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2.方法经股静脉方法，将引导鞘自肺动脉通过动脉导管未闭定位于降主动脉。 | [
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选取比动脉导管未闭最狭窄处直径大3～6mm的堵塞装置。 | [
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释放钢丝穿过装载器，其头端与封堵器螺纹相接。 | [
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封堵装置与装载器一起浸于盐水中，然后装置被拉入装载器。 | [
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装载器与引导鞘对接，装置由释放钢丝推送至降主动脉（推送过程中不能旋转）。 | [
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滞留盘放出，然后拉向动脉导管未闭口，这可通过透视、或可感到与主动脉搏动同步的拖拉感。 | [
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引导鞘后撤，装置的圆柱形部分便安全展开于动脉导管未闭内。 | [
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再行主动脉造影以确定装置位置正确，如不满意可将装置回收入鞘内重新定位。 | [
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一旦证实装置的位置正确，可逆向旋转释放钢丝释放封堵装置。 | [
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3.疗效评价作者所在单位近200余例自膨性蘑菇伞动脉导管未闭堵塞术的临床应用显示技术成功率100%，术后即刻残余分流＜5%，1月后均完全封堵，无溶血、异位等并发症，与国外的报道类似，因而认为本方法安全、有效、操作方便、适应证广，值得推广，但其中长期疗效尚需进一步随访研究。 | [
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4.并发症及处理残余分流：通常术后可存在少量残余分流，随访时不久即消失。 | [
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但对于明显残余分流，多由于堵塞装置太小或移位，一些病例发生溶血，常于术后数小时至10余小时，呈典型溶血表现，需及时内科处理，无效时需要再加弹簧圈堵塞或外科手术。 | [
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偶见堵塞装置脱落，多由于操作不当或选择堵塞装置太小所致，可用异物钳抓取，必要时需外科手术。 | [
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五、腹膜平衡试验和透析充分性对于慢性肾衰竭的长期腹膜透析，必须考虑患儿的透析效果，并且最大限度地保护腹膜功能，腹膜平衡试验和透析充分性是两个重要部分。 | [
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（一）腹膜平衡试验由于每个患者的腹膜对溶质转运能力各异，因此腹透疗效亦不同。 | [
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腹膜平衡试验（peritonealequilibrationtest，PET）是通过透析液灌入腹腔4小时中，观察腹透液葡萄糖浓度的变化，以及透析液肌酐与血肌酐比值的变化，来了解每位患者腹膜对葡萄糖的吸收能力，对肌酐的清除情况以及对水的超滤能力。 | [
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并根据腹膜对溶质转运个体差异来协助患者制定出合理的腹膜透析处方。 | [
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因此PET是作为腹透患者常规、定期评价腹膜功能的工具。 | [
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具体操作方法是：①试验前腹透液留置腹腔内8～12小时；②晨起采取立位或坐位，将腹腔内透析液完全排空，记录超滤量；③取平卧位，用2.5%葡萄糖透析液，按50ml/kg透析量在10min内均匀缓慢注入腹腔，并每2min做一次翻身动作，在10min灌完后计时为0小时；④透析液留置在腹腔4小时后，采用坐位或立位彻底排空腹透液记录超滤量；⑤分别在0、2、4小时留取透析液标本，2小时抽血2ml，所有标本送检测肌酐和葡萄糖；⑥计算腹膜对肌酐的清除（D/Pcr）及腹膜对葡萄糖吸收（D/Do）。 | [
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儿童PET的结果与成年腹透患者的PET比较，证明了与儿童的腹膜表面积大有关，而且这样特征伴随年龄越小更突出。 | [
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PET试验的结果证实，腹膜对肌酐的清除能力与腹膜对葡萄糖转运呈正相关，而超滤量与肌酐清除呈负相关。 | [
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由于腹膜表面大同时也增加了有效滤过面积，抵消了腹膜对葡萄糖吸收率高引起超滤下降，因此认为对于儿童腹透患者使用低渗透析液仍可得到满意的超滤效果。 | [
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（二）透析充分性腹膜透析作为肾脏替代疗法起到了清除毒素和保持体内水平衡作用，但由于是肾脏替代治疗，并不能完全替代正常人体肾脏功能，因此透析只能使尿毒症症状减轻，随着残余肾功能丧失，腹膜透析充分与否与腹透患儿的营养状态、生长发育及生存率密切相关。 | [
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"label": "pro"
},
{
"id": 3,
"entity": "毒素",
"start_offset": 25,
"end_offset": 27,
"label": "mic"
},
{
"id": 4,
"entity": "水",
"start_offset": 32,
"end_offset": 33,
"label": "bod"
},
{
"id": 5,
"entity": "肾脏替代治疗",
"start_offset": 42,
"end_offset": 48,
"label": "pro"
},
{
"id": 6,
"entity": "肾脏",
"start_offset": 60,
"end_offset": 62,
"label": "bod"
},
{
"id": 7,
"entity": "透析",
"start_offset": 67,
"end_offset": 69,
"label": "pro"
},
{
"id": 8,
"entity": "尿毒症",
"start_offset": 72,
"end_offset": 75,
"label": "dis"
},
{
"id": 9,
"entity": "肾",
"start_offset": 84,
"end_offset": 85,
"label": "bod"
},
{
"id": 10,
"entity": "腹膜透析",
"start_offset": 90,
"end_offset": 94,
"label": "pro"
},
{
"id": 11,
"entity": "腹透",
"start_offset": 99,
"end_offset": 101,
"label": "pro"
}
] |
评估儿童腹膜透析充分性包括：1.充分透析剂量通常需要50ml/kg或1100ml/m2</sup>，每日4～5次，此透析液量才能使人体每天代谢产物的产出达到平衡，同时由于儿童与成年人比较处于高代谢状态，给予充分透析剂量下监测尿素氮水平，BUN应＜50mg/dl（17.86mmol/L）。 | [
{
"id": 0,
"entity": "腹膜透析",
"start_offset": 4,
"end_offset": 8,
"label": "pro"
},
{
"id": 1,
"entity": "透析",
"start_offset": 18,
"end_offset": 20,
"label": "pro"
},
{
"id": 2,
"entity": "透析液",
"start_offset": 58,
"end_offset": 61,
"label": "dru"
},
{
"id": 3,
"entity": "尿素氮",
"start_offset": 112,
"end_offset": 115,
"label": "ite"
}
] |
2.透析充分指标（1）KT/Vurea：KT/Vurea又称尿素清除指数，是指单位时间内机体对尿素的清除量，包括腹膜和残余肾单位，K为尿液和腹透液中尿素的清除量，T为每周透析天数，V为尿素的分布容积。 | [
{
"id": 0,
"entity": "透析",
"start_offset": 2,
"end_offset": 4,
"label": "pro"
},
{
"id": 1,
"entity": "KT/Vurea",
"start_offset": 11,
"end_offset": 19,
"label": "ite"
},
{
"id": 2,
"entity": "KT/Vurea",
"start_offset": 20,
"end_offset": 28,
"label": "ite"
},
{
"id": 3,
"entity": "尿素清除指数",
"start_offset": 30,
"end_offset": 36,
"label": "ite"
},
{
"id": 4,
"entity": "尿素",
"start_offset": 47,
"end_offset": 49,
"label": "bod"
},
{
"id": 5,
"entity": "腹膜",
"start_offset": 56,
"end_offset": 58,
"label": "bod"
},
{
"id": 6,
"entity": "肾单位",
"start_offset": 61,
"end_offset": 64,
"label": "bod"
},
{
"id": 7,
"entity": "尿液",
"start_offset": 67,
"end_offset": 69,
"label": "bod"
},
{
"id": 8,
"entity": "腹透液",
"start_offset": 70,
"end_offset": 73,
"label": "dru"
},
{
"id": 9,
"entity": "尿素",
"start_offset": 74,
"end_offset": 76,
"label": "bod"
},
{
"id": 10,
"entity": "透析",
"start_offset": 85,
"end_offset": 87,
"label": "pro"
},
{
"id": 11,
"entity": "尿素",
"start_offset": 92,
"end_offset": 94,
"label": "bod"
}
] |
通过计算KT/Vurea来作为透析充分的参考指标，CAPDKT/Vurea为2.0/w，最低不小于1.9/w，CCPDKT/Vurea为2.1/w，NIPDKT/Vurea为2.2/w。 | [
{
"id": 0,
"entity": "KT/Vurea",
"start_offset": 4,
"end_offset": 12,
"label": "ite"
},
{
"id": 1,
"entity": "透析",
"start_offset": 15,
"end_offset": 17,
"label": "pro"
},
{
"id": 2,
"entity": "CAPDKT/Vurea",
"start_offset": 25,
"end_offset": 37,
"label": "ite"
},
{
"id": 3,
"entity": "CCPDKT/Vurea",
"start_offset": 55,
"end_offset": 67,
"label": "ite"
}
] |
（2）肌酐清除率（creatinineclearancerate，Ccr）：与KT/Vurea相比，对肌酐清除率的计算能反映腹膜对大分子的溶质清除，因此对于透析充分性除有KT/Vurea值以外，临床上常用Ccr来作为判断透析效能的指标。 | [
{
"id": 0,
"entity": "肌酐清除率",
"start_offset": 3,
"end_offset": 8,
"label": "ite"
},
{
"id": 1,
"entity": "creatinineclearancerate",
"start_offset": 9,
"end_offset": 32,
"label": "ite"
},
{
"id": 2,
"entity": "Ccr",
"start_offset": 33,
"end_offset": 36,
"label": "ite"
},
{
"id": 3,
"entity": "KT/Vurea",
"start_offset": 39,
"end_offset": 47,
"label": "ite"
},
{
"id": 4,
"entity": "肌酐清除率",
"start_offset": 51,
"end_offset": 56,
"label": "ite"
},
{
"id": 5,
"entity": "腹膜",
"start_offset": 62,
"end_offset": 64,
"label": "bod"
},
{
"id": 6,
"entity": "透析",
"start_offset": 78,
"end_offset": 80,
"label": "pro"
},
{
"id": 7,
"entity": "KT/Vurea",
"start_offset": 85,
"end_offset": 93,
"label": "ite"
},
{
"id": 8,
"entity": "Ccr",
"start_offset": 102,
"end_offset": 105,
"label": "ite"
},
{
"id": 9,
"entity": "透析",
"start_offset": 110,
"end_offset": 112,
"label": "pro"
}
] |
如果将KT/Vurea与Ccr指标综合判断能提高其准确性。 | [
{
"id": 0,
"entity": "KT/Vurea",
"start_offset": 3,
"end_offset": 11,
"label": "ite"
},
{
"id": 1,
"entity": "Ccr",
"start_offset": 12,
"end_offset": 15,
"label": "ite"
}
] |
其标准为CAPD时肌酐为60L/w或9L/d；CCPD为63L/w，NIPD为66L/w。 | [
{
"id": 0,
"entity": "CAPD",
"start_offset": 4,
"end_offset": 8,
"label": "pro"
},
{
"id": 1,
"entity": "肌酐",
"start_offset": 9,
"end_offset": 11,
"label": "ite"
},
{
"id": 2,
"entity": "CCPD",
"start_offset": 23,
"end_offset": 27,
"label": "ite"
},
{
"id": 3,
"entity": "NIPD",
"start_offset": 34,
"end_offset": 38,
"label": "ite"
}
] |
3.透析充分的临床标准患者自我感觉良好，血压稳定，无恶心、呕吐、乏力和厌食，生长发育正常。 | [
{
"id": 0,
"entity": "透析",
"start_offset": 2,
"end_offset": 4,
"label": "pro"
},
{
"id": 1,
"entity": "血压",
"start_offset": 20,
"end_offset": 22,
"label": "ite"
},
{
"id": 2,
"entity": "恶心",
"start_offset": 26,
"end_offset": 28,
"label": "sym"
},
{
"id": 3,
"entity": "呕吐",
"start_offset": 29,
"end_offset": 31,
"label": "sym"
},
{
"id": 4,
"entity": "乏力",
"start_offset": 32,
"end_offset": 34,
"label": "sym"
},
{
"id": 5,
"entity": "厌食",
"start_offset": 35,
"end_offset": 37,
"label": "sym"
},
{
"id": 6,
"entity": "生长发育正常",
"start_offset": 38,
"end_offset": 44,
"label": "sym"
}
] |
贫血改善；电解质正常，尿素氮＜50mg/dl（＜17.86mmol/L）。 | [
{
"id": 0,
"entity": "贫血改善",
"start_offset": 0,
"end_offset": 4,
"label": "sym"
},
{
"id": 1,
"entity": "电解质正常",
"start_offset": 5,
"end_offset": 10,
"label": "sym"
}
] |
第八节吸入性肺炎吸入性肺炎（aspirationpneumonia）是指呼吸道直接吸入有机或无机物质造成的肺部炎性病变。 | [
{
"id": 0,
"entity": "吸入性肺炎",
"start_offset": 3,
"end_offset": 8,
"label": "dis"
},
{
"id": 1,
"entity": "吸入性肺炎",
"start_offset": 8,
"end_offset": 13,
"label": "dis"
},
{
"id": 2,
"entity": "aspirationpneumonia",
"start_offset": 14,
"end_offset": 33,
"label": "dis"
},
{
"id": 3,
"entity": "呼吸道",
"start_offset": 36,
"end_offset": 39,
"label": "bod"
}
] |
大多见于早产、弱小婴儿、重度营养不良或有腭裂的婴儿，如平卧喂奶或小儿哭叫时强迫服药易造成吸入；也见于用麻醉剂、中枢神经系统疾病等导致咽部反射或咳嗽反射失灵的患儿。 | [
{
"id": 0,
"entity": "早产",
"start_offset": 4,
"end_offset": 6,
"label": "sym"
},
{
"id": 1,
"entity": "弱小",
"start_offset": 7,
"end_offset": 9,
"label": "sym"
},
{
"id": 2,
"entity": "重度营养不良",
"start_offset": 12,
"end_offset": 18,
"label": "sym"
},
{
"id": 3,
"entity": "有腭裂",
"start_offset": 19,
"end_offset": 22,
"label": "sym"
},
{
"id": 4,
"entity": "麻醉剂",
"start_offset": 51,
"end_offset": 54,
"label": "dru"
},
{
"id": 5,
"entity": "中枢神经系统疾病",
"start_offset": 55,
"end_offset": 63,
"label": "dis"
},
{
"id": 6,
"entity": "咳嗽反射失灵",
"start_offset": 71,
"end_offset": 77,
"label": "sym"
}
] |
吸入物进入呼吸道后可产生物理或化学刺激，初期多为细支气管和毛细支气管痉挛，导致肺气肿或不张，以后可发生肺实质、肺间质、支气管的炎性病变。 | [
{
"id": 0,
"entity": "呼吸道",
"start_offset": 5,
"end_offset": 8,
"label": "bod"
},
{
"id": 1,
"entity": "肺气肿或不张",
"start_offset": 39,
"end_offset": 45,
"label": "dis"
},
{
"id": 2,
"entity": "肺实质",
"start_offset": 51,
"end_offset": 54,
"label": "dis"
},
{
"id": 3,
"entity": "肺间质",
"start_offset": 55,
"end_offset": 58,
"label": "dis"
},
{
"id": 4,
"entity": "支气管的炎性病变",
"start_offset": 59,
"end_offset": 67,
"label": "dis"
}
] |
一、类脂性肺炎类脂性肺炎（lipoidpneumonia）系鱼肝油、石蜡油、油性滴鼻剂等油脂性物质吸入造成的一种肺炎，病理特征为慢性间质性肺炎。 | [
{
"id": 0,
"entity": "类脂性肺炎",
"start_offset": 2,
"end_offset": 7,
"label": "dis"
},
{
"id": 1,
"entity": "类脂性肺炎",
"start_offset": 7,
"end_offset": 12,
"label": "dis"
},
{
"id": 2,
"entity": "lipoidpneumonia",
"start_offset": 13,
"end_offset": 28,
"label": "dis"
},
{
"id": 3,
"entity": "肺炎",
"start_offset": 56,
"end_offset": 58,
"label": "dis"
},
{
"id": 4,
"entity": "慢性间质性肺炎",
"start_offset": 64,
"end_offset": 71,
"label": "dis"
}
] |
重者可出现阵发性呼吸暂停及发绀。 | [
{
"id": 0,
"entity": "阵发性呼吸暂停及发绀",
"start_offset": 5,
"end_offset": 15,
"label": "sym"
}
] |
急性期外周血白细胞数增高肺部可闻湿啰音、痰鸣音肺实变体征胸部X线检查常见肺门阴影增大变浓，重症可见两肺气肿、肺门旁及肺野内有片絮状密度增深阴影条索状间质性浸润。 | [
{
"id": 0,
"entity": "急性期外周血白细胞数增高",
"start_offset": 0,
"end_offset": 12,
"label": "sym"
},
{
"id": 1,
"entity": "肺部可闻湿啰音、痰鸣音",
"start_offset": 12,
"end_offset": 23,
"label": "sym"
},
{
"id": 2,
"entity": "肺实变体征",
"start_offset": 23,
"end_offset": 28,
"label": "sym"
},
{
"id": 3,
"entity": "胸部X线检查",
"start_offset": 28,
"end_offset": 34,
"label": "ite"
},
{
"id": 4,
"entity": "肺门阴影增大",
"start_offset": 36,
"end_offset": 42,
"label": "sym"
},
{
"id": 5,
"entity": "变浓",
"start_offset": 42,
"end_offset": 44,
"label": "sym"
},
{
"id": 6,
"entity": "重症可见两肺气肿、肺门旁及肺野内有片絮状密度增深阴影",
"start_offset": 45,
"end_offset": 71,
"label": "sym"
},
{
"id": 7,
"entity": "条索状间质性浸润",
"start_offset": 71,
"end_offset": 79,
"label": "sym"
}
] |
根据年龄及病史，病变不易吸收，痰中找到含油滴的巨噬细胞即可以确诊。 | [
{
"id": 0,
"entity": "痰",
"start_offset": 15,
"end_offset": 16,
"label": "bod"
},
{
"id": 1,
"entity": "巨噬细胞",
"start_offset": 23,
"end_offset": 27,
"label": "bod"
}
] |
婴幼儿慎用油类口服药物，尤其勿强制灌药。 | [
{
"id": 0,
"entity": "强制灌药",
"start_offset": 15,
"end_offset": 19,
"label": "pro"
}
] |
半昏迷时更应避免，并禁止油剂滴鼻。 | [
{
"id": 0,
"entity": "油剂滴鼻",
"start_offset": 12,
"end_offset": 16,
"label": "pro"
}
] |
四、肺隔离症肺隔离症（pulmonarysequestration）的特征为一部分胚胎性囊性肺组织与正常的肺组织相隔离，其血供来自体循环。 | [
{
"id": 0,
"entity": "肺隔离症",
"start_offset": 2,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "肺隔离症",
"start_offset": 6,
"end_offset": 10,
"label": "dis"
},
{
"id": 2,
"entity": "pulmonarysequestration",
"start_offset": 11,
"end_offset": 33,
"label": "dis"
},
{
"id": 3,
"entity": "肺组织",
"start_offset": 46,
"end_offset": 49,
"label": "bod"
},
{
"id": 4,
"entity": "肺组织",
"start_offset": 53,
"end_offset": 56,
"label": "bod"
},
{
"id": 5,
"entity": "血",
"start_offset": 61,
"end_offset": 62,
"label": "bod"
}
] |
按其病理解剖特点分为：（一）肺内型较常见，张雷等报道42例中，37例（88%）为肺内型。 | [
{
"id": 0,
"entity": "肺内型",
"start_offset": 14,
"end_offset": 17,
"label": "dis"
}
] |
病变在某肺叶中，由共同的胸膜包被。 | [
{
"id": 0,
"entity": "肺叶",
"start_offset": 4,
"end_offset": 6,
"label": "bod"
},
{
"id": 1,
"entity": "胸膜",
"start_offset": 12,
"end_offset": 14,
"label": "bod"
}
] |
病变内的囊腔可与支气管相通。 | [
{
"id": 0,
"entity": "囊腔",
"start_offset": 4,
"end_offset": 6,
"label": "bod"
},
{
"id": 1,
"entity": "支气管",
"start_offset": 8,
"end_offset": 11,
"label": "bod"
}
] |
其血液供应来源于胸主动脉或腹主动脉，通过肺韧带进入肺内。 | [
{
"id": 0,
"entity": "血液",
"start_offset": 1,
"end_offset": 3,
"label": "bod"
},
{
"id": 1,
"entity": "胸主动脉",
"start_offset": 8,
"end_offset": 12,
"label": "bod"
},
{
"id": 2,
"entity": "腹主动脉",
"start_offset": 13,
"end_offset": 17,
"label": "bod"
},
{
"id": 3,
"entity": "肺韧带",
"start_offset": 20,
"end_offset": 23,
"label": "bod"
},
{
"id": 4,
"entity": "肺",
"start_offset": 25,
"end_offset": 26,
"label": "bod"
}
] |
（二）肺外型隔离的肺组织位于肺叶外，且不与支气管相通，其血液供应多来源于腹主动脉异常分支，跨过横膈的食管裂隙或主动脉裂隙进入隔离的肺组织。 | [
{
"id": 0,
"entity": "肺外型",
"start_offset": 3,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "肺组织",
"start_offset": 9,
"end_offset": 12,
"label": "bod"
},
{
"id": 2,
"entity": "肺叶外",
"start_offset": 14,
"end_offset": 17,
"label": "bod"
},
{
"id": 3,
"entity": "支气管",
"start_offset": 21,
"end_offset": 24,
"label": "bod"
},
{
"id": 4,
"entity": "血液",
"start_offset": 28,
"end_offset": 30,
"label": "bod"
},
{
"id": 5,
"entity": "腹主动脉",
"start_offset": 36,
"end_offset": 40,
"label": "bod"
},
{
"id": 6,
"entity": "横膈",
"start_offset": 47,
"end_offset": 49,
"label": "bod"
},
{
"id": 7,
"entity": "食管裂隙",
"start_offset": 50,
"end_offset": 54,
"label": "bod"
},
{
"id": 8,
"entity": "主动脉裂隙",
"start_offset": 55,
"end_offset": 60,
"label": "bod"
},
{
"id": 9,
"entity": "肺组织",
"start_offset": 65,
"end_offset": 68,
"label": "bod"
}
] |
多发生于左侧肺下叶后基底部与横膈之间，常伴有横膈缺损。 | [
{
"id": 0,
"entity": "多发生于左侧肺下叶后基底部与横膈之间",
"start_offset": 0,
"end_offset": 18,
"label": "sym"
},
{
"id": 1,
"entity": "常伴有横膈缺损",
"start_offset": 19,
"end_offset": 26,
"label": "sym"
}
] |
本病可能系胚胎发育异常所致，但亦有人认为肺内型可能是感染和炎症的结果或是一种囊腺瘤样畸形。 | [
{
"id": 0,
"entity": "胚胎发育异常",
"start_offset": 5,
"end_offset": 11,
"label": "dis"
},
{
"id": 1,
"entity": "肺内型",
"start_offset": 20,
"end_offset": 23,
"label": "dis"
},
{
"id": 2,
"entity": "感染",
"start_offset": 26,
"end_offset": 28,
"label": "dis"
},
{
"id": 3,
"entity": "炎症",
"start_offset": 29,
"end_offset": 31,
"label": "dis"
}
] |
两型隔离肺均易并发其他先天性畸形，如膈疝、肠重复畸形、先天性心脏病等。 | [
{
"id": 0,
"entity": "两型隔离肺",
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{
"id": 1,
"entity": "先天性畸形",
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{
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"entity": "膈疝",
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{
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"entity": "肠重复畸形",
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"label": "dis"
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{
"id": 4,
"entity": "先天性心脏病",
"start_offset": 27,
"end_offset": 33,
"label": "dis"
}
] |
肺内型隔离肺多与支气管相通，易引起肺部感染，主要表现为反复发作的肺部感染。 | [
{
"id": 0,
"entity": "肺内型隔离",
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{
"id": 1,
"entity": "肺多与支气管相通",
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{
"id": 2,
"entity": "肺部感染",
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{
"id": 3,
"entity": "反复发作的肺部感染",
"start_offset": 27,
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"label": "sym"
}
] |
囊内如出现液平，提示囊腔与支气管相通。 | [
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"id": 0,
"entity": "囊内如出现液平",
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{
"id": 1,
"entity": "提示囊腔与支气管相通",
"start_offset": 8,
"end_offset": 18,
"label": "sym"
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] |
支气管造影显示造影剂不能进入病变区，邻近的正常支气管阴影受到挤压出现移位。 | [
{
"id": 0,
"entity": "支气管造影",
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"label": "pro"
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{
"id": 1,
"entity": "造影剂",
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"end_offset": 10,
"label": "dru"
},
{
"id": 2,
"entity": "邻近的正常支气管阴影受到挤压出现移位",
"start_offset": 18,
"end_offset": 36,
"label": "sym"
}
] |
选择性血管造影可显示隔离肺、异常血管及其途径，有助于诊断并判断异常血管的方位。 | [
{
"id": 0,
"entity": "选择性血管造影",
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"label": "pro"
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{
"id": 1,
"entity": "肺",
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},
{
"id": 2,
"entity": "异常血管",
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"label": "bod"
},
{
"id": 3,
"entity": "血管",
"start_offset": 33,
"end_offset": 35,
"label": "bod"
}
] |
肺隔离症一般应考虑手术切除，肺外型一般做病灶切除即可，肿内型则需做肺叶切除。 | [
{
"id": 0,
"entity": "肺隔离症",
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{
"id": 1,
"entity": "手术",
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{
"id": 2,
"entity": "肺外型",
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"label": "dis"
},
{
"id": 3,
"entity": "肿内型",
"start_offset": 27,
"end_offset": 30,
"label": "dis"
}
] |
Lopoo等随访14例胎儿隔离肺，2例因张力性水胸行宫内胸腔羊膜腔分流术，4例出生前病变完全退缩，10例择期手术均获成功。 | [
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"id": 0,
"entity": "胎儿隔离肺",
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"label": "dis"
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{
"id": 1,
"entity": "张力性水胸",
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"label": "sym"
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{
"id": 2,
"entity": "宫内胸腔羊膜腔分流术",
"start_offset": 26,
"end_offset": 36,
"label": "pro"
}
] |
第二节急性上呼吸道感染急性上呼吸道感染（acuteupperrespiratoryinfection，AURI）简称上感，是小儿最常见的疾病。 | [
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"id": 0,
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{
"id": 1,
"entity": "急性上呼吸道感染",
"start_offset": 12,
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"label": "dis"
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{
"id": 2,
"entity": "acuteupperrespiratoryinfection",
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{
"id": 3,
"entity": "AURI",
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"label": "dis"
},
{
"id": 4,
"entity": "上感",
"start_offset": 59,
"end_offset": 61,
"label": "dis"
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] |
婴幼儿由于上呼吸道的解剖生理特点和免疫特点易患本病。 | [
{
"id": 0,
"entity": "上呼吸道",
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"end_offset": 9,
"label": "bod"
}
] |
若有全身诱因如维生素D缺乏性佝偻病、营养不良等疾病；或护理不当、气候改变和不良环境因素等，则易致反复感染或使病程迁延。 | [
{
"id": 0,
"entity": "维生素D缺乏性佝偻病",
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"end_offset": 17,
"label": "dis"
},
{
"id": 1,
"entity": "营养不良",
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"end_offset": 22,
"label": "dis"
},
{
"id": 2,
"entity": "感染",
"start_offset": 50,
"end_offset": 52,
"label": "dis"
}
] |
与患儿年龄、感染病原及机体抵抗力不同有关，年长儿症状较轻，而婴幼儿常较重。 | [
{
"id": 0,
"entity": "感染",
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"end_offset": 8,
"label": "dis"
}
] |
一、急性鼻咽炎急性鼻咽炎（acutenasopharyngitis）俗称伤风或感冒（commoncold），病原体侵犯鼻及鼻咽部为主，主要病原为鼻病毒、副流感病毒、呼吸道合胞病毒和冠状病毒，其他病原少见。 | [
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"id": 0,
"entity": "急性鼻咽炎",
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"end_offset": 7,
"label": "dis"
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{
"id": 1,
"entity": "急性鼻咽炎",
"start_offset": 7,
"end_offset": 12,
"label": "dis"
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{
"id": 2,
"entity": "acutenasopharyngitis",
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"label": "dis"
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{
"id": 3,
"entity": "伤风",
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"label": "dis"
},
{
"id": 4,
"entity": "感冒",
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"label": "dis"
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{
"id": 5,
"entity": "commoncold",
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"end_offset": 52,
"label": "dis"
},
{
"id": 6,
"entity": "鼻",
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"end_offset": 60,
"label": "bod"
},
{
"id": 7,
"entity": "鼻咽部",
"start_offset": 61,
"end_offset": 64,
"label": "bod"
},
{
"id": 8,
"entity": "鼻病毒",
"start_offset": 72,
"end_offset": 75,
"label": "mic"
},
{
"id": 9,
"entity": "副流感病毒",
"start_offset": 76,
"end_offset": 81,
"label": "mic"
},
{
"id": 10,
"entity": "呼吸道合胞病毒",
"start_offset": 82,
"end_offset": 89,
"label": "mic"
},
{
"id": 11,
"entity": "冠状病毒",
"start_offset": 90,
"end_offset": 94,
"label": "mic"
}
] |
年长儿症状较轻，常于受凉后1～3天出现上述卡他症状；有些在发病早期可有阵发性脐周疼痛，与发热所致阵发性肠痉挛或肠系膜淋巴结炎有关。 | [
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"id": 0,
"entity": "卡他症状",
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},
{
"id": 1,
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"label": "bod"
},
{
"id": 2,
"entity": "阵发性脐周疼痛",
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"label": "sym"
},
{
"id": 3,
"entity": "发热",
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},
{
"id": 4,
"entity": "阵发性肠痉挛",
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},
{
"id": 5,
"entity": "肠系膜淋巴结炎",
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"end_offset": 62,
"label": "dis"
}
] |
第十一节新生儿破伤风新生儿破伤风（neonataltetanus）是由破伤风厌氧芽胞梭状杆菌由脐部侵入引起的一种急性感染性疾病。 | [
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"id": 0,
"entity": "新生儿破伤风",
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"label": "dis"
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{
"id": 1,
"entity": "新生儿破伤风",
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"end_offset": 16,
"label": "dis"
},
{
"id": 2,
"entity": "neonataltetanus",
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"label": "dis"
},
{
"id": 3,
"entity": "破伤风厌氧芽胞梭状杆菌",
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"label": "mic"
},
{
"id": 4,
"entity": "急性感染性疾病",
"start_offset": 56,
"end_offset": 63,
"label": "dis"
}
] |
常在生后7天左右发病，临床上以全身骨骼肌的强直性痉挛、牙关紧闭为特征，故有“脐风”、“七日风”、“锁口风”之称。 | [
{
"id": 0,
"entity": "全身骨骼肌的强直性痉挛",
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"end_offset": 26,
"label": "sym"
},
{
"id": 1,
"entity": "牙关紧闭",
"start_offset": 27,
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"label": "sym"
}
] |
【临床流行病学】（一）发病率和病死率新生儿破伤风在世界各国的发病率有很大差异，自19世纪80年代无菌接生法和妊娠期破伤风免疫预防的推广，其发病率和死亡率已有所下降。 | [
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"id": 0,
"entity": "新生儿破伤风",
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"label": "dis"
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] |
据WHO调查，在1994年每年有约51万名新生儿死于破伤风，其中约80%发生于东南亚和非洲的国家。 | [
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] |
（二）病原学1.病原菌特点破伤风杆菌为革兰染色阳性、产芽胞的、梭形厌氧菌，长2～5μm，宽0.3～0.5μm，无荚膜，有周身鞭毛，能运动。 | [
{
"id": 0,
"entity": "病原菌",
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{
"id": 1,
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},
{
"id": 2,
"entity": "厌氧菌",
"start_offset": 33,
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"label": "mic"
}
] |
破伤风杆菌不是组织侵袭性细菌，仅通过破伤风痉挛毒素致病；破伤风毒素是已知毒素中排位第二的毒素，仅次于肉毒毒素，其致死量约10-6</sup>mg/kg。 | [
{
"id": 0,
"entity": "破伤风杆菌",
"start_offset": 0,
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"label": "mic"
},
{
"id": 1,
"entity": "破伤风痉挛毒素",
"start_offset": 18,
"end_offset": 25,
"label": "mic"
},
{
"id": 2,
"entity": "破伤风毒素",
"start_offset": 28,
"end_offset": 33,
"label": "mic"
},
{
"id": 3,
"entity": "肉毒毒素",
"start_offset": 50,
"end_offset": 54,
"label": "mic"
}
] |
2.感染方式用未消毒的剪刀、线绳来断脐、结扎脐带；接生者的手或包盖脐带残端的棉花纱布未严格消毒时，破伤风梭菌即可由此侵入。 | [
{
"id": 0,
"entity": "破伤风梭菌",
"start_offset": 49,
"end_offset": 54,
"label": "mic"
}
] |
【发病机制】坏死的脐残端及其上的覆盖物使该处氧化还原电势降低，有利于破伤风梭菌出芽繁殖并产生破伤风痉挛毒素而致病。 | [
{
"id": 0,
"entity": "氧化还原电势降低",
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"end_offset": 30,
"label": "sym"
},
{
"id": 1,
"entity": "破伤风梭菌",
"start_offset": 34,
"end_offset": 39,
"label": "mic"
},
{
"id": 2,
"entity": "破伤风梭菌出芽繁殖",
"start_offset": 34,
"end_offset": 43,
"label": "sym"
},
{
"id": 3,
"entity": "破伤风痉挛毒素",
"start_offset": 46,
"end_offset": 53,
"label": "mic"
},
{
"id": 4,
"entity": "产生破伤风痉挛毒素",
"start_offset": 44,
"end_offset": 53,
"label": "sym"
}
] |
破伤风毒素经淋巴液中淋巴细胞入血，附在球蛋白到达中枢神经系统；也可由肌肉神经结合处吸收，通过外周神经的内膜和外膜间隙或运动神经轴上行至脊髓和脑干。 | [
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"id": 0,
"entity": "破伤风毒素",
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{
"id": 1,
"entity": "淋巴液",
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"label": "bod"
},
{
"id": 2,
"entity": "球蛋白",
"start_offset": 19,
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"label": "bod"
},
{
"id": 3,
"entity": "中枢神经系统",
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"end_offset": 30,
"label": "bod"
},
{
"id": 4,
"entity": "肌肉神经",
"start_offset": 34,
"end_offset": 38,
"label": "bod"
},
{
"id": 5,
"entity": "运动神经轴",
"start_offset": 59,
"end_offset": 64,
"label": "bod"
},
{
"id": 6,
"entity": "脊髓",
"start_offset": 67,
"end_offset": 69,
"label": "bod"
},
{
"id": 7,
"entity": "脑干",
"start_offset": 70,
"end_offset": 72,
"label": "bod"
}
] |
此毒素一旦与中枢神经组织中的神经节苷脂结合，抗毒素也不能中和。 | [
{
"id": 0,
"entity": "中枢神经组织",
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"label": "bod"
},
{
"id": 1,
"entity": "神经节苷脂",
"start_offset": 14,
"end_offset": 19,
"label": "bod"
}
] |
毒素与灰质中突触小体膜的神经节苷脂结合后，使它不能释放抑制性神经介质（甘氨酸、氨基丁酸），以致运动神经系统对传入刺激的反射强化，导致屈肌与伸肌同时强烈地持续收缩。 | [
{
"id": 0,
"entity": "甘氨酸",
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"label": "bod"
},
{
"id": 1,
"entity": "氨基丁酸",
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"label": "bod"
},
{
"id": 2,
"entity": "运动神经系统",
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},
{
"id": 3,
"entity": "屈肌与伸肌同时强烈地持续收缩",
"start_offset": 66,
"end_offset": 80,
"label": "sym"
}
] |
活动越频繁的肌群，越先受累，故咀嚼肌痉挛使牙关紧闭，面肌痉挛而呈苦笑面容，腹背肌当痉挛较强后，形成角弓反张。 | [
{
"id": 0,
"entity": "咀嚼肌痉挛",
"start_offset": 15,
"end_offset": 20,
"label": "sym"
},
{
"id": 1,
"entity": "牙关紧闭",
"start_offset": 21,
"end_offset": 25,
"label": "sym"
},
{
"id": 2,
"entity": "面肌痉挛而呈苦笑面容",
"start_offset": 26,
"end_offset": 36,
"label": "sym"
},
{
"id": 3,
"entity": "形成角弓反张",
"start_offset": 47,
"end_offset": 53,
"label": "sym"
}
] |
此毒素亦可兴奋交感神经，导致心动过速、高血压、多汗等表现。 | [
{
"id": 0,
"entity": "兴奋交感神经",
"start_offset": 5,
"end_offset": 11,
"label": "bod"
},
{
"id": 1,
"entity": "心动过速",
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"label": "sym"
},
{
"id": 2,
"entity": "高血压",
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"label": "sym"
},
{
"id": 3,
"entity": "多汗",
"start_offset": 23,
"end_offset": 25,
"label": "sym"
}
] |
一般以哭吵不安起病，患儿想吃，但口张不大，吸吮困难。 | [
{
"id": 0,
"entity": "哭吵不安",
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{
"id": 1,
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},
{
"id": 2,
"entity": "吸吮困难",
"start_offset": 21,
"end_offset": 25,
"label": "sym"
}
] |
随后牙关紧闭，眉举额皱，口角上牵，出现“苦笑”面容，双拳紧握，上肢过度屈曲，下肢伸直，成角弓反张状。 | [
{
"id": 0,
"entity": "牙关紧闭",
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"end_offset": 6,
"label": "sym"
},
{
"id": 1,
"entity": "眉举额皱",
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"label": "sym"
},
{
"id": 2,
"entity": "口角上牵",
"start_offset": 12,
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"label": "sym"
},
{
"id": 3,
"entity": "出现“苦笑”面容",
"start_offset": 17,
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"label": "sym"
},
{
"id": 4,
"entity": "双拳紧握",
"start_offset": 26,
"end_offset": 30,
"label": "sym"
},
{
"id": 5,
"entity": "上肢过度屈曲",
"start_offset": 31,
"end_offset": 37,
"label": "sym"
},
{
"id": 6,
"entity": "下肢伸直",
"start_offset": 38,
"end_offset": 42,
"label": "sym"
},
{
"id": 7,
"entity": "成角弓反张状",
"start_offset": 43,
"end_offset": 49,
"label": "sym"
}
] |
强直性痉挛阵阵发作，间歇期肌肉收缩仍继续存在，轻微刺激（声、光、轻触、饮水、轻刺等）常诱发痉挛发作。 | [
{
"id": 0,
"entity": "强直性痉挛阵阵发作",
"start_offset": 0,
"end_offset": 9,
"label": "sym"
},
{
"id": 1,
"entity": "间歇期肌肉收缩仍继续存在",
"start_offset": 10,
"end_offset": 22,
"label": "sym"
},
{
"id": 2,
"entity": "轻微刺激",
"start_offset": 23,
"end_offset": 27,
"label": "sym"
},
{
"id": 3,
"entity": "诱发痉挛",
"start_offset": 43,
"end_offset": 47,
"label": "sym"
}
] |
患儿神志清醒，早期多不发热，以后体温升高可因全身肌肉反复强直痉挛引起，亦可因肺炎等继发感染所致。 | [
{
"id": 0,
"entity": "体温升高",
"start_offset": 16,
"end_offset": 20,
"label": "sym"
},
{
"id": 1,
"entity": "全身肌肉反复强直痉挛",
"start_offset": 22,
"end_offset": 32,
"label": "sym"
},
{
"id": 2,
"entity": "肺炎",
"start_offset": 38,
"end_offset": 40,
"label": "dis"
}
] |
否则，因越发越频，缺氧窒息或继发感染而死亡。 | [
{
"id": 0,
"entity": "缺氧窒息",
"start_offset": 9,
"end_offset": 13,
"label": "sym"
},
{
"id": 1,
"entity": "感染",
"start_offset": 16,
"end_offset": 18,
"label": "sym"
},
{
"id": 2,
"entity": "死亡",
"start_offset": 19,
"end_offset": 21,
"label": "sym"
}
] |
【实验室检查】常规实验室检查多正常，周围血象中白细胞可因脐带继发感染或持续痉挛引起的应激反应而升高。 | [
{
"id": 0,
"entity": "白细胞",
"start_offset": 23,
"end_offset": 26,
"label": "bod"
},
{
"id": 1,
"entity": "周围血象中白细胞可因脐带继发感染或持续痉挛引起的应激反应而升高",
"start_offset": 18,
"end_offset": 49,
"label": "sym"
}
] |
脐部分泌物培养仅部分患儿阳性。 | [
{
"id": 0,
"entity": "脐部",
"start_offset": 0,
"end_offset": 2,
"label": "bod"
},
{
"id": 1,
"entity": "脐部分泌物培养仅部分患儿阳性",
"start_offset": 0,
"end_offset": 14,
"label": "sym"
}
] |
【诊断】破伤风的症状最有特征性，根据消毒不严的接生史、出生后典型发作表现，一般容易诊断；早期尚无典型表现时，可用压舌板检查患儿咽部，若越用力下压，压舌板反被咬得越紧，也可确诊。 | [
{
"id": 0,
"entity": "破伤风",
"start_offset": 4,
"end_offset": 7,
"label": "dis"
}
] |
同时，肌注青霉素3～4天及破伤风抗毒素1500～3000U或人体破伤风免疫球蛋白75～250U。 | [
{
"id": 0,
"entity": "青霉素",
"start_offset": 5,
"end_offset": 8,
"label": "dru"
},
{
"id": 1,
"entity": "破伤风抗毒素",
"start_offset": 13,
"end_offset": 19,
"label": "dru"
},
{
"id": 2,
"entity": "免疫球蛋白",
"start_offset": 35,
"end_offset": 40,
"label": "dru"
}
] |
3.对不能保证无菌接生的孕妇，于妊娠晚期可注射2次破伤风类毒素0.5ml，相隔1个月，第二次至少在产前2周（最好1个月时）肌注。 | [
{
"id": 0,
"entity": "注射",
"start_offset": 21,
"end_offset": 23,
"label": "pro"
},
{
"id": 1,
"entity": "破伤风类毒素",
"start_offset": 25,
"end_offset": 31,
"label": "dru"
},
{
"id": 2,
"entity": "肌注",
"start_offset": 61,
"end_offset": 63,
"label": "pro"
}
] |
【治疗】（一）一般治疗1.护理保持室内安静、避光，减少刺激，避免扰动，必需的操作（如测体温、翻身等）尽量集中同时进行。 | [
{
"id": 0,
"entity": "保持室内安静",
"start_offset": 15,
"end_offset": 21,
"label": "pro"
},
{
"id": 1,
"entity": "避光",
"start_offset": 22,
"end_offset": 24,
"label": "pro"
},
{
"id": 2,
"entity": "减少刺激",
"start_offset": 25,
"end_offset": 29,
"label": "pro"
},
{
"id": 3,
"entity": "避免扰动",
"start_offset": 30,
"end_offset": 34,
"label": "pro"
}
] |
及时清除痰液，保持呼吸道通畅及口腔、皮肤清洁。 | [
{
"id": 0,
"entity": "清除痰液",
"start_offset": 2,
"end_offset": 6,
"label": "pro"
},
{
"id": 1,
"entity": "保持呼吸道通畅及口腔",
"start_offset": 7,
"end_offset": 17,
"label": "pro"
},
{
"id": 2,
"entity": "皮肤清洁",
"start_offset": 18,
"end_offset": 22,
"label": "pro"
}
] |
2.保证营养和水分供给后期可鼻饲乳品，如痉挛频繁不能鼻饲，可用静脉营养。 | [
{
"id": 0,
"entity": "保证营养",
"start_offset": 2,
"end_offset": 6,
"label": "pro"
},
{
"id": 1,
"entity": "水分供给",
"start_offset": 7,
"end_offset": 11,
"label": "pro"
}
] |
3.有缺氧及青紫时给氧，如窒息、呼吸衰竭者应用呼吸机辅助通气。 | [
{
"id": 0,
"entity": "窒息",
"start_offset": 13,
"end_offset": 15,
"label": "sym"
},
{
"id": 1,
"entity": "呼吸机辅助通气",
"start_offset": 23,
"end_offset": 30,
"label": "pro"
}
] |
有脑水肿者应用甘露醇等脱水剂。 | [
{
"id": 0,
"entity": "甘露醇",
"start_offset": 7,
"end_offset": 10,
"label": "dru"
}
] |
1.地西泮有松弛肌肉及抗惊厥作用，每次0.2～0.3mg/kg，缓慢静注，4～6小时1次，若止痉效果不佳，可逐渐增加至每次1mg/kg，痉挛好转后再鼻饲给药，可每次0.5～1mg/kg，必要时还可加大剂量，口服地西泮的半衰期长达10余小时～3天。 | [
{
"id": 0,
"entity": "地西泮",
"start_offset": 2,
"end_offset": 5,
"label": "dru"
},
{
"id": 1,
"entity": "惊厥",
"start_offset": 12,
"end_offset": 14,
"label": "dis"
},
{
"id": 2,
"entity": "静注",
"start_offset": 34,
"end_offset": 36,
"label": "pro"
},
{
"id": 3,
"entity": "地西泮",
"start_offset": 105,
"end_offset": 108,
"label": "dru"
}
] |
近年来，国内有报道应用大剂量地西泮治疗重症新生儿破伤风有较好疗效，即患儿入院后先用地西泮3～5mg注射，15分钟后未达“地西泮化”者加用7.5mg，静脉缓推，最大量每次10mg，达“地西泮化”后每2～3小时给地西泮化量的地西泮1次维持，一般要求用量达到“地西泮化”标准，即患儿浅睡，咳嗽吞咽反射存在，体检时无抽搐，仅在注射、穿刺或吸痰时出现短暂肌强硬，下次给药前可有轻微而短暂的抽搐，但无明显发绀。 | [
{
"id": 0,
"entity": "地西泮",
"start_offset": 14,
"end_offset": 17,
"label": "dru"
},
{
"id": 1,
"entity": "破伤风",
"start_offset": 24,
"end_offset": 27,
"label": "dis"
},
{
"id": 2,
"entity": "地西泮",
"start_offset": 41,
"end_offset": 44,
"label": "dru"
},
{
"id": 3,
"entity": "静脉缓推",
"start_offset": 74,
"end_offset": 78,
"label": "pro"
},
{
"id": 4,
"entity": "地西泮",
"start_offset": 110,
"end_offset": 113,
"label": "dru"
},
{
"id": 5,
"entity": "体检时无抽搐",
"start_offset": 150,
"end_offset": 156,
"label": "sym"
},
{
"id": 6,
"entity": "注射",
"start_offset": 159,
"end_offset": 161,
"label": "pro"
},
{
"id": 7,
"entity": "穿刺",
"start_offset": 162,
"end_offset": 164,
"label": "pro"
},
{
"id": 8,
"entity": "吸痰",
"start_offset": 165,
"end_offset": 167,
"label": "pro"
},
{
"id": 9,
"entity": "短暂肌强硬",
"start_offset": 170,
"end_offset": 175,
"label": "sym"
}
] |
2.苯巴比妥（鲁米那）负荷量10～20mg/kg，静脉或肌内注射，12小时后维持量5mg/（kg•d）。 | [
{
"id": 0,
"entity": "苯巴比妥",
"start_offset": 2,
"end_offset": 6,
"label": "dru"
},
{
"id": 1,
"entity": "鲁米那",
"start_offset": 7,
"end_offset": 10,
"label": "dru"
},
{
"id": 2,
"entity": "注射",
"start_offset": 30,
"end_offset": 32,
"label": "pro"
}
] |
3.氯丙嗪每次0.5～1mg/kg，稀释后静滴，每6～8小时可重复一次。 | [
{
"id": 0,
"entity": "氯丙嗪",
"start_offset": 2,
"end_offset": 5,
"label": "dru"
},
{
"id": 1,
"entity": "静滴",
"start_offset": 21,
"end_offset": 23,
"label": "pro"
}
] |
但剂量过大或持续时间过长可出现软瘫或体温下降，故不宜多用。 | [
{
"id": 0,
"entity": "软瘫",
"start_offset": 15,
"end_offset": 17,
"label": "sym"
},
{
"id": 1,
"entity": "体温下降",
"start_offset": 18,
"end_offset": 22,
"label": "sym"
}
] |
4.水合氯醛止痉作用快，作为痉挛发作时临时性增加药物。 | [
{
"id": 0,
"entity": "水合氯醛",
"start_offset": 2,
"end_offset": 6,
"label": "dru"
}
] |
常用10%溶液每次0.5ml/kg，灌肠或鼻饲注入。 | [
{
"id": 0,
"entity": "灌肠",
"start_offset": 18,
"end_offset": 20,
"label": "pro"
},
{
"id": 1,
"entity": "鼻饲",
"start_offset": 21,
"end_offset": 23,
"label": "pro"
}
] |
5.副醛止惊效果快而安全，但主要由肺排出刺激呼吸道黏膜，有肺炎时不宜采用。 | [
{
"id": 0,
"entity": "副醛",
"start_offset": 2,
"end_offset": 4,
"label": "dru"
},
{
"id": 1,
"entity": "呼吸道黏膜",
"start_offset": 22,
"end_offset": 27,
"label": "bod"
},
{
"id": 2,
"entity": "肺炎",
"start_offset": 29,
"end_offset": 31,
"label": "dis"
}
] |
多为临时使用一次，每次0.1～0.2ml/kg（稀释成5%溶液）静注或0.2～0.3ml/kg每次肌注或灌肠。 | [
{
"id": 0,
"entity": "静注",
"start_offset": 32,
"end_offset": 34,
"label": "pro"
},
{
"id": 1,
"entity": "肌注",
"start_offset": 49,
"end_offset": 51,
"label": "pro"
},
{
"id": 2,
"entity": "灌肠",
"start_offset": 52,
"end_offset": 54,
"label": "pro"
}
] |
6.泮库溴铵（pavulon，pancuronium）神经肌肉阻滞药或肌松药，每次0.05～1mg/kg，静脉注射，2～3小时1次，对重症患儿在使用人工呼吸机的情况下可以采用。 | [
{
"id": 0,
"entity": "泮库溴铵",
"start_offset": 2,
"end_offset": 6,
"label": "dru"
},
{
"id": 1,
"entity": "pavulon",
"start_offset": 7,
"end_offset": 14,
"label": "dru"
},
{
"id": 2,
"entity": "pancuronium",
"start_offset": 15,
"end_offset": 26,
"label": "dru"
},
{
"id": 3,
"entity": "肌松药",
"start_offset": 35,
"end_offset": 38,
"label": "dru"
}
] |
一般认为，大剂量地西泮和鲁苯巴比妥交替鼻饲，止痉效果确切，可作为新生儿破伤风止痉的首选搭配，临时可增加水合氯醛或副醛，以上治疗无效时，可给予普鲁卡因6～8mg/（kg•d），稀释后缓慢静脉滴入。 | [
{
"id": 0,
"entity": "地西泮",
"start_offset": 8,
"end_offset": 11,
"label": "dru"
},
{
"id": 1,
"entity": "鲁苯巴比妥",
"start_offset": 12,
"end_offset": 17,
"label": "dru"
},
{
"id": 2,
"entity": "鼻饲",
"start_offset": 19,
"end_offset": 21,
"label": "pro"
},
{
"id": 3,
"entity": "水合氯醛",
"start_offset": 51,
"end_offset": 55,
"label": "dru"
},
{
"id": 4,
"entity": "副醛",
"start_offset": 56,
"end_offset": 58,
"label": "dru"
},
{
"id": 5,
"entity": "普鲁卡因",
"start_offset": 70,
"end_offset": 74,
"label": "dru"
},
{
"id": 6,
"entity": "静脉滴入",
"start_offset": 92,
"end_offset": 96,
"label": "pro"
}
] |
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