
"entity": "VLBW",
"start_offset": 10,
"end_offset": 14,
"label": "dis"
},
{
"id": 2,
"entity": "特异性免疫球蛋白",
"start_offset": 45,
"end_offset": 53,
"label": "bod"
}
] |
VLBW在黄疸不高的情况下，由于低蛋白血症和血脑屏障的发育不完善，也容易发生核黄疸，有人认为体重在1000g的新生儿，一旦其总胆红素为10mg/dl就应换血，以避免核黄疸的发生。 | [
{
"id": 0,
"entity": "VLBW",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "黄",
"start_offset": 5,
"end_offset": 6,
"label": "dis"
},
{
"id": 2,
"entity": "黄",
"start_offset": 5,
"end_offset": 6,
"label": "pro"
},
{
"id": 3,
"entity": "下，由于低",
"start_offset": 12,
"end_offset": 17,
"label": "dis"
},
{
"id": 4,
"entity": "白血症和",
"start_offset": 18,
"end_offset": 22,
"label": "dis"
},
{
"id": 5,
"entity": "容易发",
"start_offset": 34,
"end_offset": 37,
"label": "dis"
},
{
"id": 6,
"entity": "有人",
"start_offset": 42,
"end_offset": 44,
"label": "ite"
},
{
"id": 7,
"entity": "，一旦其",
"start_offset": 58,
"end_offset": 62,
"label": "ite"
},
{
"id": 8,
"entity": "，一旦其总胆红素为10m",
"start_offset": 58,
"end_offset": 70,
"label": "sym"
},
{
"id": 9,
"entity": "dl",
"start_offset": 72,
"end_offset": 74,
"label": "pro"
},
{
"id": 10,
"entity": "，以避",
"start_offset": 78,
"end_offset": 81,
"label": "dis"
}
] |
第六章上呼吸道疾病第一节先天性喉喘鸣先天性喉喘鸣（congenitallaryngealstridor），常发生于出生后不久，主要症状为吸气时发生喘鸣。 | [
{
"id": 0,
"entity": "上呼吸道疾病",
"start_offset": 4,
"end_offset": 10,
"label": "dis"
},
{
"id": 1,
"entity": "先天性喉喘鸣",
"start_offset": 13,
"end_offset": 19,
"label": "dis"
},
{
"id": 2,
"entity": "先天性喉喘鸣",
"start_offset": 19,
"end_offset": 25,
"label": "dis"
},
{
"id": 3,
"entity": "congenitallaryngealstridor",
"start_offset": 26,
"end_offset": 52,
"label": "dis"
},
{
"id": 4,
"entity": "吸气时发生喘鸣",
"start_offset": 69,
"end_offset": 76,
"label": "sym"
}
] |
喉软化和气管软化是最主要的原因。 | [
{
"id": 0,
"entity": "喉软化",
"start_offset": 0,
"end_offset": 3,
"label": "dis"
},
{
"id": 1,
"entity": "气管软化",
"start_offset": 4,
"end_offset": 8,
"label": "dis"
}
] |
由于吸气时负压较大，使会厌边缘与杓状软骨接近，喉部成活瓣状关闭，从而发生喉喘鸣。 | [
{
"id": 0,
"entity": "会厌",
"start_offset": 11,
"end_offset": 13,
"label": "bod"
},
{
"id": 1,
"entity": "杓状软骨",
"start_offset": 16,
"end_offset": 20,
"label": "bod"
},
{
"id": 2,
"entity": "喉部",
"start_offset": 23,
"end_offset": 25,
"label": "bod"
},
{
"id": 3,
"entity": "喉喘鸣",
"start_offset": 36,
"end_offset": 39,
"label": "dis"
}
] |
35%喉软化患儿伴有其他病变，如气管软化、声门下狭窄、声带麻痹等。 | [
{
"id": 0,
"entity": "喉软化",
"start_offset": 3,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "气管软化",
"start_offset": 16,
"end_offset": 20,
"label": "dis"
},
{
"id": 2,
"entity": "声门下狭窄",
"start_offset": 21,
"end_offset": 26,
"label": "dis"
},
{
"id": 3,
"entity": "声带麻痹",
"start_offset": 27,
"end_offset": 31,
"label": "dis"
}
] |
重者喘鸣为持续性，并出现三凹征。 | [
{
"id": 0,
"entity": "喘鸣",
"start_offset": 2,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "三凹征",
"start_offset": 12,
"end_offset": 15,
"label": "sym"
}
] |
由于影响哺乳及睡眠，常有不同程度的营养不良。 | [
{
"id": 0,
"entity": "营养不良",
"start_offset": 17,
"end_offset": 21,
"label": "sym"
}
] |
同时，由于呼吸困难及长期缺氧，可见明显的漏斗胸或鸡胸。 | [
{
"id": 0,
"entity": "呼吸困难",
"start_offset": 5,
"end_offset": 9,
"label": "sym"
},
{
"id": 1,
"entity": "长期缺氧",
"start_offset": 10,
"end_offset": 14,
"label": "sym"
},
{
"id": 2,
"entity": "漏斗胸",
"start_offset": 20,
"end_offset": 23,
"label": "sym"
},
{
"id": 3,
"entity": "鸡胸",
"start_offset": 24,
"end_offset": 26,
"label": "sym"
}
] |
明显喉喘鸣持续数个月至1年，随喉软骨逐渐发育，多数患儿在18个月内消失。 | [
{
"id": 0,
"entity": "喉喘鸣",
"start_offset": 2,
"end_offset": 5,
"label": "dis"
},
{
"id": 1,
"entity": "喉软骨",
"start_offset": 15,
"end_offset": 18,
"label": "bod"
}
] |
少数可于呼吸道感染、运动或哭吵时出现喘鸣症状。 | [
{
"id": 0,
"entity": "呼吸道感染",
"start_offset": 4,
"end_offset": 9,
"label": "dis"
},
{
"id": 1,
"entity": "喘鸣",
"start_offset": 18,
"end_offset": 20,
"label": "sym"
}
] |
根据出生后不久即出现喉喘鸣，无其他疾病的病史、体征，一般不难做出诊断。 | [
{
"id": 0,
"entity": "喉喘鸣",
"start_offset": 10,
"end_offset": 13,
"label": "dis"
}
] |
注意防治呼吸道感染。 | [
{
"id": 0,
"entity": "呼吸道感染",
"start_offset": 4,
"end_offset": 9,
"label": "dis"
}
] |
一般不需气管切开。 | [
{
"id": 0,
"entity": "气管",
"start_offset": 4,
"end_offset": 6,
"label": "bod"
}
] |
如并发其他解剖畸形，应进行相应处理。 | [
{
"id": 0,
"entity": "解剖畸形",
"start_offset": 5,
"end_offset": 9,
"label": "dis"
}
] |
第三节病毒性肺炎一、呼吸道合胞病毒性肺炎呼吸道合胞病毒（RSV）是婴儿下呼吸道感染的主要病原，尤其易发生于2～4月龄的小婴儿。 | [
{
"id": 0,
"entity": "病毒性肺炎",
"start_offset": 3,
"end_offset": 8,
"label": "dis"
},
{
"id": 1,
"entity": "呼吸道合胞病毒性肺炎",
"start_offset": 10,
"end_offset": 20,
"label": "dis"
},
{
"id": 2,
"entity": "呼吸道合胞病毒",
"start_offset": 20,
"end_offset": 27,
"label": "dis"
},
{
"id": 3,
"entity": "RSV",
"start_offset": 28,
"end_offset": 31,
"label": "dis"
},
{
"id": 4,
"entity": "下呼吸道",
"start_offset": 35,
"end_offset": 39,
"label": "bod"
}
] |
据浙江大学医学院附属儿童医院观察，冬春季节RSV感染占3岁以下婴幼儿肺炎的35%左右。 | [
{
"id": 0,
"entity": "RSV感染",
"start_offset": 21,
"end_offset": 26,
"label": "dis"
},
{
"id": 1,
"entity": "3岁以下婴幼儿肺炎",
"start_offset": 27,
"end_offset": 36,
"label": "dis"
}
] |
RSV毛细支气管炎的发病机制尚不明确，但有证据表明，免疫损伤可能参与了其发病过程。 | [
{
"id": 0,
"entity": "RSV毛细支气管炎",
"start_offset": 0,
"end_offset": 9,
"label": "dis"
}
] |
初期上呼吸道感染症状突出，如鼻塞、流涕，继而咳嗽、低热、喘鸣。 | [
{
"id": 0,
"entity": "上呼吸道",
"start_offset": 2,
"end_offset": 6,
"label": "bod"
},
{
"id": 1,
"entity": "鼻塞",
"start_offset": 14,
"end_offset": 16,
"label": "sym"
},
{
"id": 2,
"entity": "流涕",
"start_offset": 17,
"end_offset": 19,
"label": "sym"
},
{
"id": 3,
"entity": "咳嗽",
"start_offset": 22,
"end_offset": 24,
"label": "sym"
},
{
"id": 4,
"entity": "低热",
"start_offset": 25,
"end_offset": 27,
"label": "sym"
},
{
"id": 5,
"entity": "喘鸣",
"start_offset": 28,
"end_offset": 30,
"label": "sym"
}
] |
随病情进展，出现呼吸困难、鼻扇、呼气延长、呼吸时呻吟和三凹征等。 | [
{
"id": 0,
"entity": "呼吸困难",
"start_offset": 8,
"end_offset": 12,
"label": "sym"
},
{
"id": 1,
"entity": "鼻扇",
"start_offset": 13,
"end_offset": 15,
"label": "sym"
},
{
"id": 2,
"entity": "呼气延长",
"start_offset": 16,
"end_offset": 20,
"label": "sym"
},
{
"id": 3,
"entity": "呼吸时呻吟",
"start_offset": 21,
"end_offset": 26,
"label": "sym"
},
{
"id": 4,
"entity": "三凹征",
"start_offset": 27,
"end_offset": 30,
"label": "sym"
}
] |
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