text stringlengths 4 4.87k | entities list |
|---|---|
上纵隔内显示一充气盲囊影，为上段食管闭锁之盲袋。 | [
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"entity": "上纵隔内显示一充气盲囊影，为上段食管闭锁之盲袋",
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多数患儿因有食管远段一气管瘘，腹部有气体；少数病例远段食管与气管无交通，腹部无气体。 | [
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食管闭锁常合并其他消化道、心血管及骨骼畸形，因此常规胸腹部照片是不可缺少的。 | [
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"entity": "消化道",
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"entity": "心血管",
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"entity": "骨骼畸形",
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"label": "dis"
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"entity": "胸腹部照片",
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但平片不能最后确诊。 | [
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②自鼻胃管内注入1～2ml稀钡剂，透视下点片，转动体位至侧卧位便于瘘管显影。 | [
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"entity": "稀钡剂",
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"entity": "瘘管显影",
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（二）食管裂孔疝食管裂孔疝（hiatushernia）是小儿常见的呕吐原因。 | [
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系食管下端和周围膈食管裂孔的先天发育缺陷食管裂孔滑疝、食管旁疝和混合型疝三种类型。 | [
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"entity": "食管下端和周围膈食管裂孔的先天发育缺陷",
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"entity": "食管裂孔滑疝",
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"entity": "食管旁疝",
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"entity": "混合型疝",
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最多见的为食管裂孔滑疝，其胸腹部平片无特征，钡餐显示：①食管持续反流胃底疝入膈上2～4cm，胃黏膜较粗、数目多、弯曲食管环位于膈上食管裂孔增大，食管胃角增大变钝胃食管反流当胃食管抗反流屏障作用发生异常，则极易导致病理性胃食管反流。 | [
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"entity": "钡餐",
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"entity": "食管持续反流",
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"id": 5,
"entity": "胃黏膜",
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"entity": "胃底疝入膈上2～4cm，胃黏膜较粗、数目多、弯曲",
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"id": 7,
"entity": "食管",
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"entity": "食管环位于膈上",
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"id": 9,
"entity": "食管胃角",
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"label": "bod"
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"id": 10,
"entity": "食管裂孔增大，食管胃角增大变钝",
"start_offset": 65,
"end_offset": 80,
"label": "sym"
},
{
"id": 11,
"entity": "胃食管反流",
"start_offset": 80,
"end_offset": 85,
"label": "dis"
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"id": 12,
"entity": "胃食管抗反流屏障",
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"end_offset": 94,
"label": "bod"
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"id": 13,
"entity": "病理性胃食管反流",
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"label": "dis"
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生后3个月以上仍有反流应考虑为病理性。 | [
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胃内容物反流到食管，食管下端黏膜受到反流液的侵袭而导致反流性食管炎。 | [
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"entity": "反流性食管炎",
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临床表现为呕吐、肺部反复感染，并发生反流性食管炎。 | [
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影像诊断：①钡餐检查：仰卧位见胃内钡剂进入食管即可诊断，但需注意5分钟内反流3次方能诊断。 | [
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另外，还可见反流性食管炎的X线表现。 | [
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早期和轻度的食管炎引起食管痉挛性收缩，在钡剂造影时常可以看到食管下端数厘米的一段轻度狭窄，其上方有少量钡剂存留，尚可通过食管黏膜面呈针尖状钡点影或颗粒状小结节影超声检查：食管有一半以上充盈，且在下段食管有液体来回运动为阳性反流的诊断标准。 | [
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"entity": "钡剂",
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"entity": "在钡剂造影时常可以看到食管下端数厘米的一段轻度狭窄，其上方有少量钡剂存留，尚可通过",
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"entity": "食管黏膜",
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"label": "bod"
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"id": 7,
"entity": "食管黏膜面呈针尖状钡点影或颗粒状小结节影",
"start_offset": 60,
"end_offset": 80,
"label": "sym"
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"id": 8,
"entity": "超声检查",
"start_offset": 80,
"end_offset": 84,
"label": "pro"
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"id": 9,
"entity": "食管",
"start_offset": 85,
"end_offset": 87,
"label": "bod"
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{
"id": 10,
"entity": "下段食管",
"start_offset": 97,
"end_offset": 101,
"label": "bod"
},
{
"id": 11,
"entity": "食管有一半以上充盈，且在下段食管有液体来回运动为阳性反流的诊断标准",
"start_offset": 85,
"end_offset": 118,
"label": "sym"
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（四）胃及十二指肠疾病1.先天性肥厚性幽门狭窄先天性肥厚性幽门狭窄多见于足月儿，男多于女，发生率男女之比约5∶1。 | [
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"entity": "先天性肥厚性幽门狭窄",
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"entity": "先天性肥厚性幽门狭窄",
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生后2～3周出现进食后呕吐，进行性加重呈喷射性呕吐，呕吐物不含胆汁。 | [
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可见胃蠕动波，右上腹可触及橄榄样包块。 | [
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（1）腹部直立位平片：可见典型的单气泡征。 | [
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钡餐检查具特异性，其特征改变为：①幽门管梗阻征象：钡剂排空延迟，胃蠕动增强幽门管细长呈线样征及鸟嘴征；③幽门环肌肥厚产生的征象：肥厚的环肌在胃窦的压迹呈肩样征，在十二指肠球底压迹呈蕈样征超声检查：可探得幽门管的长度和幽门壁的厚度以协助诊断。 | [
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"entity": "幽门管梗阻征象：钡剂排空延迟，胃蠕动增强",
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"entity": "幽门管细长呈线样征及鸟嘴征",
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"entity": "幽门环肌",
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"id": 6,
"entity": "胃窦",
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"label": "dru"
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"id": 7,
"entity": "十二指肠球",
"start_offset": 81,
"end_offset": 86,
"label": "bod"
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"id": 8,
"entity": "幽门环肌肥厚产生的征象：肥厚的环肌在胃窦的压迹呈肩样征，在十二指肠球底压迹呈蕈样征",
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"id": 9,
"entity": "超声检查",
"start_offset": 93,
"end_offset": 97,
"label": "pro"
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{
"id": 10,
"entity": "幽门管",
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"label": "bod"
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"id": 11,
"entity": "幽门壁",
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超声显像诊断本病的标准是：①幽门管直径≥1.3cm幽门壁厚度≥0.4cm幽门肌长度≥1.9cm胃及十二指肠球部溃疡小儿消化性溃疡并不少见，从新生儿到学龄儿童均可发生。 | [
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"entity": "幽门壁厚度≥0.4cm",
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"entity": "幽门肌",
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"entity": "幽门肌长度≥1.9cm",
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"id": 7,
"entity": "胃及十二指肠球部溃疡",
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"id": 8,
"entity": "小儿消化性溃疡",
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"label": "dis"
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] |
儿童十二指肠球部溃疡较胃溃疡更多见。 | [
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钡餐检查的主要征象是龛影，胃溃疡常位于胃小弯，龛影周围有放射状黏膜，皱襞向溃疡集中。 | [
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十二指肠溃疡显示除胃溃疡的征象外，还可见球部变形，造影剂通过球部较快。 | [
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必须注意的是继发性溃疡一般表浅，难于在一般X线检查时发现。 | [
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3.十二指肠梗阻（duodenalobstruction）十二指肠梗阻的原因多为先天性，如十二指肠闭锁和狭窄、十二指肠腔内隔膜狭窄、肠旋转不良以及环状胰腺等。 | [
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{
"id": 6,
"entity": "肠旋转不良",
"start_offset": 66,
"end_offset": 71,
"label": "dis"
},
{
"id": 7,
"entity": "环状胰腺",
"start_offset": 73,
"end_offset": 77,
"label": "dis"
}
] |
腹部平片显示胃及十二指肠扩张呈双泡征或三泡征。 | [
{
"id": 0,
"entity": "腹部平片",
"start_offset": 0,
"end_offset": 4,
"label": "pro"
},
{
"id": 1,
"entity": "胃及十二指肠扩张呈双泡征或三泡征",
"start_offset": 6,
"end_offset": 22,
"label": "sym"
}
] |
不完全梗阻则梗阻点远端可见充气肠曲。 | [
{
"id": 0,
"entity": "不完全梗阻",
"start_offset": 0,
"end_offset": 5,
"label": "dis"
},
{
"id": 1,
"entity": "梗阻点远端可见充气肠曲",
"start_offset": 6,
"end_offset": 17,
"label": "sym"
}
] |
完全梗阻则梗阻点远端肠管不充气。 | [
{
"id": 0,
"entity": "完全梗阻",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "梗阻点远端肠管不充气",
"start_offset": 5,
"end_offset": 15,
"label": "sym"
}
] |
先天性肠旋转不良（congenitalintestinalmalrotation）的诊断依靠X线钡餐检查及钡灌肠。 | [
{
"id": 0,
"entity": "先天性肠旋转不良",
"start_offset": 0,
"end_offset": 8,
"label": "dis"
},
{
"id": 1,
"entity": "congenitalintestinalmalrotation",
"start_offset": 9,
"end_offset": 40,
"label": "dis"
},
{
"id": 2,
"entity": "X线钡餐检查",
"start_offset": 46,
"end_offset": 52,
"label": "pro"
},
{
"id": 3,
"entity": "钡灌肠",
"start_offset": 53,
"end_offset": 56,
"label": "pro"
}
] |
钡餐检查显示十二指肠降段或水平段狭窄，狭窄以上肠管及胃扩张空肠位于右上腹。 | [
{
"id": 0,
"entity": "钡餐检查",
"start_offset": 0,
"end_offset": 4,
"label": "pro"
},
{
"id": 1,
"entity": "肠管",
"start_offset": 23,
"end_offset": 25,
"label": "bod"
},
{
"id": 2,
"entity": "胃",
"start_offset": 26,
"end_offset": 27,
"label": "bod"
},
{
"id": 3,
"entity": "十二指肠降段或水平段狭窄，狭窄以上肠管及胃扩张",
"start_offset": 6,
"end_offset": 29,
"label": "sym"
},
{
"id": 4,
"entity": "空肠位于右上腹",
"start_offset": 29,
"end_offset": 36,
"label": "sym"
}
] |
伴肠扭转时，十二指肠及上段空肠沿中腹部呈螺旋形下降。 | [
{
"id": 0,
"entity": "伴肠",
"start_offset": 0,
"end_offset": 2,
"label": "bod"
},
{
"id": 1,
"entity": "十二指肠",
"start_offset": 6,
"end_offset": 10,
"label": "bod"
},
{
"id": 2,
"entity": "伴肠扭转时，十二指肠及上段空肠沿中腹部呈螺旋形下降",
"start_offset": 0,
"end_offset": 25,
"label": "sym"
}
] |
钡灌肠显示盲肠位于右上腹或上腹部，结肠大部在左腹部迂回。 | [
{
"id": 0,
"entity": "钡灌肠",
"start_offset": 0,
"end_offset": 3,
"label": "pro"
},
{
"id": 1,
"entity": "盲肠位于右上腹或上腹部，结肠大部在左腹部迂回",
"start_offset": 5,
"end_offset": 27,
"label": "sym"
}
] |
（五）小肠及结肠疾病1.肠套叠肠套叠为婴儿期常见的急腹症，近端肠管套入远端肠管小肠低位梗阻。 | [
{
"id": 0,
"entity": "小肠及结肠疾病",
"start_offset": 3,
"end_offset": 10,
"label": "dis"
},
{
"id": 1,
"entity": "肠套叠",
"start_offset": 12,
"end_offset": 15,
"label": "dis"
},
{
"id": 2,
"entity": "肠套叠",
"start_offset": 15,
"end_offset": 18,
"label": "dis"
},
{
"id": 3,
"entity": "急腹症",
"start_offset": 25,
"end_offset": 28,
"label": "dis"
},
{
"id": 4,
"entity": "远端肠管",
"start_offset": 35,
"end_offset": 39,
"label": "bod"
},
{
"id": 5,
"entity": "近端肠管套入远端肠管",
"start_offset": 29,
"end_offset": 39,
"label": "sym"
},
{
"id": 6,
"entity": "小肠低位梗阻",
"start_offset": 39,
"end_offset": 45,
"label": "dis"
}
] |
婴儿肠套叠大多为原发性，可能由多种原因引起的肠蠕动紊乱所致。 | [
{
"id": 0,
"entity": "肠套叠",
"start_offset": 2,
"end_offset": 5,
"label": "dis"
},
{
"id": 1,
"entity": "肠蠕动紊乱",
"start_offset": 22,
"end_offset": 27,
"label": "dis"
}
] |
也可为继发性，见于梅克尔憩室、肠道炎症、过敏性紫癜、息肉及肿瘤等。 | [
{
"id": 0,
"entity": "梅克尔憩室",
"start_offset": 9,
"end_offset": 14,
"label": "dis"
},
{
"id": 1,
"entity": "肠道炎症",
"start_offset": 15,
"end_offset": 19,
"label": "dis"
},
{
"id": 2,
"entity": "过敏性紫癜",
"start_offset": 20,
"end_offset": 25,
"label": "dis"
},
{
"id": 3,
"entity": "息肉",
"start_offset": 26,
"end_offset": 28,
"label": "dis"
},
{
"id": 4,
"entity": "肿瘤",
"start_offset": 29,
"end_offset": 31,
"label": "dis"
}
] |
临床以阵发性哭吵、呕吐、果酱样大便及腹部包块为特征。 | [
{
"id": 0,
"entity": "阵发性哭吵",
"start_offset": 3,
"end_offset": 8,
"label": "sym"
},
{
"id": 1,
"entity": "呕吐",
"start_offset": 9,
"end_offset": 11,
"label": "sym"
},
{
"id": 2,
"entity": "果酱样大便",
"start_offset": 12,
"end_offset": 17,
"label": "sym"
},
{
"id": 3,
"entity": "腹部包块",
"start_offset": 18,
"end_offset": 22,
"label": "sym"
}
] |
腹部平片可见低位小肠梗阻。 | [
{
"id": 0,
"entity": "腹部平片",
"start_offset": 0,
"end_offset": 4,
"label": "pro"
},
{
"id": 1,
"entity": "低位小肠梗阻",
"start_offset": 6,
"end_offset": 12,
"label": "sym"
}
] |
进一步可作钡灌肠或空气灌肠明确诊断。 | [
{
"id": 0,
"entity": "钡灌肠",
"start_offset": 5,
"end_offset": 8,
"label": "pro"
},
{
"id": 1,
"entity": "空气灌肠",
"start_offset": 9,
"end_offset": 13,
"label": "pro"
}
] |
钡剂或空气注入后，在套叠处可以看到受阻影像。 | [
{
"id": 0,
"entity": "钡剂",
"start_offset": 0,
"end_offset": 2,
"label": "dru"
}
] |
套入肠管的头端呈圆形，透视下钡剂呈螺旋状或杯口形。 | [
{
"id": 0,
"entity": "套入肠管的头端呈圆形，透视下钡剂呈螺旋状或杯口形",
"start_offset": 0,
"end_offset": 24,
"label": "sym"
}
] |
空气灌肠不如钡剂显示清晰，但可见类似的影像即可得出诊断。 | [
{
"id": 0,
"entity": "空气灌肠",
"start_offset": 0,
"end_offset": 4,
"label": "pro"
},
{
"id": 1,
"entity": "钡剂",
"start_offset": 6,
"end_offset": 8,
"label": "pro"
}
] |
空气灌肠经济简便，整复较快，减少了X线暴露时间。 | [
{
"id": 0,
"entity": "空气灌肠",
"start_offset": 0,
"end_offset": 4,
"label": "pro"
},
{
"id": 1,
"entity": "X线",
"start_offset": 17,
"end_offset": 19,
"label": "pro"
}
] |
凡病程在48小时以内，腹部无肠坏死征象者均可采用空气灌肠诊断和治疗。 | [
{
"id": 0,
"entity": "腹部无肠坏死",
"start_offset": 11,
"end_offset": 17,
"label": "sym"
},
{
"id": 1,
"entity": "空气灌肠",
"start_offset": 24,
"end_offset": 28,
"label": "pro"
}
] |
2.先天性巨结肠先天性巨结肠为婴幼儿较常见的先天性结肠病变。 | [
{
"id": 0,
"entity": "先天性巨结肠",
"start_offset": 2,
"end_offset": 8,
"label": "dis"
},
{
"id": 1,
"entity": "先天性巨结肠",
"start_offset": 8,
"end_offset": 14,
"label": "dis"
},
{
"id": 2,
"entity": "先天性结肠病变",
"start_offset": 22,
"end_offset": 29,
"label": "dis"
}
] |
本病因结肠壁肌间神经节细胞缺如或减少，使病变肠段不能松弛，呈痉挛状态，而近段肠管代偿性扩张和肥厚。 | [
{
"id": 0,
"entity": "结肠壁肌间神经节细胞",
"start_offset": 3,
"end_offset": 13,
"label": "bod"
},
{
"id": 1,
"entity": "结肠壁肌间神经节细胞缺如或减少，使病变肠段不能松弛，呈痉挛状态",
"start_offset": 3,
"end_offset": 34,
"label": "sym"
},
{
"id": 2,
"entity": "而近段肠管代偿性扩张和肥厚",
"start_offset": 35,
"end_offset": 48,
"label": "sym"
}
] |
一般分型为：①超短段型，病变局限于直肠远端；②短段型，病变位于直肠中段远端，距肛门距离不超过6.5cm；③常见型，病变位于直肠近端或直肠乙状结肠交界处，距肛门约9cm；④长段型，病变延至乙状结肠或降结肠；⑤全结肠型，病变波及全部结肠及回肠，距回盲瓣30cm以内；⑥全肠型，病变波及全部结肠以及回肠30cm以上。 | [
{
"id": 0,
"entity": "超短段型",
"start_offset": 7,
"end_offset": 11,
"label": "dis"
},
{
"id": 1,
"entity": "病变局限于直肠远端",
"start_offset": 12,
"end_offset": 21,
"label": "sym"
},
{
"id": 2,
"entity": "短段型",
"start_offset": 23,
"end_offset": 26,
"label": "dis"
},
{
"id": 3,
"entity": "直肠中段远端",
"start_offset": 31,
"end_offset": 37,
"label": "bod"
},
{
"id": 4,
"entity": "肛门",
"start_offset": 39,
"end_offset": 41,
"label": "bod"
},
{
"id": 5,
"entity": "病变位于直肠中段远端，距肛门距离不超过6.5cm",
"start_offset": 27,
"end_offset": 51,
"label": "sym"
},
{
"id": 6,
"entity": "常见型",
"start_offset": 53,
"end_offset": 56,
"label": "dis"
},
{
"id": 7,
"entity": "直肠近端",
"start_offset": 61,
"end_offset": 65,
"label": "bod"
},
{
"id": 8,
"entity": "直肠乙状结肠",
"start_offset": 66,
"end_offset": 72,
"label": "bod"
},
{
"id": 9,
"entity": "肛门",
"start_offset": 77,
"end_offset": 79,
"label": "bod"
},
{
"id": 10,
"entity": "病变位于直肠近端或直肠乙状结肠交界处，距肛门约9cm",
"start_offset": 57,
"end_offset": 83,
"label": "sym"
},
{
"id": 11,
"entity": "长段型",
"start_offset": 85,
"end_offset": 88,
"label": "dis"
},
{
"id": 12,
"entity": "病变延至乙状结肠或降结肠",
"start_offset": 89,
"end_offset": 101,
"label": "sym"
},
{
"id": 13,
"entity": "全结肠型",
"start_offset": 103,
"end_offset": 107,
"label": "dis"
},
{
"id": 14,
"entity": "结肠",
"start_offset": 114,
"end_offset": 116,
"label": "bod"
},
{
"id": 15,
"entity": "回肠",
"start_offset": 117,
"end_offset": 119,
"label": "bod"
},
{
"id": 16,
"entity": "病变波及全部结肠及回肠，距回盲瓣30cm以内",
"start_offset": 108,
"end_offset": 130,
"label": "sym"
},
{
"id": 17,
"entity": "全肠型",
"start_offset": 132,
"end_offset": 135,
"label": "dis"
},
{
"id": 18,
"entity": "病变波及全部结肠以及回肠30cm以上",
"start_offset": 136,
"end_offset": 154,
"label": "sym"
}
] |
肛门指诊指肠空虚，肛查后有大量气体和粪便排出。 | [
{
"id": 0,
"entity": "肛门指诊",
"start_offset": 0,
"end_offset": 4,
"label": "pro"
},
{
"id": 1,
"entity": "指肠",
"start_offset": 4,
"end_offset": 6,
"label": "bod"
},
{
"id": 2,
"entity": "指肠空虚",
"start_offset": 4,
"end_offset": 8,
"label": "sym"
},
{
"id": 3,
"entity": "肛查",
"start_offset": 9,
"end_offset": 11,
"label": "pro"
},
{
"id": 4,
"entity": "粪便",
"start_offset": 18,
"end_offset": 20,
"label": "bod"
},
{
"id": 5,
"entity": "肛查后有大量气体和粪便排出",
"start_offset": 9,
"end_offset": 22,
"label": "sym"
}
] |
（1）腹部平片：显示低位肠梗阻，结肠与小肠有不同程度扩张，有时见液平钡剂灌肠：是很有价值的确诊方法。 | [
{
"id": 0,
"entity": "腹部平片",
"start_offset": 3,
"end_offset": 7,
"label": "pro"
},
{
"id": 1,
"entity": "低位肠梗阻",
"start_offset": 10,
"end_offset": 15,
"label": "dis"
},
{
"id": 2,
"entity": "结肠",
"start_offset": 16,
"end_offset": 18,
"label": "bod"
},
{
"id": 3,
"entity": "小肠",
"start_offset": 19,
"end_offset": 21,
"label": "bod"
},
{
"id": 4,
"entity": "显示低位肠梗阻，结肠与小肠有不同程度扩张，有时见液平",
"start_offset": 8,
"end_offset": 34,
"label": "sym"
},
{
"id": 5,
"entity": "钡剂灌肠",
"start_offset": 34,
"end_offset": 38,
"label": "pro"
}
] |
典型表现显示痉挛段、移行段与扩张段三部分。 | [
{
"id": 0,
"entity": "扩张段",
"start_offset": 14,
"end_offset": 17,
"label": "sym"
}
] |
①痉挛段：为长短不一的狭窄肠段，边缘呈不规则花边状、锯齿状；②移行段：位于痉挛段的近端，多呈漏斗状；③扩张段：移行段近端肠管明显扩张，黏膜粗厚。 | [
{
"id": 0,
"entity": "痉挛段",
"start_offset": 1,
"end_offset": 4,
"label": "sym"
},
{
"id": 1,
"entity": "为长短不一的狭窄肠段，边缘呈不规则花边状、锯齿状",
"start_offset": 5,
"end_offset": 29,
"label": "sym"
},
{
"id": 2,
"entity": "移行段",
"start_offset": 31,
"end_offset": 34,
"label": "sym"
},
{
"id": 3,
"entity": "位于痉挛段的近端，多呈漏斗状",
"start_offset": 35,
"end_offset": 49,
"label": "sym"
},
{
"id": 4,
"entity": "扩张段",
"start_offset": 51,
"end_offset": 54,
"label": "sym"
},
{
"id": 5,
"entity": "移行段近端肠管明显扩张，黏膜粗厚",
"start_offset": 55,
"end_offset": 71,
"label": "sym"
}
] |
注意事项：①钡剂灌肠前不作清洁灌肠，尤其对新生儿，以免影响扩张段显示；②注钡肛管宜用细导尿管，且不能放置过深；③注钡压力不能过高；④摄正侧位片；⑤如遇不能确诊者，24小时后重复透视。 | [
{
"id": 0,
"entity": "钡剂灌肠",
"start_offset": 6,
"end_offset": 10,
"label": "pro"
},
{
"id": 1,
"entity": "注钡肛管",
"start_offset": 36,
"end_offset": 40,
"label": "equ"
},
{
"id": 2,
"entity": "细导尿管",
"start_offset": 42,
"end_offset": 46,
"label": "equ"
},
{
"id": 3,
"entity": "摄正侧位片",
"start_offset": 66,
"end_offset": 71,
"label": "pro"
}
] |
3.结肠息肉在良性肠肿瘤中，以结肠息肉多见。 | [
{
"id": 0,
"entity": "结肠息肉",
"start_offset": 2,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "良性肠肿瘤",
"start_offset": 7,
"end_offset": 12,
"label": "dis"
},
{
"id": 2,
"entity": "结肠息肉",
"start_offset": 15,
"end_offset": 19,
"label": "dis"
}
] |
息肉可分为三类：①幼年性息肉：此型最多见，95%为单发，多见于直肠或乙状结肠家族性腺瘤病：有遗传性，息肉为多发性；③Peutz-Jephens综合征：小肠、结肠多发性息肉，同时面部皮肤、唇及口腔黏膜色素沉着钡餐造影显示圆形或椭圆形、大小不等的充盈缺损。 | [
{
"id": 0,
"entity": "幼年性息肉",
"start_offset": 9,
"end_offset": 14,
"label": "dis"
},
{
"id": 1,
"entity": "直肠",
"start_offset": 31,
"end_offset": 33,
"label": "bod"
},
{
"id": 2,
"entity": "此型最多见，95%为单发，多见于直肠或乙状结肠",
"start_offset": 15,
"end_offset": 38,
"label": "sym"
},
{
"id": 3,
"entity": "家族性腺瘤病",
"start_offset": 38,
"end_offset": 44,
"label": "dis"
},
{
"id": 4,
"entity": "有遗传性，息肉为多发性",
"start_offset": 45,
"end_offset": 56,
"label": "sym"
},
{
"id": 5,
"entity": "Peutz-Jephens综合征",
"start_offset": 58,
"end_offset": 74,
"label": "dis"
},
{
"id": 6,
"entity": "小肠",
"start_offset": 75,
"end_offset": 77,
"label": "bod"
},
{
"id": 7,
"entity": "结肠",
"start_offset": 78,
"end_offset": 80,
"label": "bod"
},
{
"id": 8,
"entity": "皮肤",
"start_offset": 90,
"end_offset": 92,
"label": "bod"
},
{
"id": 9,
"entity": "唇",
"start_offset": 93,
"end_offset": 94,
"label": "bod"
},
{
"id": 10,
"entity": "口腔黏膜",
"start_offset": 95,
"end_offset": 99,
"label": "bod"
},
{
"id": 11,
"entity": "小肠、结肠多发性息肉，同时面部皮肤、唇及口腔黏膜色素沉着",
"start_offset": 75,
"end_offset": 103,
"label": "sym"
},
{
"id": 12,
"entity": "钡餐造影",
"start_offset": 103,
"end_offset": 107,
"label": "pro"
},
{
"id": 13,
"entity": "圆形或椭圆形、大小不等的充盈缺损",
"start_offset": 109,
"end_offset": 125,
"label": "sym"
}
] |
气钡双重造影显示钡剂涂布息肉表层显示完整或呈波浪状的边缘。 | [
{
"id": 0,
"entity": "气钡双重造影",
"start_offset": 0,
"end_offset": 6,
"label": "pro"
},
{
"id": 1,
"entity": "钡剂涂布息肉表层显示完整或呈波浪状的边缘",
"start_offset": 8,
"end_offset": 28,
"label": "sym"
}
] |
（六）肝、胆、胰1.肝脓肿（hepaticabscess）可以是阿米巴性或细菌性。 | [
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"id": 0,
"entity": "肝",
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"end_offset": 4,
"label": "bod"
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{
"id": 1,
"entity": "胆",
"start_offset": 5,
"end_offset": 6,
"label": "bod"
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{
"id": 2,
"entity": "胰",
"start_offset": 7,
"end_offset": 8,
"label": "bod"
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{
"id": 3,
"entity": "肝脓肿",
"start_offset": 10,
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"label": "bod"
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{
"id": 4,
"entity": "hepaticabscess",
"start_offset": 14,
"end_offset": 28,
"label": "bod"
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{
"id": 5,
"entity": "阿米巴性",
"start_offset": 32,
"end_offset": 36,
"label": "mic"
},
{
"id": 6,
"entity": "细菌性",
"start_offset": 37,
"end_offset": 40,
"label": "mic"
}
] |
脓肿可单发或多发，多见于肝右叶。 | [
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"entity": "脓肿",
"start_offset": 0,
"end_offset": 2,
"label": "dis"
},
{
"id": 1,
"entity": "单发或多发，多见于肝右叶",
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"end_offset": 15,
"label": "sym"
}
] |
临床上，主要表现为寒战、高热或弛张热、右季肋部钝痛，胆增大并有明显压痛。 | [
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"id": 0,
"entity": "寒战",
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"end_offset": 11,
"label": "sym"
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{
"id": 1,
"entity": "高热",
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{
"id": 2,
"entity": "弛张热",
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"label": "sym"
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{
"id": 3,
"entity": "右季肋部钝痛",
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"end_offset": 25,
"label": "sym"
},
{
"id": 4,
"entity": "胆增大并有明显压痛",
"start_offset": 26,
"end_offset": 35,
"label": "sym"
}
] |
影像检查：①超声检查是诊断肝脓肿的首选方法。 | [
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"entity": "超声检查",
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"end_offset": 10,
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{
"id": 1,
"entity": "肝脓肿",
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"label": "dis"
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] |
典型声像图表现为液性暗区，移动探头可显示脓肿呈球形。 | [
{
"id": 0,
"entity": "声像图表现为液性暗区，移动探头可显示脓肿呈球形",
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"end_offset": 25,
"label": "sym"
}
] |
还可见坏死组织等形成的点状或线状回声。 | [
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"id": 0,
"entity": "可见坏死组织等形成的点状或线状回声",
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"end_offset": 18,
"label": "sym"
}
] |
脓肿边缘较厚，内有散在细小光点。 | [
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"entity": "脓肿边缘较厚，内有散在细小光点",
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] |
②X线检查可见膈肌升高、运动减弱，可有轻微胸膜反应使肋膈角或有少量胸腔积液在肝区可见含气或含液的空腔先天性胆总管囊肿（congenitalcholedochocyst）先天性胆总管囊肿为常见的一种先天性胆道囊性扩张症，男与女的比例大约为1∶4。 | [
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"id": 0,
"entity": "X线检查",
"start_offset": 1,
"end_offset": 5,
"label": "pro"
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{
"id": 1,
"entity": "可见膈肌升高、运动减弱",
"start_offset": 5,
"end_offset": 16,
"label": "sym"
},
{
"id": 2,
"entity": "胸腔积液",
"start_offset": 33,
"end_offset": 37,
"label": "bod"
},
{
"id": 3,
"entity": "可有轻微胸膜反应使肋膈角或有少量胸腔积液",
"start_offset": 17,
"end_offset": 37,
"label": "sym"
},
{
"id": 4,
"entity": "肝",
"start_offset": 38,
"end_offset": 39,
"label": "bod"
},
{
"id": 5,
"entity": "在肝区可见含气或含液的空腔",
"start_offset": 37,
"end_offset": 50,
"label": "sym"
},
{
"id": 6,
"entity": "先天性胆总管囊肿",
"start_offset": 50,
"end_offset": 58,
"label": "dis"
},
{
"id": 7,
"entity": "congenitalcholedochocyst",
"start_offset": 59,
"end_offset": 83,
"label": "dis"
},
{
"id": 8,
"entity": "先天性胆总管囊肿",
"start_offset": 84,
"end_offset": 92,
"label": "dis"
},
{
"id": 9,
"entity": "先天性胆道囊性扩张症",
"start_offset": 98,
"end_offset": 108,
"label": "dis"
}
] |
本病的病因多数认为与先天性胆道或胰胆管发育异常有关。 | [
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"id": 0,
"entity": "先天性胆道",
"start_offset": 10,
"end_offset": 15,
"label": "dis"
},
{
"id": 1,
"entity": "胰胆管发育异常",
"start_offset": 16,
"end_offset": 23,
"label": "dis"
}
] |
腹痛、黄疸及腹部肿块为本病的三个典型症状。 | [
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"id": 0,
"entity": "腹痛",
"start_offset": 0,
"end_offset": 2,
"label": "sym"
},
{
"id": 1,
"entity": "黄疸",
"start_offset": 3,
"end_offset": 5,
"label": "sym"
},
{
"id": 2,
"entity": "腹部肿块",
"start_offset": 6,
"end_offset": 10,
"label": "sym"
}
] |
B超检查：肝脏下方显示界限清楚的低回声区，并可查明肝内胆管扩张的程度和范围X线检查：①腹部平片：胆总管囊肿较大时，于右上腹可见密度均匀的、与肝影相连的软组织样肿块并可见胃及结肠被推移钡餐检查：可见胃窦部推向左上方，十二指肠段向右前移十二指肠环增大。 | [
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"id": 0,
"entity": "B超检查",
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"end_offset": 4,
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},
{
"id": 1,
"entity": "肝脏",
"start_offset": 5,
"end_offset": 7,
"label": "bod"
},
{
"id": 2,
"entity": "肝脏下方显示界限清楚的低回声区，并可查明肝内胆管扩张的程度和范围",
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{
"id": 3,
"entity": "X线检查",
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{
"id": 4,
"entity": "腹部平片",
"start_offset": 43,
"end_offset": 47,
"label": "pro"
},
{
"id": 5,
"entity": "胆总管囊肿",
"start_offset": 48,
"end_offset": 53,
"label": "dis"
},
{
"id": 6,
"entity": "胆总管囊肿较大时，于右上腹可见密度均匀的、与肝影相连的软组织样肿块",
"start_offset": 48,
"end_offset": 81,
"label": "sym"
},
{
"id": 7,
"entity": "胃",
"start_offset": 84,
"end_offset": 85,
"label": "bod"
},
{
"id": 8,
"entity": "结肠",
"start_offset": 86,
"end_offset": 88,
"label": "bod"
},
{
"id": 9,
"entity": "并可见胃及结肠被推移",
"start_offset": 81,
"end_offset": 91,
"label": "sym"
},
{
"id": 10,
"entity": "钡餐检查",
"start_offset": 91,
"end_offset": 95,
"label": "pro"
},
{
"id": 11,
"entity": "胃窦部",
"start_offset": 98,
"end_offset": 101,
"label": "bod"
},
{
"id": 12,
"entity": "十二指肠",
"start_offset": 107,
"end_offset": 111,
"label": "bod"
},
{
"id": 13,
"entity": "可见胃窦部推向左上方，十二指肠段向右前移",
"start_offset": 96,
"end_offset": 116,
"label": "sym"
},
{
"id": 14,
"entity": "十二指肠环增大",
"start_offset": 116,
"end_offset": 123,
"label": "sym"
}
] |
③CT检查：CT可明确胆总管囊肿的大小，胆总管远端狭窄的程度，以及胆囊及肝管的解剖等，有助于手术方式的选择。 | [
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"id": 0,
"entity": "CT检查",
"start_offset": 1,
"end_offset": 5,
"label": "pro"
},
{
"id": 1,
"entity": "CT",
"start_offset": 6,
"end_offset": 8,
"label": "pro"
},
{
"id": 2,
"entity": "胆总管囊肿",
"start_offset": 11,
"end_offset": 16,
"label": "dis"
},
{
"id": 3,
"entity": "胆总管",
"start_offset": 20,
"end_offset": 23,
"label": "bod"
},
{
"id": 4,
"entity": "胆囊",
"start_offset": 33,
"end_offset": 35,
"label": "bod"
},
{
"id": 5,
"entity": "肝管",
"start_offset": 36,
"end_offset": 38,
"label": "bod"
}
] |
3.胰腺炎小儿胰腺炎少见，多为急性胰腺炎。 | [
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"id": 0,
"entity": "胰腺炎",
"start_offset": 2,
"end_offset": 5,
"label": "dis"
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{
"id": 1,
"entity": "胰腺炎",
"start_offset": 7,
"end_offset": 10,
"label": "dis"
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{
"id": 2,
"entity": "急性胰腺炎",
"start_offset": 15,
"end_offset": 20,
"label": "dis"
}
] |
临床表现多为剧烈腹痛，伴恶心、呕吐及发热等。 | [
{
"id": 0,
"entity": "剧烈腹痛",
"start_offset": 6,
"end_offset": 10,
"label": "sym"
},
{
"id": 1,
"entity": "伴恶心、呕吐及发热等",
"start_offset": 11,
"end_offset": 21,
"label": "sym"
}
] |
B超：显示胰腺体积增大，密度降低，并可确定有无假性囊肿的存在。 | [
{
"id": 0,
"entity": "B超",
"start_offset": 0,
"end_offset": 2,
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},
{
"id": 1,
"entity": "显示胰腺体积增大，密度降低，并可确定有无假性囊肿的存在",
"start_offset": 3,
"end_offset": 30,
"label": "sym"
}
] |
腹部平片：胃、横结肠、十二指肠和上部空肠扩张、积气，并可见“横结肠截断征CT：显示胰腺普遍增大，密度降低，胰腺轮廓不清慢性胰腺炎可见胰实质钙化。 | [
{
"id": 0,
"entity": "腹部平片",
"start_offset": 0,
"end_offset": 4,
"label": "pro"
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{
"id": 1,
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"start_offset": 5,
"end_offset": 6,
"label": "bod"
},
{
"id": 2,
"entity": "横结肠",
"start_offset": 7,
"end_offset": 10,
"label": "bod"
},
{
"id": 3,
"entity": "十二指肠",
"start_offset": 11,
"end_offset": 15,
"label": "bod"
},
{
"id": 4,
"entity": "上部空肠",
"start_offset": 16,
"end_offset": 20,
"label": "bod"
},
{
"id": 5,
"entity": "胃、横结肠、十二指肠和上部空肠扩张、积气，并可见“横结肠截断征",
"start_offset": 5,
"end_offset": 36,
"label": "sym"
},
{
"id": 6,
"entity": "CT",
"start_offset": 36,
"end_offset": 38,
"label": "pro"
},
{
"id": 7,
"entity": "胰腺",
"start_offset": 41,
"end_offset": 43,
"label": "bod"
},
{
"id": 8,
"entity": "胰腺普遍增大，密度降低，胰腺轮廓不清",
"start_offset": 41,
"end_offset": 59,
"label": "sym"
},
{
"id": 9,
"entity": "慢性胰腺炎",
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"end_offset": 64,
"label": "dis"
},
{
"id": 10,
"entity": "胰实质钙化",
"start_offset": 66,
"end_offset": 71,
"label": "sym"
}
] |
五、双气囊小肠镜2001年，日本学者Yamamoto在世界上率先报道了使用推进式双气囊小肠镜（double-balloonenteroscopy，DBE）进行全小肠检查。 | [
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{
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"entity": "小肠检查",
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] |
推进式双气囊小肠镜是在原先的推进式小肠镜外加上一个顶端带气囊的外套管，同时也在小肠镜顶端加装一个气囊。 | [
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"id": 0,
"entity": "推进式双气囊小肠镜",
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"id": 1,
"entity": "推进式小肠镜",
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{
"id": 2,
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{
"id": 3,
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{
"id": 4,
"entity": "气囊",
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] |
双气囊小肠镜的问世与应用，使消化内镜对消化道检查已拓展至主深部小肠，原先无法抵达的部位和不能直接检出的情况发生了根本性变化，上下结合方式的双气囊小肠镜检查基本完成了对整个消化道的彻底无盲区的检查。 | [
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"id": 0,
"entity": "双气囊小肠镜",
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{
"id": 1,
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{
"id": 2,
"entity": "消化道检查",
"start_offset": 19,
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{
"id": 3,
"entity": "主深部小肠",
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{
"id": 4,
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},
{
"id": 5,
"entity": "消化道",
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}
] |
除了具有检查范围广的优势外，双气囊小肠镜还具有普通电子内镜的共同优点：图像清晰，操作可控制，能取活检等特点，使病变性质得以明确。 | [
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"id": 0,
"entity": "双气囊小肠镜",
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] |
双气囊小肠镜不仅可直视检查整个小肠的病变情况，而且可对病灶进行活检和治疗，该技术的应用，为小肠疾病检查提供了全新的方法。 | [
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"id": 0,
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{
"id": 2,
"entity": "小肠疾病检查",
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] |
四、先天性心脏病血管堵塞术以往异常血管通道的外科治疗，是通过切除含有小的血管瘤的病理组织，结扎异常血管通道或直视切开心腔进行修补缺损达到治疗目的。 | [
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"id": 0,
"entity": "先天性心脏病血管堵塞术",
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{
"id": 1,
"entity": "血管",
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{
"id": 2,
"entity": "外科",
"start_offset": 22,
"end_offset": 24,
"label": "dep"
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{
"id": 3,
"entity": "切除含有小的血管瘤的病理组织",
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},
{
"id": 4,
"entity": "结扎异常血管通道",
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},
{
"id": 5,
"entity": "直视切开心腔进行修补缺损",
"start_offset": 54,
"end_offset": 66,
"label": "pro"
}
] |
而经导管堵塞术，则是将特殊的堵塞材料经递送导管达特定的位置，达到与外科手术同样的治疗目的，从而免除了外科手术。 | [
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"id": 0,
"entity": "经导管堵塞术",
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{
"id": 1,
"entity": "堵塞材料",
"start_offset": 14,
"end_offset": 18,
"label": "equ"
},
{
"id": 2,
"entity": "递送导管",
"start_offset": 19,
"end_offset": 23,
"label": "equ"
},
{
"id": 3,
"entity": "外科手术",
"start_offset": 33,
"end_offset": 37,
"label": "pro"
},
{
"id": 4,
"entity": "外科手术",
"start_offset": 50,
"end_offset": 54,
"label": "pro"
}
] |
常用的治疗方法有：①微血管栓塞法，如对于肺小动静脉瘘（arteriovenousfistula），可应用明胶海绵、Ivalon碎片等对整个肺小动静脉瘘进行栓塞，达到与外科进行肺叶或肺段切除同样的作用，但血管堵塞法可尽量保持正常的肺组织及肺功能，使治疗更符合生理要求；②堵塞远端血管或动静脉畸形的上流血管，如主动脉-肺侧支循环、肺动静脉畸形、冠状动静脉瘘等，常采用弹簧圈，可脱卸球囊等达到堵断异常血管的目的；③关闭心内外异常缺损或粗的异常血管通道，如动脉导管未闭、冠状动静脉瘘、左上腔静脉入左心房等需要借助于特种堵塞装置，如多种类型伞状堵塞装置等。 | [
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"id": 0,
"entity": "微血管栓塞法",
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"end_offset": 16,
"label": "pro"
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{
"id": 1,
"entity": "肺小动静脉瘘",
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"label": "dis"
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"id": 2,
"entity": "arteriovenousfistula",
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{
"id": 3,
"entity": "明胶海绵",
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{
"id": 4,
"entity": "Ivalon碎片",
"start_offset": 57,
"end_offset": 65,
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{
"id": 5,
"entity": "肺小动静脉瘘",
"start_offset": 69,
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"label": "dis"
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{
"id": 6,
"entity": "栓塞",
"start_offset": 77,
"end_offset": 79,
"label": "pro"
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{
"id": 7,
"entity": "外科",
"start_offset": 83,
"end_offset": 85,
"label": "dep"
},
{
"id": 8,
"entity": "肺叶或肺段切除",
"start_offset": 87,
"end_offset": 94,
"label": "pro"
},
{
"id": 9,
"entity": "血管堵塞法",
"start_offset": 101,
"end_offset": 106,
"label": "pro"
},
{
"id": 10,
"entity": "肺组织",
"start_offset": 114,
"end_offset": 117,
"label": "bod"
},
{
"id": 11,
"entity": "肺",
"start_offset": 118,
"end_offset": 119,
"label": "bod"
},
{
"id": 12,
"entity": "堵塞远端血管或动静脉畸形的上流血管",
"start_offset": 134,
"end_offset": 151,
"label": "pro"
},
{
"id": 13,
"entity": "主动脉-肺侧支循环",
"start_offset": 153,
"end_offset": 162,
"label": "dis"
},
{
"id": 14,
"entity": "肺动静脉畸形",
"start_offset": 163,
"end_offset": 169,
"label": "dis"
},
{
"id": 15,
"entity": "冠状动静脉瘘",
"start_offset": 170,
"end_offset": 176,
"label": "dis"
},
{
"id": 16,
"entity": "弹簧圈",
"start_offset": 181,
"end_offset": 184,
"label": "equ"
},
{
"id": 17,
"entity": "脱卸球囊",
"start_offset": 186,
"end_offset": 190,
"label": "pro"
},
{
"id": 18,
"entity": "血管",
"start_offset": 197,
"end_offset": 199,
"label": "bod"
},
{
"id": 19,
"entity": "关闭心内外异常缺损或粗的异常血管通道",
"start_offset": 204,
"end_offset": 222,
"label": "pro"
},
{
"id": 20,
"entity": "动脉导管未闭",
"start_offset": 224,
"end_offset": 230,
"label": "dis"
},
{
"id": 21,
"entity": "冠状动静脉瘘",
"start_offset": 231,
"end_offset": 237,
"label": "dis"
},
{
"id": 22,
"entity": "左上腔静脉入左心房",
"start_offset": 238,
"end_offset": 247,
"label": "dis"
},
{
"id": 23,
"entity": "堵塞装置",
"start_offset": 255,
"end_offset": 259,
"label": "equ"
},
{
"id": 24,
"entity": "多种类型伞状堵塞装置",
"start_offset": 261,
"end_offset": 271,
"label": "equ"
}
] |
本节介绍目前广泛应用的经导管动脉导管未闭堵塞术。 | [
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虽然Porstmann早在1967年就首次应用海绵塞法成功堵塞动脉导管未闭，但由于该法操作复杂、并发症多，且仅限用于年长儿及成人，因此目前已很少应用。 | [
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"entity": "动脉导管未闭",
"start_offset": 31,
"end_offset": 37,
"label": "sym"
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此后Rashkind设计的双盘堵塞装置，包括其改良型，如蚌壳状关闭式（Lock）、纽扣式双盘装置（Sideris）等，因术后残余分流发生率高、需要较粗的递送导管，较难适用于小婴儿及过小的或过大的动脉导管未闭。 | [
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"id": 0,
"entity": "双盘堵塞装置",
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"entity": "Lock",
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"entity": "纽扣式双盘装置",
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"label": "equ"
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{
"id": 4,
"entity": "Sideris",
"start_offset": 49,
"end_offset": 56,
"label": "equ"
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{
"id": 5,
"entity": "残余分流",
"start_offset": 62,
"end_offset": 66,
"label": "sym"
},
{
"id": 6,
"entity": "递送导管",
"start_offset": 76,
"end_offset": 80,
"label": "equ"
},
{
"id": 7,
"entity": "动脉导管未闭",
"start_offset": 97,
"end_offset": 103,
"label": "dis"
}
] |
因此，在20世纪90年代之前，经导管堵塞动脉导管未闭在国内外未获推广应用。 | [
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1992年，Combiel等首先报道应用弹簧圈（coil）堵塞小型动脉导管未闭获得成功，上海第二医科大学附属新华医院也在国内最早报告用该法堵塞动脉导管未闭。 | [
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{
"id": 1,
"entity": "堵塞动脉导管未闭",
"start_offset": 69,
"end_offset": 77,
"label": "pro"
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] |
由于弹簧圈堵塞术具有操作简便、疗效好、递送导管细、损伤小及可用于小婴儿等优点，深受使用者欢迎。 | [
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"id": 0,
"entity": "弹簧圈堵塞术",
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{
"id": 1,
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"label": "equ"
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] |
但对于中等以上的动脉导管未闭动脉导管未闭仍无合适的堵塞装置。 | [
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"id": 0,
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"id": 1,
"entity": "动脉导管未闭",
"start_offset": 14,
"end_offset": 20,
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{
"id": 2,
"entity": "堵塞装置",
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"label": "equ"
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] |
1998年，Masura等报道应用自膨性蘑菇伞堵塞装置堵塞动脉导管未闭。 | [
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该法安全、简便、几乎无残余分流，可应用于中、大型动脉导管未闭，使动脉导管未闭的介入治疗获得突破性进展。 | [
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"id": 0,
"entity": "无残余分流",
"start_offset": 10,
"end_offset": 15,
"label": "sym"
},
{
"id": 1,
"entity": "中、大型动脉导管未闭",
"start_offset": 20,
"end_offset": 30,
"label": "dis"
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{
"id": 2,
"entity": "动脉导管未闭的介入治疗",
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"end_offset": 43,
"label": "pro"
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目前，根据作者的经验及文献综述，弹簧圈堵塞术及自膨性蘑菇伞堵塞术的合理选择、操作方法规范并掌握一定的要点，几乎所有类型的动脉导管未闭（包括婴幼儿及合并肺动脉高压者）均能有效经导管关闭。 | [
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"id": 0,
"entity": "弹簧圈堵塞术",
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{
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"id": 2,
"entity": "动脉导管未闭",
"start_offset": 60,
"end_offset": 66,
"label": "dis"
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{
"id": 3,
"entity": "肺动脉高压",
"start_offset": 75,
"end_offset": 80,
"label": "dis"
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{
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"entity": "经导管关闭",
"start_offset": 86,
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"label": "pro"
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] |
（一）经导管弹簧圈动脉导管未闭堵塞术1.指征目前主要适应证为：直径≤2.5mm的动脉导管未闭，未经手术或外科手术后残余分流者，适合的解剖类型主要为管型或漏斗型。 | [
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"id": 1,
"entity": "动脉导管未闭",
"start_offset": 40,
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{
"id": 2,
"entity": "手术",
"start_offset": 49,
"end_offset": 51,
"label": "pro"
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{
"id": 3,
"entity": "外科手术",
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] |
2.方法经皮股动静脉插管，分别测压和血氧测定，估价分流严重性。 | [
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导管置于升主动脉进行左侧位造影，观察动脉导管大小，形态及走向，并排除其他心血管畸形，精确测量动脉导管最狭窄处直径。 | [
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"entity": "动脉导管",
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{
"id": 4,
"entity": "心血管畸形",
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"end_offset": 41,
"label": "dis"
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{
"id": 5,
"entity": "动脉导管",
"start_offset": 46,
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"label": "equ"
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] |
pfm公司的双螺旋双圆锥弹簧圈及Cook公司的管形弹簧圈操作方法有所不同，但基本原则相似，有经股静脉顺向法及经股动脉逆向法。 | [
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{
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"entity": "管形弹簧圈",
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"entity": "经股静脉顺向法",
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"entity": "经股动脉逆向法",
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3.并发症及其处理弹簧圈释放后可产生残余分流，如释放后尚未脱钩前如有中等分流时需再增加一个弹簧圈，如仅为极少量分流，随访观察表明大部分在短期内消失。 | [
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"entity": "弹簧圈",
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少量病例发生溶血，多是由于较明显残余分流引起红细胞破坏所致。 | [
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经短期内科对症处理及密切观察下无效，超声检查示左向右分流明显，需再次增加安置弹簧圈或作外科手术处理。 | [
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弹簧圈脱落常由于选择太小或操作不当引起，常向肺动脉方向至肺，可经肺动脉插入圈套装置将弹簧圈取出。 | [
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{
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] |
根据上海第二医科大学附属新华医院应用经验，经导管弹簧圈动脉导管未闭堵塞术具有操作简便、疗效好、递送导管细、损伤小及可用于小婴儿等优点，特别适用于直径≤2mm的动脉导管未闭。 | [
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{
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"entity": "递送导管",
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"id": 2,
"entity": "直径≤2mm的动脉导管未闭",
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"label": "dis"
}
] |
但对于＞2mm的动脉导管未闭，还是推荐应用下面将叙述的自膨性蘑菇伞堵塞装置堵塞。 | [
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"id": 0,
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"entity": "自膨性蘑菇伞堵塞装置",
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] |
（二）经导管自膨性蘑菇伞动脉导管未闭堵塞术1.适应证及禁忌证（1）适应证：直径＞2.5mm、位置正常的动脉导管未闭，不管形状及动脉导管未闭大小，血流动力学监测无器质性肺高压者均为适应症，病人的体重通常应＞5kg。 | [
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{
"id": 2,
"entity": "动脉导管未闭",
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"label": "dis"
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{
"id": 3,
"entity": "血流动力学",
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"label": "ite"
},
{
"id": 4,
"entity": "器质性肺高压",
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{
"id": 5,
"entity": "体重通常应＞5kg",
"start_offset": 96,
"end_offset": 105,
"label": "sym"
}
] |
（2）禁忌证：①重症肺动脉高压，经规范方法（压力、阻力、肺小动脉造影及堵塞试验）评价为器质性肺高压或临界病例者；②伴有需胸外手术的先天性心脏畸形；③体重＜5kg。 | [
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"id": 0,
"entity": "重症肺动脉高压",
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"label": "dis"
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{
"id": 1,
"entity": "肺小动脉造影",
"start_offset": 28,
"end_offset": 34,
"label": "pro"
},
{
"id": 2,
"entity": "堵塞试验",
"start_offset": 35,
"end_offset": 39,
"label": "pro"
},
{
"id": 3,
"entity": "器质性肺高压",
"start_offset": 43,
"end_offset": 49,
"label": "dis"
},
{
"id": 4,
"entity": "临界病例",
"start_offset": 50,
"end_offset": 54,
"label": "dis"
},
{
"id": 5,
"entity": "胸外手术",
"start_offset": 60,
"end_offset": 64,
"label": "pro"
},
{
"id": 6,
"entity": "先天性心脏畸形",
"start_offset": 65,
"end_offset": 72,
"label": "dis"
},
{
"id": 7,
"entity": "体重＜5kg",
"start_offset": 74,
"end_offset": 80,
"label": "sym"
}
] |
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