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stringlengths 5
708
| id
int64 1
2.07k
| event
list |
|---|---|---|
1年前住院胸部ct发现肺部结节，考虑肺癌可能，未进一步诊治；4月前患者于我院住院，胸水中查见肿瘤细胞，倾向腺癌细胞，诊断为肺腺癌伴胸膜转移（iv期，t4nxm1），院外口服“吉非替尼”靶向药物治疗。 | 794 | [
{
"anatomy_list": [
"肺部"
],
"character": [],
"core_name": "结节",
"tendency": ""
},
{
"anatomy_list": [
"肺"
],
"character": [],
"core_name": "癌",
"tendency": "不确定"
},
{
"anatomy_list": [],
"character": [
"胸水中"
],
"core_name": "肿瘤细胞",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"胸水中"
],
"core_name": "腺癌细胞",
"tendency": "不确定"
},
{
"anatomy_list": [
"肺"
],
"character": [
"胸膜转移iv期",
"t4nxm1"
],
"core_name": "腺癌",
"tendency": ""
}
] |
2019/11/7ct检查报告：左肺癌肺癌根治术后表现，残余左肺少许炎性改变，左胸及纵隔、双侧胸壁皮下、胸背部、颈部较多积气。 | 1,814 | [
{
"anatomy_list": [
"残余左肺"
],
"character": [
"少许"
],
"core_name": "炎性改变",
"tendency": ""
},
{
"anatomy_list": [
"左胸皮下",
"左胸纵隔皮下",
"左胸双侧胸壁皮下",
"胸背部",
"颈部"
],
"character": [
"较多"
],
"core_name": "积气",
"tendency": ""
}
] |
后患者每年秋冬季节均出现咳嗽、咳痰，均自购“感冒药”服用后好转；2月前患者因“反复心悸、气促1+月”于我院心内科住院，完善相关检查：胸部+上腹部ct(256)检查（2018-03-01，我院）：1.左肺门包绕下叶支气管跨叶生长肿块如上述，考虑肿瘤。 | 1,259 | [
{
"anatomy_list": [],
"character": [
"“感冒药”服用后好转"
],
"core_name": "咳嗽",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"“感冒药”服用后好转"
],
"core_name": "咳痰",
"tendency": ""
},
{
"anatomy_list": [
"心"
],
"character": [
"反复"
],
"core_name": "心悸",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"反复"
],
"core_name": "气促",
"tendency": ""
},
{
"anatomy_list": [
"左肺门"
],
"character": [
"包绕下叶支气管跨叶生长"
],
"core_name": "肿块",
"tendency": ""
}
] |
（吻合口近端、吻合口远端、放射状切缘）未见癌累及。网膜及阑尾组织。 | 637 | [
{
"anatomy_list": [
"吻合口近端",
"吻合口远端",
"放射状切缘"
],
"character": [
"累及"
],
"core_name": "癌",
"tendency": "否定"
}
] |
现患者为求以“右侧胸腔积液；右肺腺癌”，收入我科。 | 1,248 | [
{
"anatomy_list": [
"右侧胸腔"
],
"character": [],
"core_name": "积液",
"tendency": ""
},
{
"anatomy_list": [
"右肺"
],
"character": [],
"core_name": "腺癌",
"tendency": ""
}
] |
曾因上述症状于外院就诊，查c无明显异常，腹部b超提示：1、脂肪肝；2、脾大；3、右肾周少量积液。 | 1,697 | [
{
"anatomy_list": [
"肝"
],
"character": [
"明显"
],
"core_name": "肝功异常",
"tendency": "否定"
},
{
"anatomy_list": [
"肾"
],
"character": [
"明显"
],
"core_name": "肾功异常",
"tendency": "否定"
},
{
"anatomy_list": [
"肝"
],
"character": [],
"core_name": "脂肪肝",
"tendency": ""
},
{
"anatomy_list": [
"脾"
],
"character": [],
"core_name": "脾大",
"tendency": ""
},
{
"anatomy_list": [
"右肾周"
],
"character": [
"少量"
],
"core_name": "积液",
"tendency": ""
}
] |
院外患者全身疼痛疼痛不适，以腰背部及左侧髋关节处明显，患者自行购买芬必得止痛，效果欠佳，2月前因疼痛加重到我科就诊，建议患者行egfr、alk等基因检测，患者及其家属经慎重考虑后拒绝，自服吉非替尼治疗观察，住院期间根据疼痛调整为羟考酮缓释片 30mg q12h止痛，并予以抗肿瘤、增强免疫、唑来磷酸抗溶骨等处理好转出院。 | 779 | [
{
"anatomy_list": [
"全身"
],
"character": [],
"core_name": "疼痛",
"tendency": ""
},
{
"anatomy_list": [
"腰背部"
],
"character": [
"明显"
],
"core_name": "疼痛",
"tendency": ""
},
{
"anatomy_list": [
"左侧髋关节"
],
"character": [
"明显"
],
"core_name": "疼痛",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"加重"
],
"core_name": "疼痛",
"tendency": ""
}
] |
伴反酸、嗳气、烧心、呃逆，不伴有腹痛、腹泻、尿频、尿急等不适。 | 1,057 | [
{
"anatomy_list": [],
"character": [],
"core_name": "反酸",
"tendency": ""
},
{
"anatomy_list": [],
"character": [],
"core_name": "嗳气",
"tendency": ""
},
{
"anatomy_list": [],
"character": [],
"core_name": "烧心",
"tendency": ""
},
{
"anatomy_list": [],
"character": [],
"core_name": "呃逆",
"tendency": ""
},
{
"anatomy_list": [
"腹"
],
"character": [],
"core_name": "疼痛",
"tendency": "否定"
},
{
"anatomy_list": [
"腹"
],
"character": [],
"core_name": "腹泻",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "尿频",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "尿急",
"tendency": "否定"
}
] |
患者未予以重视，1天前，患者无明显诱因出现腰痛加重，并向双下肢放射，伴双小腿麻木、双下肢乏力；疼痛能忍受，久站、久坐及长距离行走后加重，卧床休息可稍缓解。 | 270 | [
{
"anatomy_list": [
"腰"
],
"character": [
"加重"
],
"core_name": "疼痛",
"tendency": ""
},
{
"anatomy_list": [
"双下肢"
],
"character": [
"放射性"
],
"core_name": "疼痛",
"tendency": ""
},
{
"anatomy_list": [
"双小腿"
],
"character": [],
"core_name": "麻木",
"tendency": ""
},
{
"anatomy_list": [],
"character": [],
"core_name": "乏力",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"能忍受",
"久站、久坐及长距离行走后加重",
"卧床休息可稍缓解"
],
"core_name": "疼痛",
"tendency": ""
}
] |
患者4月前无明显诱因出现右下腹疼痛，为间歇性疼痛，伴烧灼感，无明显加重或缓解因素，无畏寒、发热，无恶心、呕吐，无肉眼血尿，无尿频、尿急，无排尿疼痛，无排尿困难，无双侧腰部胀痛，无双下肢水肿。 | 296 | [
{
"anatomy_list": [
"右下腹"
],
"character": [
"间歇性",
"伴烧灼感",
"无明显加重或缓解因素"
],
"core_name": "疼痛",
"tendency": ""
},
{
"anatomy_list": [],
"character": [],
"core_name": "畏寒",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "发热",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "恶心",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "呕吐",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "血尿",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "尿频",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "尿急",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [
"排尿"
],
"core_name": "疼痛",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "排尿困难",
"tendency": "否定"
},
{
"anatomy_list": [
"双侧腰部"
],
"character": [
"胀痛"
],
"core_name": "疼痛",
"tendency": "否定"
},
{
"anatomy_list": [
"双下肢"
],
"character": [],
"core_name": "水肿",
"tendency": "否定"
}
] |
无胸闷、乏力。 | 560 | [
{
"anatomy_list": [
"胸"
],
"character": [],
"core_name": "胸闷",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "乏力",
"tendency": "否定"
}
] |
发现血压升高18年，最高血压为“200/110mmHg,目前服用“左旋氨氯地平5mg，依那普利5mg”，血压控制可，波动于130-140/80-90mmHg。 | 1,062 | [
{
"anatomy_list": [],
"character": [
"升高"
],
"core_name": "血压",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"控制可"
],
"core_name": "血压",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"波动"
],
"core_name": "血压",
"tendency": ""
}
] |
入院前1年，患者开始偶有静息下呼吸困难，无咯粉红色泡沫痰，伴长期双下肢水肿，无胸痛，无咯血，无恶心呕吐，院外予以“利尿消肿”等治疗可缓解。 | 525 | [
{
"anatomy_list": [],
"character": [
"偶有",
"静息下"
],
"core_name": "呼吸困难",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"粉红色泡沫"
],
"core_name": "咳痰",
"tendency": "否定"
},
{
"anatomy_list": [
"双下肢"
],
"character": [
"长期"
],
"core_name": "水肿",
"tendency": ""
},
{
"anatomy_list": [
"胸"
],
"character": [],
"core_name": "疼痛",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "咯血",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "恶心",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "呕吐",
"tendency": "否定"
}
] |
约47岁绝经。 | 620 | [
{
"anatomy_list": [],
"character": [],
"core_name": "绝经",
"tendency": ""
}
] |
5+月前患者因“进行性吞咽困难2+月”入我院，我院胃镜检查提示“距门齿21厘米处食管可见一隆起性新生物”，活检提示“食管鳞状细胞癌”；完善相关检查后有手术指征，无绝对手术禁忌，遂于我院行“胸腹腔镜联合食管癌根治+空肠造瘘术”。 | 1,919 | [
{
"anatomy_list": [],
"character": [
"进行性"
],
"core_name": "吞咽困难",
"tendency": ""
},
{
"anatomy_list": [
"距门齿21厘米处食管"
],
"character": [
"隆起性"
],
"core_name": "新生物",
"tendency": ""
},
{
"anatomy_list": [
"食管"
],
"character": [],
"core_name": "鳞癌",
"tendency": ""
}
] |
亚砷酸化疗两个疗程后，复查骨髓涂片：增生性骨髓象，化疗过程中，查脑脊液：细胞总数 1401.0*10＾6/L，单个核细胞比率 100.00%，脑脊液生化报告：蛋白 1158.6mg/L，遂多次行地塞米松、甲氨蝶呤、阿糖胞苷鞘内药物注射，患者病情好转出院。 | 1,355 | [
{
"anatomy_list": [
"骨髓"
],
"character": [
"增生性"
],
"core_name": "骨髓象",
"tendency": ""
}
] |
2.双肺上叶、右肺下叶背段小结节影，转移瘤或其他病变，建议随访复查。 | 280 | [
{
"anatomy_list": [
"双肺上叶",
"右肺下叶背段"
],
"character": [
"小"
],
"core_name": "结节影",
"tendency": ""
},
{
"anatomy_list": [],
"character": [],
"core_name": "转移瘤",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"其他"
],
"core_name": "病变",
"tendency": ""
}
] |
病程中患者反复出现颜面及双下肢重度水肿在我科住院治疗，血肌酐在168-425umol/l之间波动，因患者不能平卧平卧休息，伴明显活动后心累气促，考虑心衰，予以血液透析、改善心功能等处理后好转出院。 | 897 | [
{
"anatomy_list": [
"颜面"
],
"character": [
"重度",
"反复出现"
],
"core_name": "水肿",
"tendency": ""
},
{
"anatomy_list": [
"双下肢"
],
"character": [
"重度",
"反复出现"
],
"core_name": "水肿",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"不能"
],
"core_name": "平卧休息",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [
"明显活动后"
],
"core_name": "心累",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"明显活动后"
],
"core_name": "气促",
"tendency": ""
},
{
"anatomy_list": [
"心"
],
"character": [],
"core_name": "心力衰竭",
"tendency": "不确定"
}
] |
入院前8天余,患者无明显诱因出现声嘶,鼻阻,伴少量透明流涕,自行服用“阿莫西林”等药物后,流涕、鼻塞症状稍有缓解,但仍声嘶明显。 | 30 | [
{
"anatomy_list": [],
"character": [],
"core_name": "声嘶",
"tendency": ""
},
{
"anatomy_list": [
"鼻"
],
"character": [],
"core_name": "鼻阻",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"透明",
"少量"
],
"core_name": "流涕",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"症状稍有缓解"
],
"core_name": "流涕",
"tendency": ""
},
{
"anatomy_list": [
"鼻"
],
"character": [
"稍有缓解"
],
"core_name": "鼻塞",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"明显"
],
"core_name": "声嘶",
"tendency": ""
}
] |
门诊以“颈部包块待查”收入我科住院治疗。 | 254 | [
{
"anatomy_list": [
"颈部"
],
"character": [],
"core_name": "包块",
"tendency": ""
}
] |
入院前1+周，患者无意中扪及双侧乳腺肿物，约蚕豆大小，不伴有乳房疼痛，不伴有乳头溢血溢液，无局部红肿热痛。 | 655 | [
{
"anatomy_list": [
"双侧乳腺"
],
"character": [
"约蚕豆大小"
],
"core_name": "肿物",
"tendency": ""
},
{
"anatomy_list": [
"乳房"
],
"character": [],
"core_name": "疼痛",
"tendency": "否定"
},
{
"anatomy_list": [
"乳头"
],
"character": [],
"core_name": "溢血",
"tendency": "否定"
},
{
"anatomy_list": [
"乳头"
],
"character": [],
"core_name": "溢液",
"tendency": "否定"
},
{
"anatomy_list": [
"乳房"
],
"character": [
"局部"
],
"core_name": "发红",
"tendency": "否定"
},
{
"anatomy_list": [
"乳房"
],
"character": [
"局部"
],
"core_name": "肿",
"tendency": "否定"
},
{
"anatomy_list": [
"乳房"
],
"character": [
"局部"
],
"core_name": "热",
"tendency": "否定"
},
{
"anatomy_list": [
"乳房"
],
"character": [
"局部"
],
"core_name": "痛",
"tendency": "否定"
}
] |
2017年6月7日宫颈活检提示：（宫颈）见大片异型细胞，倾向恶性肿瘤，建议免疫组化10项协助诊断。 | 1,220 | [
{
"anatomy_list": [
"宫颈"
],
"character": [
"大片"
],
"core_name": "异型细胞",
"tendency": ""
},
{
"anatomy_list": [
"宫颈"
],
"character": [
"恶性"
],
"core_name": "肿瘤",
"tendency": "不确定"
}
] |
入院前1天，患者因服用“头痛粉”后出现恶心、呕吐，呕吐物为胃内容物，无喷射样呕吐，无呕血，伴乏力，无腹痛、腹胀、黑便、腹泻，无畏寒、发热，未引起重视，未进行诊治。 | 582 | [
{
"anatomy_list": [],
"character": [
"服用头痛粉"
],
"core_name": "恶心",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"呕吐物为胃内容物",
"服用头痛粉"
],
"core_name": "呕吐",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"喷射样"
],
"core_name": "呕吐",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "呕血",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "乏力",
"tendency": ""
},
{
"anatomy_list": [
"腹"
],
"character": [],
"core_name": "疼痛",
"tendency": "否定"
},
{
"anatomy_list": [
"腹"
],
"character": [],
"core_name": "腹胀",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "黑便",
"tendency": "否定"
},
{
"anatomy_list": [
"腹"
],
"character": [],
"core_name": "腹泻",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "畏寒",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "发热",
"tendency": "否定"
}
] |
患者发病以来，神志 清晰，精神可，胃纳可，大便如上，小便如常，体重未见明显下降。 | 869 | [
{
"anatomy_list": [],
"character": [
"清晰"
],
"core_name": "神志",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"可"
],
"core_name": "精神",
"tendency": ""
},
{
"anatomy_list": [
"胃"
],
"character": [
"可"
],
"core_name": "胃纳",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"如常"
],
"core_name": "小便",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"明显"
],
"core_name": "体重下降",
"tendency": "否定"
}
] |
术后病理结果提示：食管高分化鳞状细胞癌，侵及深肌层，食管切缘、胃切缘未见癌累及，右喉返旁淋巴结见癌转移（2/7），（胃周围、食管旁、胃左、隆突下）淋巴结未见癌转移。 | 1,920 | [
{
"anatomy_list": [
"食管"
],
"character": [
"高分化"
],
"core_name": "鳞癌",
"tendency": ""
},
{
"anatomy_list": [
"深肌层"
],
"character": [
"侵及"
],
"core_name": "鳞癌",
"tendency": ""
},
{
"anatomy_list": [
"食管切缘",
"胃切缘"
],
"character": [
"累及"
],
"core_name": "癌",
"tendency": "否定"
},
{
"anatomy_list": [
"右喉返旁淋巴结"
],
"character": [
"转移"
],
"core_name": "癌",
"tendency": ""
},
{
"anatomy_list": [
"胃周围淋巴结",
"食管旁淋巴结",
"胃左淋巴结",
"隆突下淋巴结"
],
"character": [
"转移"
],
"core_name": "癌",
"tendency": "否定"
}
] |
3.全身多处骨质破坏，fdg代谢增高，考虑转移。 | 1,904 | [
{
"anatomy_list": [
"全身"
],
"character": [
"多处"
],
"core_name": "骨质破坏",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"增高"
],
"core_name": "fdg代谢",
"tendency": ""
},
{
"anatomy_list": [],
"character": [],
"core_name": "转移",
"tendency": "不确定"
}
] |
”经对症治疗后，患者症状较前缓解后出院，未行放化疗及去趋势治疗，经为进一步治疗遂到我院就诊，门诊以“前列腺癌”收入我科继续治疗。 | 312 | [
{
"anatomy_list": [
"前列腺"
],
"character": [],
"core_name": "癌",
"tendency": ""
}
] |
2、轻度脂肪肝，脾稍大；3、右侧髂骨内骨岛。 | 1,935 | [
{
"anatomy_list": [
"肝"
],
"character": [
"轻度"
],
"core_name": "脂肪肝",
"tendency": ""
},
{
"anatomy_list": [
"脾"
],
"character": [
"稍"
],
"core_name": "脾大",
"tendency": ""
}
] |
到某中医院就诊，经检查考虑肺癌可能，后于某医院就诊，经胸部ct检查后考虑诊断肺癌可能，建议完善肺穿刺活检，患者拒绝并出院。 | 892 | [
{
"anatomy_list": [
"肺"
],
"character": [],
"core_name": "癌",
"tendency": "不确定"
},
{
"anatomy_list": [
"肺"
],
"character": [],
"core_name": "癌",
"tendency": "不确定"
}
] |
入院前5+月，患儿因面色苍白、乏力、皮肤瘀斑瘀点在我院经骨髓micm分型确诊为急性普通b淋巴细胞淋巴细胞白血病l11型（低危，crlf2高表达）。 | 1,469 | [
{
"anatomy_list": [
"面"
],
"character": [],
"core_name": "面色苍白",
"tendency": ""
},
{
"anatomy_list": [],
"character": [],
"core_name": "乏力",
"tendency": ""
},
{
"anatomy_list": [
"皮肤"
],
"character": [],
"core_name": "瘀斑",
"tendency": ""
},
{
"anatomy_list": [
"皮肤"
],
"character": [],
"core_name": "瘀点",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"b淋巴细胞",
"crlf2高表达",
"普通",
"低危",
"急性",
"l11型"
],
"core_name": "白血病",
"tendency": ""
}
] |
予以患者经皮经肝穿刺置管引流后黄疸较前明显好转后出院。 | 1,347 | [
{
"anatomy_list": [],
"character": [
"明显好转"
],
"core_name": "黄疸",
"tendency": ""
}
] |
患者高血压病，高血压性心脏病10+年，既往最高血压180+/？mmhg，现服用硝苯地平控释片30mg口服qd控制血压。 | 1,517 | [
{
"anatomy_list": [],
"character": [],
"core_name": "高血压",
"tendency": ""
},
{
"anatomy_list": [
"心脏"
],
"character": [
"高血压"
],
"core_name": "心脏病",
"tendency": ""
}
] |
遂到在某医院行支气管镜活检，病理提示肺鳞癌。 | 1,914 | [
{
"anatomy_list": [
"肺"
],
"character": [],
"core_name": "鳞癌",
"tendency": ""
}
] |
患者10余年前因朋友及家人发现睡眠时打鼾，不伴有夜间憋醒，自诉睡眠时伴有多梦，无心慌、胸闷，无心前区压榨感，无呼吸困难等不适。患者未予以进一步重视及治疗。 | 446 | [
{
"anatomy_list": [],
"character": [
"睡眠时"
],
"core_name": "打鼾",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"夜间"
],
"core_name": "憋醒",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [
"睡眠时"
],
"core_name": "多梦",
"tendency": ""
},
{
"anatomy_list": [
"心"
],
"character": [],
"core_name": "心慌",
"tendency": "否定"
},
{
"anatomy_list": [
"胸"
],
"character": [],
"core_name": "胸闷",
"tendency": "否定"
},
{
"anatomy_list": [
"心前区"
],
"character": [],
"core_name": "压榨感",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "呼吸困难",
"tendency": "否定"
}
] |
6月前患者复查再次于我院就诊，膀胱镜检见膀胱内一新生物由于病变极小，取组织后如为恶性肿瘤手术时无法找到病变所在位置，与患者家属沟通后患者家属要求暂不取组织活检要求行诊断性电切术，故于2018年10月18日在硬膜外麻醉下行膀胱病损电切术，术后给予患者表柔比星50mg膀胱灌注治疗。 | 1,434 | [
{
"anatomy_list": [
"膀胱内"
],
"character": [
"病变极小"
],
"core_name": "新生物",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"恶性"
],
"core_name": "肿瘤",
"tendency": "不确定"
}
] |
2019-06-03行全面下开腹探查：肿瘤位于回盲部，肿瘤侵犯侵犯右侧盆壁肌肉，肠系膜可见肿大淋巴结。 | 2,056 | [
{
"anatomy_list": [
"回盲部"
],
"character": [],
"core_name": "肿瘤",
"tendency": ""
},
{
"anatomy_list": [
"右侧盆壁肌"
],
"character": [
"侵犯"
],
"core_name": "肿瘤",
"tendency": ""
},
{
"anatomy_list": [
"肠系膜淋巴结"
],
"character": [],
"core_name": "肿大",
"tendency": ""
}
] |
于患者家属商量后于2020-04-29至2020-06-09给于（贝伐珠单抗350mg1静滴,卡培他滨1.5g连用14天,休息7天）化疗3周期，2020-07-07入院复查按recist1.1提示疾病进展（pd），考虑治疗治疗耐药，于2020-07-8至2020-08-13行贝伐珠单抗350mg1静滴+伊立替康200mg1静滴+亚叶酸钙500mg静滴d1+氟尿嘧啶0.5g静推d1+氟尿嘧啶2.8g持续泵入48h化疗3周期,2020-8-31复查按recist1.1标准评估病情稳定（sd）患者多次化疗后骨髓抑制，于患者交流后拟给于，2020-08-31于（贝伐珠单抗400mg1静滴+伊立替康160mg1静滴+亚叶酸钙500mg静滴d1+氟尿嘧啶0.5g静推d1+氟尿嘧啶2.5g持续泵入48h，患者既往行基因检查提示egfr19外显子突变，给于厄洛替尼靶向治疗，后服用靶向药物后出现严重口腔溃疡停用。现患者为行进一步治疗，门诊以“结肠癌”收入我科患者本次发病以来，食欲下降，神志清醒，精神欠佳，睡眠尚可，大便正常，小便正常，体重无明显变化。 | 887 | [
{
"anatomy_list": [
"骨髓"
],
"character": [],
"core_name": "骨髓抑制",
"tendency": ""
},
{
"anatomy_list": [
"口腔"
],
"character": [
"严重"
],
"core_name": "溃疡",
"tendency": ""
},
{
"anatomy_list": [
"结肠"
],
"character": [],
"core_name": "癌",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"下降"
],
"core_name": "食欲",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"清醒"
],
"core_name": "神志",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"欠佳"
],
"core_name": "精神",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"尚可"
],
"core_name": "睡眠",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"正常"
],
"core_name": "大便",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"正常"
],
"core_name": "小便",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"明显"
],
"core_name": "体重改变",
"tendency": "否定"
}
] |
出院后未行正规内分泌治疗，口服“康士得50mg qd”治疗，后复查行骨扫描检查提示全身多发骨转移。 | 2,020 | [
{
"anatomy_list": [
"全身"
],
"character": [
"骨",
"多发"
],
"core_name": "转移",
"tendency": ""
}
] |
入院前 10年 ，患者受凉后咳嗽， 咯白色泡沫痰 ，以晨起明显。 | 1,365 | [
{
"anatomy_list": [],
"character": [
"受凉后"
],
"core_name": "咳嗽",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"白色",
"泡沫痰",
"以晨起明显"
],
"core_name": "咳痰",
"tendency": ""
}
] |
诊断为：1.原发性肝癌，伴肝内转移，肺转移性肿瘤？2.慢性乙型病毒性肝炎（轻度）；3.高血压病3级高危组；4.肝囊肿；5.肾囊肿；6.双侧附睾囊肿。 | 154 | [
{
"anatomy_list": [
"肝"
],
"character": [
"原发性"
],
"core_name": "癌",
"tendency": ""
},
{
"anatomy_list": [
"肝内"
],
"character": [
"转移"
],
"core_name": "癌",
"tendency": ""
},
{
"anatomy_list": [
"肺"
],
"character": [
"转移性"
],
"core_name": "肿瘤",
"tendency": "不确定"
},
{
"anatomy_list": [
"肝"
],
"character": [
"慢性",
"乙型",
"轻度",
"病毒性"
],
"core_name": "肝炎",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"3级高危组"
],
"core_name": "高血压",
"tendency": ""
},
{
"anatomy_list": [
"肝"
],
"character": [],
"core_name": "囊肿",
"tendency": ""
},
{
"anatomy_list": [
"肾"
],
"character": [],
"core_name": "囊肿",
"tendency": ""
},
{
"anatomy_list": [
"双侧附睾"
],
"character": [],
"core_name": "囊肿",
"tendency": ""
}
] |
半年前患者因停经后反复阴道不规则流血就诊于我院，诊断葡萄胎，行清宫术处理，术后病检：（宫内）部分性水泡状胎块。 | 643 | [
{
"anatomy_list": [
"阴道"
],
"character": [
"停经后",
"反复",
"不规则"
],
"core_name": "出血",
"tendency": ""
},
{
"anatomy_list": [],
"character": [],
"core_name": "葡萄胎",
"tendency": ""
},
{
"anatomy_list": [
"宫内"
],
"character": [
"部分性",
"水泡状"
],
"core_name": "胎块",
"tendency": ""
}
] |
盗汗，无咳大量脓痰、咯血、喘息症状，但未规范治疗。 | 2,010 | [
{
"anatomy_list": [],
"character": [],
"core_name": "盗汗",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"大量",
"脓痰"
],
"core_name": "咳痰",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "咯血",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "气喘",
"tendency": "否定"
}
] |
心包腔少量积液。 | 529 | [
{
"anatomy_list": [
"心包腔"
],
"character": [
"少量"
],
"core_name": "积液",
"tendency": ""
}
] |
乳头及皮肤未见癌累及，腋窝淋巴结9枚，均未见癌转移（0/9）。 | 388 | [
{
"anatomy_list": [
"乳头",
"皮肤"
],
"character": [
"累及"
],
"core_name": "癌",
"tendency": "否定"
},
{
"anatomy_list": [
"腋窝淋巴结"
],
"character": [
"转移"
],
"core_name": "癌",
"tendency": "否定"
}
] |
7天前，患者无明显诱因出现腹胀，进食后加重，食欲下降、厌油，饭量减少约1/3，伴尿量减少，减少约1/3（具体量患者记不清），尿黄如浓茶色，伴双下肢轻度水肿，全身乏力，无恶心、呕吐，无畏寒、发热，无腹痛，遂于当地诊所购买“阿莫西林、扑炎痛”治疗（具体剂量不详），病情无明显好转。 | 1,046 | [
{
"anatomy_list": [
"腹"
],
"character": [
"进食后加重"
],
"core_name": "腹胀",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"下降"
],
"core_name": "食欲",
"tendency": ""
},
{
"anatomy_list": [],
"character": [],
"core_name": "厌油",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"约1/3"
],
"core_name": "饭量减少",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"约1/3"
],
"core_name": "尿量减少",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"茶色"
],
"core_name": "尿黄",
"tendency": ""
},
{
"anatomy_list": [
"双下肢"
],
"character": [
"轻度"
],
"core_name": "水肿",
"tendency": ""
},
{
"anatomy_list": [
"全身"
],
"character": [],
"core_name": "乏力",
"tendency": ""
},
{
"anatomy_list": [],
"character": [],
"core_name": "恶心",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "呕吐",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "畏寒",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "发热",
"tendency": "否定"
},
{
"anatomy_list": [
"腹"
],
"character": [],
"core_name": "疼痛",
"tendency": "否定"
}
] |
（左乳包块2袋）腺病。 | 1,762 | [
{
"anatomy_list": [
"左乳"
],
"character": [],
"core_name": "包块",
"tendency": ""
},
{
"anatomy_list": [
"左乳"
],
"character": [],
"core_name": "腺病",
"tendency": ""
}
] |
入院4月余前，患者无明显诱因出现右乳头溢液，自诉为淡黄色清亮液体，自诉扪及右乳外上鸡蛋黄大小包块，无乳头凹陷、双乳胀痛，局部皮肤无红肿、破溃、皮温升高，无橘皮样改变、酒窝征，无畏寒、发热、盗汗等不适，患者遂至某医院行乳腺彩超提示：“右乳见多个弱回声，最大位于3点钟距乳头0.6cm处，大小约2.6*0.92cm，bi-rads 4a类”，患者未予以特殊治疗。 | 968 | [
{
"anatomy_list": [
"右乳头"
],
"character": [
"淡黄色",
"清亮液体"
],
"core_name": "溢液",
"tendency": ""
},
{
"anatomy_list": [
"右乳外上"
],
"character": [
"鸡蛋黄大小"
],
"core_name": "包块",
"tendency": ""
},
{
"anatomy_list": [
"乳头"
],
"character": [],
"core_name": "凹陷",
"tendency": "否定"
},
{
"anatomy_list": [
"双乳房"
],
"character": [
"胀痛"
],
"core_name": "疼痛",
"tendency": "否定"
},
{
"anatomy_list": [
"双乳房皮肤"
],
"character": [
"局部"
],
"core_name": "红肿",
"tendency": "否定"
},
{
"anatomy_list": [
"双乳房皮肤"
],
"character": [],
"core_name": "破溃",
"tendency": "否定"
},
{
"anatomy_list": [
"双乳房"
],
"character": [
"升高"
],
"core_name": "皮温",
"tendency": "否定"
},
{
"anatomy_list": [
"双乳房"
],
"character": [
"橘皮样"
],
"core_name": "改变",
"tendency": "否定"
},
{
"anatomy_list": [
"双乳房"
],
"character": [],
"core_name": "酒窝征",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "畏寒",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "发热",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "盗汗",
"tendency": "否定"
},
{
"anatomy_list": [
"右乳"
],
"character": [
"弱",
"多个",
"最大位于3点钟距乳头0.6cm处",
"bi-rads 4a类"
],
"core_name": "回声",
"tendency": ""
}
] |
患者自诉无腹痛、腹胀，无恶心、呕吐，无厌油、乏力，无呕血、黑便等情况，无白陶土样大便，患者未予以相应治疗。 | 1,721 | [
{
"anatomy_list": [
"腹"
],
"character": [],
"core_name": "疼痛",
"tendency": "否定"
},
{
"anatomy_list": [
"腹"
],
"character": [],
"core_name": "腹胀",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "恶心",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "呕吐",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "厌油",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "乏力",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "呕血",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "黑便",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [
"白陶土样"
],
"core_name": "大便",
"tendency": "否定"
}
] |
2余月前患者再次出现咳嗽，咳白色泡沫痰，痰不易咳出，伴气促，走平路速度低于同类人。 | 190 | [
{
"anatomy_list": [],
"character": [],
"core_name": "咳嗽",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"白色",
"泡沫痰",
"不易咳出"
],
"core_name": "咳痰",
"tendency": ""
},
{
"anatomy_list": [],
"character": [],
"core_name": "气促",
"tendency": ""
}
] |
4月前患者因“两癌筛查”在当地卫生院检查tct提示宫颈细胞异常（未见检查报告），转诊患者到某妇幼保健院进一步筛查。 | 1,394 | [
{
"anatomy_list": [
"宫颈"
],
"character": [],
"core_name": "细胞异常",
"tendency": ""
}
] |
2016-10-20术后复查ct示腹腔包裹性积液，遂于2016-10-25于超声引导下行腹腔穿刺置管引流术，后带腹腔引流管出院。 | 1,753 | [
{
"anatomy_list": [
"腹腔"
],
"character": [
"包裹性"
],
"core_name": "积液",
"tendency": ""
}
] |
患者有痛经症状，程度不重，偶需服止痛药，平素无自觉症状，平素无同房出血、异常阴道排液、性交痛症状。 | 824 | [
{
"anatomy_list": [],
"character": [
"程度不重"
],
"core_name": "痛经",
"tendency": ""
},
{
"anatomy_list": [
"阴道"
],
"character": [
"同房"
],
"core_name": "出血",
"tendency": "否定"
},
{
"anatomy_list": [
"阴道"
],
"character": [
"异常"
],
"core_name": "排液",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [
"性交"
],
"core_name": "疼痛",
"tendency": "否定"
}
] |
1月余前患者无明显诱因出现下腹部隐痛，持续约4分4分钟，无肩背部放射痛，无返酸、嗳气，无恶心、呕吐、腹痛，无畏寒、发热、心慌、气促，无尿频、尿急、尿不尽，夜尿1次，解大便后症状可缓解，未正规诊治。 | 1,870 | [
{
"anatomy_list": [
"下腹部"
],
"character": [
"持续4分钟",
"隐痛"
],
"core_name": "疼痛",
"tendency": ""
},
{
"anatomy_list": [
"肩",
"背部"
],
"character": [
"放射性"
],
"core_name": "疼痛",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "返酸",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "嗳气",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "恶心",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "呕吐",
"tendency": "否定"
},
{
"anatomy_list": [
"腹部"
],
"character": [],
"core_name": "疼痛",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "畏寒",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "发热",
"tendency": "否定"
},
{
"anatomy_list": [
"心"
],
"character": [],
"core_name": "心慌",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "气促",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "尿频",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "尿急",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [
"夜间"
],
"core_name": "尿不尽",
"tendency": ""
}
] |
增强mri回示：左眼眶左上方见不规则信号影，大约4.8cmx3.4cmx2.7cm，以稍长t1影长t2信号影，增强扫描呈明显强化，尚均匀，邻近骨质破坏、吸收，左侧眼球、上直肌、外直肌、视神经及泪腺受压，与左侧泪腺分界欠清，肿块向后蔓延至颅内，左眼轻度突出。 | 418 | [
{
"anatomy_list": [
"左眼眶左上方"
],
"character": [
"不规则",
"稍长t1",
"长t2"
],
"core_name": "信号影",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"呈明显强化，尚均匀"
],
"core_name": "增强扫描",
"tendency": ""
},
{
"anatomy_list": [
"邻近"
],
"character": [],
"core_name": "骨质破坏",
"tendency": ""
},
{
"anatomy_list": [
"邻近"
],
"character": [],
"core_name": "骨质吸收",
"tendency": ""
},
{
"anatomy_list": [
"左侧眼球",
"上直肌",
"外直肌",
"视神经",
"泪腺"
],
"character": [],
"core_name": "受压",
"tendency": ""
},
{
"anatomy_list": [
"颅内"
],
"character": [
"向后蔓延"
],
"core_name": "肿块",
"tendency": ""
},
{
"anatomy_list": [
"左眼"
],
"character": [
"轻度"
],
"core_name": "突出",
"tendency": ""
}
] |
患者于8年前起出现反复头痛、头晕，伴心慌、气促，无发热畏寒、腹胀腹痛、尿频尿急等症状，发作无规律性，疼痛持续数十分钟后缓解。 | 1,199 | [
{
"anatomy_list": [
"头"
],
"character": [
"反复",
"发作无规律性"
],
"core_name": "疼痛",
"tendency": ""
},
{
"anatomy_list": [
"头"
],
"character": [
"发作无规律性"
],
"core_name": "头晕",
"tendency": ""
},
{
"anatomy_list": [
"心"
],
"character": [
"发作无规律性"
],
"core_name": "心慌",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"发作无规律性"
],
"core_name": "气促",
"tendency": ""
},
{
"anatomy_list": [],
"character": [],
"core_name": "发热",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "畏寒",
"tendency": "否定"
},
{
"anatomy_list": [
"腹"
],
"character": [],
"core_name": "腹胀",
"tendency": "否定"
},
{
"anatomy_list": [
"腹"
],
"character": [],
"core_name": "疼痛",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "尿频",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "尿急",
"tendency": "否定"
},
{
"anatomy_list": [
"头"
],
"character": [
"持续数十分钟后缓解"
],
"core_name": "疼痛",
"tendency": ""
}
] |
3年前，患者出现少尿、全身肿胀等，至某医院就诊，诊断“右上肺肺癌伴双肺、胸膜转移，copd急性加重期，冠心病，心功能iii级，2型糖尿病，糖尿病肾病，糖尿病视网膜病变，肾衰竭尿毒症期”，开始透析治疗至今，每周2次。 | 534 | [
{
"anatomy_list": [],
"character": [],
"core_name": "少尿",
"tendency": ""
},
{
"anatomy_list": [
"全身"
],
"character": [],
"core_name": "肿胀",
"tendency": ""
},
{
"anatomy_list": [
"右上肺"
],
"character": [],
"core_name": "癌",
"tendency": ""
},
{
"anatomy_list": [
"双肺",
"胸膜"
],
"character": [
"转移"
],
"core_name": "癌",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"急性加重期"
],
"core_name": "copd",
"tendency": ""
},
{
"anatomy_list": [
"心"
],
"character": [],
"core_name": "冠心病",
"tendency": ""
},
{
"anatomy_list": [
"心"
],
"character": [
"iii级"
],
"core_name": "心功能",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"2型"
],
"core_name": "糖尿病",
"tendency": ""
},
{
"anatomy_list": [
"肾"
],
"character": [
"糖尿病"
],
"core_name": "肾病",
"tendency": ""
},
{
"anatomy_list": [
"视网膜"
],
"character": [
"糖尿病"
],
"core_name": "病变",
"tendency": ""
},
{
"anatomy_list": [
"肾"
],
"character": [
"尿毒症期"
],
"core_name": "肾衰竭",
"tendency": ""
}
] |
至我科门诊行ct检查:右侧腰大肌、髂腰肌异常密度，考虑转移，排除治疗禁忌后于2020-12-9，2020-12-29行化疗:贝伐珠单抗300mg1静滴+mfolfox6(奥沙利铂0.12g静滴d1+亚叶酸钙500mg静滴d1+氟尿嘧啶500mg静推+氟尿嘧啶3.3g静滴48h),14天/周期治疗2周期，患者为行进一步治疗,门诊以"结肠癌复发"收入我科. | 2,059 | [
{
"anatomy_list": [
"右侧腰大肌",
"髂腰肌"
],
"character": [],
"core_name": "异常密度",
"tendency": ""
},
{
"anatomy_list": [],
"character": [],
"core_name": "转移",
"tendency": "不确定"
},
{
"anatomy_list": [
"结肠"
],
"character": [
"复发"
],
"core_name": "癌",
"tendency": ""
}
] |
主动脉瓣关闭不全（轻度）。 | 600 | [
{
"anatomy_list": [
"主动脉瓣"
],
"character": [
"轻度"
],
"core_name": "关闭不全",
"tendency": ""
}
] |
并定期在我科行抗溶骨治疗，患者于2015年6月复查ect提示骨转移病灶较前增多，考虑病情进展，于6月14日、7月18日予以多西他赛120mg化疗，过程顺利，化疗后予以帕米磷酸二钠抗溶骨治疗，行抗溶骨治疗后，患者骨痛加重，考虑为血钙再沉积有关，予以对症处理后好转出院休息。 | 1,850 | [
{
"anatomy_list": [],
"character": [
"骨转移",
"较前增多"
],
"core_name": "病灶",
"tendency": ""
},
{
"anatomy_list": [
"骨"
],
"character": [
"加重"
],
"core_name": "疼痛",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"再沉积"
],
"core_name": "血钙",
"tendency": "不确定"
}
] |
我院门诊 腹部ct示：急诊报告：结肠脾区处管壁明显不均匀性增厚，考虑结肠ca可能性大，病变所累及处管腔狭窄，至其近端肠管梗阻；且伴腹膜及大网膜大网膜转移可能性大。 | 223 | [
{
"anatomy_list": [
"结肠脾区处管壁"
],
"character": [
"明显",
"不均匀性"
],
"core_name": "增厚",
"tendency": ""
},
{
"anatomy_list": [
"结肠"
],
"character": [],
"core_name": "癌",
"tendency": "不确定"
},
{
"anatomy_list": [
"病变所累及处管腔"
],
"character": [],
"core_name": "狭窄",
"tendency": ""
},
{
"anatomy_list": [
"近端肠管"
],
"character": [],
"core_name": "梗阻",
"tendency": ""
},
{
"anatomy_list": [
"腹膜",
"大网膜"
],
"character": [],
"core_name": "转移",
"tendency": "不确定"
}
] |
患者诉17天前于我科在全麻下行胸腔镜下右肺上叶切除+淋巴结清扫术，术后常规病理示：右上肺肺浸润浸润性腺癌，第10组淋巴结见癌转移，余支气管、肺切缘、送检淋巴结均未见癌灶。 | 308 | [
{
"anatomy_list": [
"右上肺"
],
"character": [
"浸润性"
],
"core_name": "腺癌",
"tendency": ""
},
{
"anatomy_list": [
"第10组淋巴结"
],
"character": [
"转移"
],
"core_name": "癌",
"tendency": ""
},
{
"anatomy_list": [
"支气管"
],
"character": [],
"core_name": "癌灶",
"tendency": "否定"
},
{
"anatomy_list": [
"肺切缘"
],
"character": [],
"core_name": "癌灶",
"tendency": "否定"
},
{
"anatomy_list": [
"送检淋巴结"
],
"character": [],
"core_name": "癌灶",
"tendency": "否定"
}
] |
2.双侧附件区低回声，考虑肿大淋巴结回声。 | 1,219 | [
{
"anatomy_list": [
"双侧附件区"
],
"character": [
"低"
],
"core_name": "回声",
"tendency": ""
},
{
"anatomy_list": [
"淋巴结"
],
"character": [
"肿大"
],
"core_name": "回声",
"tendency": "不确定"
}
] |
患者自发病以来，精神可，食欲欠佳，睡眠可，大便如常，小便如常，体重无明显变化。 | 1,028 | [
{
"anatomy_list": [],
"character": [
"可"
],
"core_name": "精神",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"欠佳"
],
"core_name": "食欲",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"可"
],
"core_name": "睡眠",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"如常"
],
"core_name": "大便",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"如常"
],
"core_name": "小便",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"明显"
],
"core_name": "体重改变",
"tendency": "否定"
}
] |
入院前10余天，患者咳黄色粘液痰，可见血丝，伴潮热、胸部紧缩感、活动后气促，再次到某医院就诊，行胸部ct检查发现右肺包块，为求进一步诊治，今日到我院就诊，门诊以“右肺包块”收入我科。 | 2,027 | [
{
"anatomy_list": [],
"character": [
"黄色",
"粘液",
"可见血丝"
],
"core_name": "咳痰",
"tendency": ""
},
{
"anatomy_list": [],
"character": [],
"core_name": "潮热",
"tendency": ""
},
{
"anatomy_list": [
"胸部"
],
"character": [],
"core_name": "紧缩感",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"活动后"
],
"core_name": "气促",
"tendency": ""
},
{
"anatomy_list": [
"右肺"
],
"character": [],
"core_name": "包块",
"tendency": ""
},
{
"anatomy_list": [
"右肺"
],
"character": [],
"core_name": "包块",
"tendency": ""
}
] |
病程中患者无口干、多饮、多尿、体重减轻，无泡沫尿、视物模糊、四肢冰凉等症状，定期于我科门诊随访调整降糖药。 | 1,275 | [
{
"anatomy_list": [],
"character": [],
"core_name": "口干",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "多饮",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "多尿",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "体重减轻",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "泡沫尿",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "视物模糊",
"tendency": "否定"
},
{
"anatomy_list": [
"四肢"
],
"character": [],
"core_name": "冰凉",
"tendency": "否定"
}
] |
3.右肾囊肿。 | 876 | [
{
"anatomy_list": [
"右肾"
],
"character": [],
"core_name": "囊肿",
"tendency": ""
}
] |
部分肠切除术后，术区未见明显异常。 | 165 | [
{
"anatomy_list": [
"术区"
],
"character": [
"明显"
],
"core_name": "异常",
"tendency": "否定"
}
] |
半月前于起床时再次出现头晕，明显视物旋转，发生一次耳鸣，无明显恶心呕吐、大汗淋漓，无明显头痛，无黑蒙、晕厥，无明显听力减退，无肢体无力、走路不稳。 | 1,311 | [
{
"anatomy_list": [
"头"
],
"character": [
"起床时"
],
"core_name": "头晕",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"明显"
],
"core_name": "视物旋转",
"tendency": ""
},
{
"anatomy_list": [
"耳"
],
"character": [
"一次"
],
"core_name": "耳鸣",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"明显"
],
"core_name": "恶心",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [
"明显"
],
"core_name": "呕吐",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [
"大汗"
],
"core_name": "出汗",
"tendency": "否定"
},
{
"anatomy_list": [
"头"
],
"character": [
"明显"
],
"core_name": "疼痛",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "黑朦",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "晕厥",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [
"明显"
],
"core_name": "听力减退",
"tendency": "否定"
},
{
"anatomy_list": [
"肢体"
],
"character": [],
"core_name": "无力",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "走路不稳",
"tendency": "否定"
}
] |
入院前1周，患者因服用“结核药物”后出现食欲下降，由每餐进食2两减为1两，厌油，返酸，嗳气，腹胀，无腹痛及腹泻，无明显恶心及呕吐，精神变差，双下肢乏力，患者未重视，未治疗，仍继续服用结核药物治疗。 | 1,892 | [
{
"anatomy_list": [],
"character": [
"下降"
],
"core_name": "食欲",
"tendency": ""
},
{
"anatomy_list": [],
"character": [],
"core_name": "厌油",
"tendency": ""
},
{
"anatomy_list": [],
"character": [],
"core_name": "返酸",
"tendency": ""
},
{
"anatomy_list": [],
"character": [],
"core_name": "嗳气",
"tendency": ""
},
{
"anatomy_list": [
"腹"
],
"character": [],
"core_name": "腹胀",
"tendency": ""
},
{
"anatomy_list": [
"腹"
],
"character": [],
"core_name": "疼痛",
"tendency": "否定"
},
{
"anatomy_list": [
"腹"
],
"character": [],
"core_name": "腹泻",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [
"明显"
],
"core_name": "恶心",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "呕吐",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [
"变差"
],
"core_name": "精神",
"tendency": "否定"
},
{
"anatomy_list": [
"双下肢"
],
"character": [],
"core_name": "乏力",
"tendency": "否定"
}
] |
彩超检查(2016-02-24):双侧锁骨上窝、腋窝及腹股沟区可见淋巴结回声。 | 49 | [
{
"anatomy_list": [
"双侧锁骨上窝",
"腋窝",
"腹股沟区",
"淋巴结"
],
"character": [],
"core_name": "回声",
"tendency": ""
}
] |
近1月自觉恶心、乏力、疲惫，偶有心慌，无头晕、头痛、气促，无呕吐，无腹痛、腹胀，无腰骶部胀痛，无肛门坠胀，二便正常。 | 689 | [
{
"anatomy_list": [],
"character": [],
"core_name": "恶心",
"tendency": ""
},
{
"anatomy_list": [],
"character": [],
"core_name": "乏力",
"tendency": ""
},
{
"anatomy_list": [],
"character": [],
"core_name": "疲惫",
"tendency": ""
},
{
"anatomy_list": [
"心"
],
"character": [
"偶有"
],
"core_name": "心慌",
"tendency": ""
},
{
"anatomy_list": [
"头"
],
"character": [],
"core_name": "头晕",
"tendency": "否定"
},
{
"anatomy_list": [
"头"
],
"character": [],
"core_name": "疼痛",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "气促",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "呕吐",
"tendency": "否定"
},
{
"anatomy_list": [
"腹"
],
"character": [],
"core_name": "疼痛",
"tendency": "否定"
},
{
"anatomy_list": [
"腹"
],
"character": [],
"core_name": "腹胀",
"tendency": "否定"
},
{
"anatomy_list": [
"腰骶部"
],
"character": [
"胀痛"
],
"core_name": "疼痛",
"tendency": "否定"
},
{
"anatomy_list": [
"肛门"
],
"character": [],
"core_name": "坠胀",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [
"正常"
],
"core_name": "大便",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"正常"
],
"core_name": "小便",
"tendency": ""
}
] |
右上肺肺团块影，建议ct检查。 | 290 | [
{
"anatomy_list": [
"右上肺"
],
"character": [],
"core_name": "团块影",
"tendency": ""
}
] |
遂进一步就诊于某医院，完善颅脑平扫ct以及骨扫描检查未见异常，腹部彩超提示肝脏血管瘤及囊肿，未行特殊治疗。 | 277 | [
{
"anatomy_list": [
"肝脏"
],
"character": [],
"core_name": "血管瘤",
"tendency": ""
},
{
"anatomy_list": [
"肝脏"
],
"character": [],
"core_name": "囊肿",
"tendency": ""
}
] |
8年前，患者因血糖控制不佳于某医院就诊，调整降糖方案为胰岛素诺和灵30r早餐前6u，晚餐前6u控制血糖，未规律监测血糖，血糖控制情况不佳。 | 1,879 | [
{
"anatomy_list": [],
"character": [
"控制不佳"
],
"core_name": "血糖",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"控制情况不佳"
],
"core_name": "血糖",
"tendency": ""
}
] |
2019-04-20再次出现阴道出血，为鲜红色，每次量少，无血凝块，无腹痛、腹胀，无阴道阴道坠胀，无尿频、尿急、尿痛、血尿，无呕血、黑便，无畏寒、发热，遂于我院复查盆腔mri示：宫颈癌术后放化疗后：盆腔偏左侧见两个略长t1略长t2信号团块状影及周围结节影，结合病史，考虑肿瘤转移。请结合临床。 | 1,025 | [
{
"anatomy_list": [
"阴道"
],
"character": [
"量少",
"鲜红色",
"无血凝块"
],
"core_name": "出血",
"tendency": ""
},
{
"anatomy_list": [
"腹"
],
"character": [],
"core_name": "疼痛",
"tendency": "否定"
},
{
"anatomy_list": [
"腹"
],
"character": [],
"core_name": "腹胀",
"tendency": "否定"
},
{
"anatomy_list": [
"阴道"
],
"character": [],
"core_name": "坠胀",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "尿频",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "尿急",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "尿痛",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [
"红色"
],
"core_name": "血尿",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "呕血",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "黑便",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "畏寒",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "发热",
"tendency": "否定"
},
{
"anatomy_list": [
"宫颈"
],
"character": [
"术后",
"化放疗后"
],
"core_name": "癌",
"tendency": ""
},
{
"anatomy_list": [
"盆腔偏左侧"
],
"character": [
"略长t1",
"略长t2信号"
],
"core_name": "团块影",
"tendency": ""
},
{
"anatomy_list": [
"盆腔周围"
],
"character": [
"略长t1",
"略长t2信号"
],
"core_name": "结节影",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"转移"
],
"core_name": "肿瘤",
"tendency": "不确定"
}
] |
患者从发病至今未行任何诊治，今日为明确水肿原因，故就诊于我院，门诊以“水肿原因待查”收入我科。 | 1,118 | [
{
"anatomy_list": [],
"character": [],
"core_name": "水肿",
"tendency": "不确定"
}
] |
患者自患病以来，精神、饮食、睡眠可，大小便正常，体重无明显变化。 | 273 | [
{
"anatomy_list": [],
"character": [
"可"
],
"core_name": "精神",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"可"
],
"core_name": "饮食",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"可"
],
"core_name": "睡眠",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"正常"
],
"core_name": "大小便",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"明显"
],
"core_name": "体重变化",
"tendency": "否定"
}
] |
遂于2017-02-08开始行新辅助化疗（方案：表柔比星 100mg 环磷酰胺 600mg 多西他赛 120mg），于2017-02-23行第二次辅助化疗化疗，方案更改为tp+曲妥珠单抗（多西他赛 120mg；洛铂 50mg；曲妥珠单抗首剂 440mg，后330mg）化疗后无剧烈恶心、呕吐等不适，有轻度骨髓抑制，白细胞最低为1.84×109/l，予以升白细胞治疗后好转。 | 83 | [
{
"anatomy_list": [],
"character": [
"剧烈"
],
"core_name": "恶心",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [
"剧烈"
],
"core_name": "呕吐",
"tendency": "否定"
},
{
"anatomy_list": [
"骨髓"
],
"character": [
"轻度"
],
"core_name": "骨髓抑制",
"tendency": ""
}
] |
1天前右眼出现眼红，无视力下降，无视物变形，无视物重影，3小时前突发视力骤降，遂来我院，门诊检眼左眼视力数指/10cm，眼底血管动脉变细，测血压154/70mmHg，30分钟前视力骤降至仅为光感，建议立即住院积极治疗挽救视功能，急诊以“右眼急性球后视神经炎、缺血性视神经病变？”收住我科。 | 256 | [
{
"anatomy_list": [
"右眼"
],
"character": [],
"core_name": "眼红",
"tendency": ""
},
{
"anatomy_list": [],
"character": [],
"core_name": "视力下降",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "视物变形",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "视物重影",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [
"突发"
],
"core_name": "视力下降",
"tendency": ""
},
{
"anatomy_list": [
"眼底血管",
"动脉"
],
"character": [],
"core_name": "变细",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"骤",
"仅为光感"
],
"core_name": "视力骤降",
"tendency": ""
},
{
"anatomy_list": [
"右眼",
"球后视神经"
],
"character": [
"急性"
],
"core_name": "神经炎",
"tendency": "不确定"
},
{
"anatomy_list": [
"视神经"
],
"character": [
"缺血性"
],
"core_name": "病变",
"tendency": "不确定"
}
] |
患者于6月前因“进行性吞咽困难”，在某医院诊断为“食道癌”。 | 1,147 | [
{
"anatomy_list": [],
"character": [
"进行性"
],
"core_name": "吞咽困难",
"tendency": ""
},
{
"anatomy_list": [
"食道"
],
"character": [],
"core_name": "癌",
"tendency": ""
}
] |
3.所示肝实质内多个结节影，请结合腹部增强检查。 | 281 | [
{
"anatomy_list": [
"肝实质内"
],
"character": [
"多个"
],
"core_name": "结节影",
"tendency": ""
}
] |
肠壁上淋巴结未见癌转移（0/12）。 | 1,091 | [
{
"anatomy_list": [
"肠壁上淋巴结"
],
"character": [
"转移"
],
"core_name": "癌",
"tendency": "否定"
}
] |
患者发病自今未行特殊诊治，今日患者自感头昏、心悸有所加重，遂就诊于我院急诊科，测血压为130/92mmHg，未行其余特殊检查，为进一步诊治，患者遂收入我科。 | 1,114 | [
{
"anatomy_list": [
"头"
],
"character": [
"加重"
],
"core_name": "头昏",
"tendency": ""
},
{
"anatomy_list": [
"心"
],
"character": [
"加重"
],
"core_name": "心悸",
"tendency": ""
}
] |
鼻中隔偏曲，双侧下鼻甲及右侧中鼻甲鼻甲肥大；3.右侧中鼻道似见增多软组织影。 | 284 | [
{
"anatomy_list": [
"鼻中隔"
],
"character": [],
"core_name": "偏曲",
"tendency": ""
},
{
"anatomy_list": [
"双侧下鼻甲",
"右侧中鼻甲"
],
"character": [],
"core_name": "肥大",
"tendency": ""
},
{
"anatomy_list": [
"右侧中鼻道"
],
"character": [
"增多"
],
"core_name": "软组织影",
"tendency": "不确定"
}
] |
患者于入院前３年余无明显诱因出现排便困难，为黄绿色稀便，大便表面可见少量鲜血，量约50-100g/次，1-2次/天，伴里急后重感，遂到某医院行肠镜发现直肠距肛缘10cm处有一新生物，考虑直肠癌可能，行全腹部增强ct提示：直肠壁增厚伴强化，未见明显肿大淋巴结，遂行直肠癌根治术，术后病检示：直肠中分化腺癌，浸及浅肌层，近切、远切未见癌组织，局部淋巴结未见癌转移，病理分期（t2n0M0，i期）。 | 721 | [
{
"anatomy_list": [],
"character": [
"困难"
],
"core_name": "排便",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"黄绿色",
"稀便"
],
"core_name": "大便",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"少量鲜血"
],
"core_name": "大便",
"tendency": ""
},
{
"anatomy_list": [
"腹"
],
"character": [],
"core_name": "腹泻",
"tendency": ""
},
{
"anatomy_list": [],
"character": [],
"core_name": "里急后重感",
"tendency": ""
},
{
"anatomy_list": [
"直肠距肛缘10cm处"
],
"character": [],
"core_name": "新生物",
"tendency": ""
},
{
"anatomy_list": [
"直肠"
],
"character": [],
"core_name": "癌",
"tendency": "不确定"
},
{
"anatomy_list": [
"直肠壁"
],
"character": [],
"core_name": "增厚",
"tendency": ""
},
{
"anatomy_list": [
"直肠壁"
],
"character": [],
"core_name": "强化",
"tendency": ""
},
{
"anatomy_list": [
"淋巴结"
],
"character": [
"明显"
],
"core_name": "肿大",
"tendency": "否定"
},
{
"anatomy_list": [
"直肠"
],
"character": [
"中分化",
"浸及浅肌层",
"t2n0M0，i期"
],
"core_name": "腺癌",
"tendency": ""
},
{
"anatomy_list": [
"直肠近切",
"直肠远切"
],
"character": [],
"core_name": "癌组织",
"tendency": "否定"
},
{
"anatomy_list": [
"淋巴结"
],
"character": [
"转移",
"局部"
],
"core_name": "癌",
"tendency": "否定"
}
] |
入院前40+天，患者因胸及肩部疼痛，就诊于我院行胸部ct（2016-10-25 我院）提示：1.前纵隔占位性病变，考虑肿瘤，胸腺瘤或其它？2.符合慢性支气管炎、肺气肿表现，左肺上叶舌段纤维灶。 | 680 | [
{
"anatomy_list": [
"肩部"
],
"character": [],
"core_name": "疼痛",
"tendency": ""
},
{
"anatomy_list": [
"胸"
],
"character": [],
"core_name": "疼痛",
"tendency": ""
},
{
"anatomy_list": [
"前纵隔"
],
"character": [
"占位性"
],
"core_name": "病变",
"tendency": ""
},
{
"anatomy_list": [
"前纵隔"
],
"character": [],
"core_name": "肿瘤",
"tendency": "不确定"
},
{
"anatomy_list": [
"胸腺"
],
"character": [],
"core_name": "瘤",
"tendency": "不确定"
},
{
"anatomy_list": [
"支气管"
],
"character": [
"慢性"
],
"core_name": "支气管炎",
"tendency": "不确定"
},
{
"anatomy_list": [
"肺"
],
"character": [],
"core_name": "肺气肿",
"tendency": "不确定"
},
{
"anatomy_list": [
"左肺上叶舌段"
],
"character": [],
"core_name": "纤维灶",
"tendency": ""
}
] |
2019-07患者因气促入院，彩超检查(2019-07-17):右侧胸腔大量积液。 | 763 | [
{
"anatomy_list": [],
"character": [],
"core_name": "气促",
"tendency": ""
},
{
"anatomy_list": [
"右侧胸腔"
],
"character": [
"大量"
],
"core_name": "积液",
"tendency": ""
}
] |
患者21个月前，因大便带血在当地医院治疗，诊断为“直肠癌”，在当地医院行腹腔镜下直肠癌根治术+回肠造瘘术，术后予对症、支持治疗，于2016年2月26日开始予“奥沙利铂+卡培他滨”8个疗程规律化疗，化疗过程顺利，2016年8月行回肠造瘘口还纳术，患者10月21号出现腹泻不适，伴大便带血丝，再次入当地医院治疗，肠镜检查提示：吻合口溃疡，病检提示：结肠粘膜慢性炎，患者为求进一步治疗，来我院以“直肠吻合口溃疡”收入我科患者本次发病以来，食欲正常，神志清醒，精神尚可，睡眠尚可，大便正常，小便正常，体重无明显变化。 | 431 | [
{
"anatomy_list": [],
"character": [
"带血"
],
"core_name": "大便",
"tendency": ""
},
{
"anatomy_list": [
"直肠"
],
"character": [],
"core_name": "癌",
"tendency": ""
},
{
"anatomy_list": [
"腹"
],
"character": [],
"core_name": "腹泻",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"带血丝"
],
"core_name": "大便",
"tendency": ""
},
{
"anatomy_list": [
"吻合口"
],
"character": [],
"core_name": "溃疡",
"tendency": ""
},
{
"anatomy_list": [
"结肠粘膜"
],
"character": [
"慢性"
],
"core_name": "炎",
"tendency": ""
},
{
"anatomy_list": [
"直肠吻合口"
],
"character": [],
"core_name": "溃疡",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"正常"
],
"core_name": "食欲",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"清醒"
],
"core_name": "神志",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"尚可"
],
"core_name": "精神",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"尚可"
],
"core_name": "睡眠质量",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"正常"
],
"core_name": "大便",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"正常"
],
"core_name": "小便",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"明显"
],
"core_name": "体重变化",
"tendency": "否定"
}
] |
<左侧髂血管血管旁、右侧髂血管血管旁、腹壁>送检淋巴结均未见肿瘤转移（分别为0/4、0/6、0/2）、<肠脂垂结节>送检为脂肪组织，密切随访。 | 709 | [
{
"anatomy_list": [
"左侧髂血管旁淋巴结",
"右侧髂血管旁淋巴结",
"腹壁淋巴结"
],
"character": [
"转移"
],
"core_name": "肿瘤",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [
"肠脂垂",
"脂肪组织"
],
"core_name": "结节",
"tendency": ""
}
] |
半年前，患者开始出现头痛，主要为头顶部疼痛，为持续性跳痛，为中-重度，每次持续时间约数小时至1天左右可缓解，每次间隔数天发作，发作时无恶心呕吐，无视物模糊以及肢体麻木无力，2天前，患者再次出现头痛，症状同前。 | 1,548 | [
{
"anatomy_list": [
"头顶部"
],
"character": [],
"core_name": "疼痛",
"tendency": ""
},
{
"anatomy_list": [
"头顶部"
],
"character": [
"可缓解",
"持续性",
"跳痛",
"中-重度",
"每次间隔数天发作"
],
"core_name": "疼痛",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"发作时"
],
"core_name": "恶心",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [
"发作时"
],
"core_name": "呕吐",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "视物模糊",
"tendency": "否定"
},
{
"anatomy_list": [
"肢体"
],
"character": [],
"core_name": "麻木",
"tendency": "否定"
},
{
"anatomy_list": [
"肢体"
],
"character": [],
"core_name": "无力",
"tendency": "否定"
},
{
"anatomy_list": [
"头"
],
"character": [],
"core_name": "疼痛",
"tendency": ""
}
] |
患者为求进一步治疗，急诊以“不完全性肠梗阻”收入我科。 | 333 | [
{
"anatomy_list": [
"肠"
],
"character": [
"不完全性"
],
"core_name": "梗阻",
"tendency": ""
}
] |
入院前7年患者于受凉后开始出现咳嗽、咳痰，为白色粘痰，易咳出，每年持续3月以上，呈反复发作，每于冬春季节及受凉后好发作。 | 811 | [
{
"anatomy_list": [],
"character": [
"受凉后",
"呈反复发作",
"每于冬春季节及受凉后好发作"
],
"core_name": "咳嗽",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"受凉后",
"白色粘痰",
"易咳出",
"呈反复发作",
"每于冬春季节及受凉后好发作"
],
"core_name": "咳痰",
"tendency": ""
}
] |
曾因咳嗽，喘息加重多次在当地门诊治疗（不详）。 | 1,331 | [
{
"anatomy_list": [],
"character": [
"加重"
],
"core_name": "咳嗽",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"加重"
],
"core_name": "喘息",
"tendency": ""
}
] |
2010年7月27日开始口服卡培他滨（1g bid d1-d14）后，无明显恶心、呕吐、腹泻、腹痛等不适，随后在我科共行5个周期化疗（奥沙利铂 90mg d1+卡培他滨 1g bid d1-d14）,每21天为1周期，化疗过程顺利，无明显消化道反应及骨髓抑制，好转出院，但仍有每日排便2-4次，为黄色稀便，无肛门坠胀、大便失禁等，末次化疗于2010年11月5日结束。 | 723 | [
{
"anatomy_list": [],
"character": [
"明显"
],
"core_name": "恶心",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "呕吐",
"tendency": "否定"
},
{
"anatomy_list": [
"腹"
],
"character": [],
"core_name": "腹泻",
"tendency": "否定"
},
{
"anatomy_list": [
"腹"
],
"character": [],
"core_name": "疼痛",
"tendency": "否定"
},
{
"anatomy_list": [
"消化道"
],
"character": [
"明显"
],
"core_name": "消化道反应",
"tendency": "否定"
},
{
"anatomy_list": [
"骨髓"
],
"character": [
"明显"
],
"core_name": "骨髓抑制",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [
"黄色",
"稀便"
],
"core_name": "大便",
"tendency": ""
},
{
"anatomy_list": [
"肛门"
],
"character": [],
"core_name": "坠胀",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [
"失禁"
],
"core_name": "大便",
"tendency": "否定"
}
] |
近期体重变化不明显。 | 1,800 | [
{
"anatomy_list": [],
"character": [
"明显"
],
"core_name": "体重改变",
"tendency": "否定"
}
] |
2.双肾多发囊肿，较前比较未见变化。 | 1,541 | [
{
"anatomy_list": [
"双肾"
],
"character": [
"多发"
],
"core_name": "囊肿",
"tendency": ""
}
] |
患者本次发病以来，食欲减退， 神志清醒，精神尚可，睡眠欠佳，大便正常，小便正常，体重无明显变化。 | 629 | [
{
"anatomy_list": [],
"character": [
"减退"
],
"core_name": "食欲",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"清醒"
],
"core_name": "神志",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"尚可"
],
"core_name": "精神",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"欠佳"
],
"core_name": "睡眠质量",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"正常"
],
"core_name": "大便",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"正常"
],
"core_name": "小便",
"tendency": ""
},
{
"anatomy_list": [],
"character": [
"明显"
],
"core_name": "体重改变",
"tendency": "否定"
}
] |
体重无明显变化。 | 775 | [
{
"anatomy_list": [],
"character": [
"明显"
],
"core_name": "体重改变",
"tendency": "否定"
}
] |
术后予sox方案行了三周期化疗，化疗期间无恶心、呕吐、皮肤巩膜黄染、手足麻木疼痛等不适，查血常规、肝肾功未见异常。 | 1,867 | [
{
"anatomy_list": [],
"character": [
"化疗期间"
],
"core_name": "恶心",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [
"化疗期间"
],
"core_name": "呕吐",
"tendency": "否定"
},
{
"anatomy_list": [
"皮肤",
"巩膜"
],
"character": [
"化疗期间"
],
"core_name": "黄染",
"tendency": "否定"
},
{
"anatomy_list": [
"手",
"足"
],
"character": [
"化疗期间"
],
"core_name": "麻木",
"tendency": "否定"
},
{
"anatomy_list": [
"手",
"足"
],
"character": [
"化疗期间"
],
"core_name": "疼痛",
"tendency": "否定"
},
{
"anatomy_list": [
"肝"
],
"character": [],
"core_name": "肝功能异常",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "血常规异常",
"tendency": "否定"
}
] |
入院前10+天，患者无意中发现右侧颈部一包块，可扪及大小约3xxx3cm，质软，边界清楚，无压痛，随吞咽上下移动，无怕热、多汗、全身乏力、易疲劳、咳嗽等症状，无声嘶、饮水呛咳，无食欲亢进，无恶心、呕吐，无吞咽困难、呼吸困难。 | 1,172 | [
{
"anatomy_list": [
"右侧颈部"
],
"character": [
"质软",
"边界清楚",
"无压痛",
"随吞咽上下移动"
],
"core_name": "包块",
"tendency": ""
},
{
"anatomy_list": [],
"character": [],
"core_name": "怕热",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [
"多汗"
],
"core_name": "出汗",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [
"全身"
],
"core_name": "乏力",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [
"易"
],
"core_name": "疲劳",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "咳嗽",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "声嘶",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [
"亢进"
],
"core_name": "食欲",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "恶心",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "呕吐",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "吞咽困难",
"tendency": "否定"
},
{
"anatomy_list": [],
"character": [],
"core_name": "呼吸困难",
"tendency": "否定"
}
] |
Subsets and Splits