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肺部可闻干啰音。
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偶有鼻出血。
[ { "end_idx": 4, "entity": "鼻出血", "start_idx": 2, "type": "sym" }, { "end_idx": 2, "entity": "鼻", "start_idx": 2, "type": "bod" }, { "end_idx": 4, "entity": "血", "start_idx": 4, "type": "bod" } ]
1/3患者出现腹泻水样便。
[ { "end_idx": 8, "entity": "腹泻", "start_idx": 7, "type": "sym" }, { "end_idx": 7, "entity": "腹", "start_idx": 7, "type": "bod" }, { "end_idx": 11, "entity": "水样便", "start_idx": 9, "type": "sym" }, { "end_idx": 11, "entity": "便", "start_idx": 11, "type": "bod" } ]
甲、乙型流感临床症状相似,但后者全身症状轻,鼻及眼部症状明显。
[ { "end_idx": 5, "entity": "甲、乙型流感", "start_idx": 0, "type": "dis" }, { "end_idx": 17, "entity": "全身", "start_idx": 16, "type": "bod" }, { "end_idx": 22, "entity": "鼻", "start_idx": 22, "type": "bod" }, { "end_idx": 25, "entity": "眼部", "start_idx": 24, "type": "bod" } ]
个别患者发生急性肌炎,以腓肠肌和比目鱼肌受累多见,常发生于病后1周,临床症状改善不久。
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X线检查双肺有散在絮状或结节状阴影,由肺门向四周扩散。
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多于5~10日内因呼吸与循环衰竭而死亡,病死率高达80%以上。
[ { "end_idx": 15, "entity": "呼吸与循环衰竭", "start_idx": 9, "type": "sym" } ]
3.扎那米韦(zanamivir)为NA抑制剂。
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对高热烦躁者给予解热镇静剂,避免使用阿司匹林(因其可能诱发Reye综合征)。
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在新生儿或小婴儿时期,如先天性(原始)反射不出现,或表现不对称,或3~4个月以上仍持续存在,均提示可能存在神经系统异常。
[ { "end_idx": 58, "entity": "神经系统异常", "start_idx": 53, "type": "sym" }, { "end_idx": 56, "entity": "神经系统", "start_idx": 53, "type": "bod" } ]
二度房室传导阻滞:部分心房激动不能传至心室。
[ { "end_idx": 7, "entity": "二度房室传导阻滞", "start_idx": 0, "type": "dis" }, { "end_idx": 20, "entity": "部分心房激动不能传至心室", "start_idx": 9, "type": "sym" }, { "end_idx": 12, "entity": "心房", "start_idx": 11, "type": "bod" }, { "end_idx": 20, "entity": "心室", "start_idx": 19, "type": "bod" } ]
莫氏Ⅱ型有发生晕厥的可能,并有可能进展。
[ { "end_idx": 8, "entity": "晕厥", "start_idx": 7, "type": "sym" } ]
毒蛇咬伤后的症状常因被咬者的年龄、体质、被咬部位、毒液量多少以及毒蛇的种类等因素决定,一般在15~20分钟内出现症状。
[ { "end_idx": 3, "entity": "咬伤", "start_idx": 2, "type": "dis" }, { "end_idx": 23, "entity": "被咬部位", "start_idx": 20, "type": "bod" } ]
我国常见的毒蛇有眼镜王蛇、银环蛇、金环蛇、竹叶青蛇、蝮蛇等,毒蛇咬伤多发生在夏季并以南方地区多见。
[ { "end_idx": 33, "entity": "咬伤", "start_idx": 32, "type": "dis" } ]
神经毒素早期主要表现局部症状轻微,不易引起重视,以后发展头晕、嗜睡、无力、吞咽困难、声音嘶哑、肌肉麻痹、四肢瘫痪、呼吸麻痹、昏迷和死亡。
[ { "end_idx": 29, "entity": "头晕", "start_idx": 28, "type": "sym" }, { "end_idx": 28, "entity": "头", "start_idx": 28, "type": "bod" }, { "end_idx": 32, "entity": "嗜睡", "start_idx": 31, "type": "sym" }, { "end_idx": 35, "entity": "无力", "start_idx": 34, "type": "sym" }, { "end_idx": 40, "entity": "吞咽困难", "start_idx": 37, "type": "sym" }, { "end_idx": 38, "entity": "咽", "start_idx": 38, "type": "bod" }, { "end_idx": 45, "entity": "声音嘶哑", "start_idx": 42, "type": "sym" }, { "end_idx": 50, "entity": "肌肉麻痹", "start_idx": 47, "type": "dis" }, { "end_idx": 55, "entity": "四肢瘫痪", "start_idx": 52, "type": "dis" }, { "end_idx": 60, "entity": "呼吸麻痹", "start_idx": 57, "type": "dis" }, { "end_idx": 63, "entity": "昏迷", "start_idx": 62, "type": "sym" } ]
尽快排毒,紧急情况下可用口吸吮,边吸边吮,并用清水漱口。
[ { "end_idx": 3, "entity": "排毒", "start_idx": 2, "type": "pro" }, { "end_idx": 14, "entity": "可用口吸吮", "start_idx": 10, "type": "pro" } ]
作十字切口并用吸引器吸出毒液,扩创排毒。
[ { "end_idx": 4, "entity": "十字切口", "start_idx": 1, "type": "pro" }, { "end_idx": 9, "entity": "吸引器", "start_idx": 7, "type": "equ" }, { "end_idx": 18, "entity": "扩创排毒", "start_idx": 15, "type": "pro" } ]
也可用各种蛇药外敷,切不可用酸类或碘烧灼伤口。
[ { "end_idx": 6, "entity": "蛇药", "start_idx": 5, "type": "dru" }, { "end_idx": 8, "entity": "外敷", "start_idx": 7, "type": "pro" }, { "end_idx": 17, "entity": "碘", "start_idx": 17, "type": "dru" }, { "end_idx": 21, "entity": "伤口", "start_idx": 20, "type": "dis" } ]
常表现为颅内压增高症状,如烦躁、恶心、呕吐、嗜睡、食欲减退、复视、视神经乳头水肿,囟门未闭者则囟门饱满。
[ { "end_idx": 8, "entity": "颅内压增高", "start_idx": 4, "type": "dis" }, { "end_idx": 14, "entity": "烦躁", "start_idx": 13, "type": "sym" }, { "end_idx": 17, "entity": "恶心", "start_idx": 16, "type": "sym" }, { "end_idx": 20, "entity": "呕吐", "start_idx": 19, "type": "sym" }, { "end_idx": 23, "entity": "嗜睡", "start_idx": 22, "type": "sym" }, { "end_idx": 28, "entity": "食欲减退", "start_idx": 25, "type": "sym" }, { "end_idx": 31, "entity": "复视", "start_idx": 30, "type": "sym" }, { "end_idx": 39, "entity": "视神经乳头水肿", "start_idx": 33, "type": "sym" }, { "end_idx": 37, "entity": "视神经乳头", "start_idx": 33, "type": "bod" }, { "end_idx": 42, "entity": "囟门", "start_idx": 41, "type": "bod" }, { "end_idx": 50, "entity": "囟门饱满", "start_idx": 47, "type": "sym" }, { "end_idx": 48, "entity": "囟门", "start_idx": 47, "type": "bod" } ]
发病的同时常伴有荨麻疹、多形红斑、血管性水肿或关节肿痛。
[ { "end_idx": 10, "entity": "荨麻疹", "start_idx": 8, "type": "dis" }, { "end_idx": 15, "entity": "多形红斑", "start_idx": 12, "type": "sym" }, { "end_idx": 21, "entity": "血管性水肿", "start_idx": 17, "type": "sym" }, { "end_idx": 26, "entity": "关节肿痛", "start_idx": 23, "type": "sym" } ]
临床表现为双下肢大小不等的皮肤瘀点、瘀斑,多自发发生和消退,很少有其他部位的出血;除了部分患者毛细血管脆性试验阳性外,其余出凝血检查及血小板计数等均正常。
[ { "end_idx": 7, "entity": "双下肢", "start_idx": 5, "type": "bod" }, { "end_idx": 16, "entity": "皮肤瘀点", "start_idx": 13, "type": "sym" }, { "end_idx": 14, "entity": "皮肤", "start_idx": 13, "type": "bod" }, { "end_idx": 19, "entity": "瘀斑", "start_idx": 18, "type": "sym" }, { "end_idx": 39, "entity": "出血", "start_idx": 38, "type": "sym" }, { "end_idx": 39, "entity": "血", "start_idx": 39, "type": "bod" }, { "end_idx": 56, "entity": "毛细血管脆性试验阳性", "start_idx": 47, "type": "sym" }, { "end_idx": 54, "entity": "毛细血管脆性试验", "start_idx": 47, "type": "pro" }, { "end_idx": 65, "entity": "出凝血检查", "start_idx": 61, "type": "pro" }, { "end_idx": 71, "entity": "血小板计数", "start_idx": 67, "type": "ite" } ]
本病初期仅见毛囊周围的瘀点、瘀斑,齿龈肿胀、出血,病情进展时可出现鼻出血、血尿、黑便,肌肉及关节腔出血等。
[ { "end_idx": 15, "entity": "毛囊周围的瘀点、瘀斑", "start_idx": 6, "type": "sym" }, { "end_idx": 9, "entity": "毛囊周围", "start_idx": 6, "type": "bod" }, { "end_idx": 18, "entity": "齿龈", "start_idx": 17, "type": "bod" }, { "end_idx": 20, "entity": "齿龈肿胀", "start_idx": 17, "type": "sym" }, { "end_idx": 23, "entity": "出血", "start_idx": 22, "type": "sym" }, { "end_idx": 23, "entity": "血", "start_idx": 23, "type": "bod" }, { "end_idx": 35, "entity": "鼻出血", "start_idx": 33, "type": "dis" }, { "end_idx": 38, "entity": "血尿", "start_idx": 37, "type": "sym" }, { "end_idx": 37, "entity": "血", "start_idx": 37, "type": "bod" }, { "end_idx": 38, "entity": "尿", "start_idx": 38, "type": "bod" }, { "end_idx": 41, "entity": "黑便", "start_idx": 40, "type": "sym" }, { "end_idx": 41, "entity": "便", "start_idx": 41, "type": "bod" }, { "end_idx": 50, "entity": "肌肉及关节腔出血", "start_idx": 43, "type": "dis" } ]
本病束臂试验阳性,凝血功能检查正常,X线及活体组织电镜检查有助确诊。
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血片中可见血小板成堆及巨大血小板,骨髓巨核细胞增生。
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本病少见,须与慢性粒细胞白血病、真性红细胞增多症、骨髓纤维化及继发性血小板增多症等鉴别。
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实验室检查可见血小板数量和形态正常,出血时间(Ivy法)延长或阿司匹林耐量试验阳性,血小板黏附率、Ⅷ∶C降低或正常、APTT延长或正常,血小板对瑞斯托霉素诱导的聚集反应降低,vWF的抗原(vWF∶Ag)减低或正常(正常者需进一步检查是否变异型)。
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早发型多在生后24小时内发病,经典型于生后2~3天发病,晚发型多于生后1个月后发病,临床可见鼻出血、脐残端出血、尿血、便血和颅内出血等。
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DIC首先出现短时间的高凝状态,消耗大量凝血因子和血小板,形成广泛的微小血栓;接着呈现消耗性低凝状态和继发性纤溶亢进;临床表现为出血、栓塞、溶血及微循环障碍等,病势凶险。
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继发性EH是指有某些病理因素所致的EH,可见于早产、缺氧缺血性脑病、颅内出血、高胆红素血症、化脓性脑膜炎以及维生素A缺乏症等。
[ { "end_idx": 4, "entity": "继发性EH", "start_idx": 0, "type": "dis" }, { "end_idx": 18, "entity": "EH", "start_idx": 17, "type": "dis" }, { "end_idx": 24, "entity": "早产", "start_idx": 23, "type": "dis" }, { "end_idx": 32, "entity": "缺氧缺血性脑病", "start_idx": 26, "type": "dis" }, { "end_idx": 37, "entity": "颅内出血", "start_idx": 34, "type": "dis" }, { "end_idx": 44, "entity": "高胆红素血症", "start_idx": 39, "type": "dis" }, { "end_idx": 51, "entity": "化脓性脑膜炎", "start_idx": 46, "type": "dis" }, { "end_idx": 60, "entity": "维生素A缺乏症", "start_idx": 54, "type": "dis" } ]
有颅内压增高者,可用碳酸酐酶抑制剂如乙酰唑胺(diamox),或脱水剂如甘露醇,以降低颅内压。
[ { "end_idx": 5, "entity": "颅内压增高", "start_idx": 1, "type": "dis" }, { "end_idx": 16, "entity": "碳酸酐酶抑制剂", "start_idx": 10, "type": "dru" }, { "end_idx": 21, "entity": "乙酰唑胺", "start_idx": 18, "type": "dru" }, { "end_idx": 28, "entity": "diamox", "start_idx": 23, "type": "dru" }, { "end_idx": 34, "entity": "脱水剂", "start_idx": 32, "type": "dru" }, { "end_idx": 38, "entity": "甘露醇", "start_idx": 36, "type": "dru" }, { "end_idx": 45, "entity": "颅内压", "start_idx": 43, "type": "ite" } ]
不主张采用前囟穿刺放液或脑脊液分流术。
[ { "end_idx": 8, "entity": "前囟穿刺", "start_idx": 5, "type": "pro" }, { "end_idx": 17, "entity": "脑脊液分流术", "start_idx": 12, "type": "pro" } ]
如有频繁惊厥发作者,可适当短期内给予抗癫痫药物。
[ { "end_idx": 5, "entity": "惊厥", "start_idx": 4, "type": "dis" }, { "end_idx": 22, "entity": "抗癫痫药物", "start_idx": 18, "type": "dru" } ]
少部分患儿可能发展成为交通性脑积水。
[ { "end_idx": 16, "entity": "交通性脑积水", "start_idx": 11, "type": "dis" } ]
近年有学者追踪随访,发现少数患儿可出现轻度的神经精神发育障碍,如运动发育迟缓和语言发育迟缓等,值得进一步研究。
[ { "end_idx": 29, "entity": "神经精神发育障碍", "start_idx": 22, "type": "dis" }, { "end_idx": 37, "entity": "运动发育迟缓", "start_idx": 32, "type": "dis" }, { "end_idx": 44, "entity": "语言发育迟缓", "start_idx": 39, "type": "dis" } ]
出生后感染性肺炎的病理改变以支气管肺炎和间质性肺炎为主,病变分散,影响一叶或数叶,有时融合成大片病灶,肺不张和肺气肿较易发生。
[ { "end_idx": 7, "entity": "出生后感染性肺炎", "start_idx": 0, "type": "dis" }, { "end_idx": 18, "entity": "支气管肺炎", "start_idx": 14, "type": "dis" }, { "end_idx": 24, "entity": "间质性肺炎", "start_idx": 20, "type": "dis" }, { "end_idx": 31, "entity": "病变分散", "start_idx": 28, "type": "sym" }, { "end_idx": 39, "entity": "影响一叶或数叶", "start_idx": 33, "type": "sym" }, { "end_idx": 49, "entity": "融合成大片病灶", "start_idx": 43, "type": "sym" }, { "end_idx": 53, "entity": "肺不张", "start_idx": 51, "type": "dis" }, { "end_idx": 57, "entity": "肺气肿", "start_idx": 55, "type": "dis" } ]
金黄色葡萄球菌肺炎在新生儿室中常有发生,并可引起流行;患儿中毒症状重,易并发化脓性脑膜炎、脓胸、脓气胸、肺大疱等。
[ { "end_idx": 8, "entity": "金黄色葡萄球菌肺炎", "start_idx": 0, "type": "mic" }, { "end_idx": 30, "entity": "中毒", "start_idx": 29, "type": "dis" }, { "end_idx": 43, "entity": "化脓性脑膜炎", "start_idx": 38, "type": "dis" }, { "end_idx": 46, "entity": "脓胸", "start_idx": 45, "type": "dis" }, { "end_idx": 50, "entity": "脓气胸", "start_idx": 48, "type": "dis" }, { "end_idx": 54, "entity": "肺大疱", "start_idx": 52, "type": "dis" } ]
大肠埃希菌肺炎时患儿有神萎、不吃、不哭、体温低、呼吸窘迫等,脓胸的液体黏稠,有臭味。
[ { "end_idx": 6, "entity": "大肠埃希菌肺炎", "start_idx": 0, "type": "dis" }, { "end_idx": 12, "entity": "神萎", "start_idx": 11, "type": "sym" }, { "end_idx": 15, "entity": "不吃", "start_idx": 14, "type": "sym" }, { "end_idx": 18, "entity": "不哭", "start_idx": 17, "type": "sym" }, { "end_idx": 22, "entity": "体温低", "start_idx": 20, "type": "sym" }, { "end_idx": 27, "entity": "呼吸窘迫", "start_idx": 24, "type": "dis" }, { "end_idx": 31, "entity": "脓胸", "start_idx": 30, "type": "dis" }, { "end_idx": 40, "entity": "液体黏稠,有臭味", "start_idx": 33, "type": "sym" } ]
X线胸片有时表现为弥漫性、深浅不一的模糊影,也可表现为两肺广泛点状或大小不一的浸润影,常伴肺气肿、肺不张,偶见大叶实变伴脓胸、脓气胸或肺大疱。
[ { "end_idx": 3, "entity": "X线胸片", "start_idx": 0, "type": "pro" }, { "end_idx": 28, "entity": "两肺", "start_idx": 27, "type": "bod" }, { "end_idx": 47, "entity": "肺气肿", "start_idx": 45, "type": "dis" }, { "end_idx": 51, "entity": "肺不张", "start_idx": 49, "type": "dis" }, { "end_idx": 58, "entity": "大叶实变", "start_idx": 55, "type": "sym" }, { "end_idx": 56, "entity": "大叶", "start_idx": 55, "type": "bod" }, { "end_idx": 61, "entity": "脓胸", "start_idx": 60, "type": "dis" }, { "end_idx": 65, "entity": "脓气胸", "start_idx": 63, "type": "dis" }, { "end_idx": 69, "entity": "肺大疱", "start_idx": 67, "type": "dis" } ]
重症并发呼吸衰竭者,可用持续正压呼吸或气管插管后机械通气。
[ { "end_idx": 7, "entity": "呼吸衰竭", "start_idx": 4, "type": "dis" }, { "end_idx": 17, "entity": "正压呼吸", "start_idx": 14, "type": "pro" }, { "end_idx": 22, "entity": "气管插管", "start_idx": 19, "type": "pro" }, { "end_idx": 27, "entity": "机械通气", "start_idx": 24, "type": "pro" } ]
病毒性肺炎可用利巴韦林或干扰素治疗,单纯疱疹病毒可用阿昔洛韦静脉滴注。
[ { "end_idx": 4, "entity": "病毒性肺炎", "start_idx": 0, "type": "dis" }, { "end_idx": 16, "entity": "利巴韦林或干扰素治疗", "start_idx": 7, "type": "pro" }, { "end_idx": 23, "entity": "单纯疱疹病毒", "start_idx": 18, "type": "mic" }, { "end_idx": 31, "entity": "阿昔洛韦静脉", "start_idx": 26, "type": "dru" }, { "end_idx": 33, "entity": "滴注", "start_idx": 32, "type": "pro" } ]
衣原体肺炎首选红霉素治疗。
[ { "end_idx": 4, "entity": "衣原体肺炎", "start_idx": 0, "type": "dis" }, { "end_idx": 11, "entity": "红霉素治疗", "start_idx": 7, "type": "pro" } ]
只具备内脏易位和支气管扩张者,称为不全性Kartagener综合征。
[ { "end_idx": 6, "entity": "内脏易位", "start_idx": 3, "type": "dis" }, { "end_idx": 12, "entity": "支气管扩张", "start_idx": 8, "type": "dis" }, { "end_idx": 32, "entity": "不全性Kartagener综合征", "start_idx": 17, "type": "dis" } ]
主要症状为随年龄增加而加重的咳嗽、咳痰和咯血,以早晨更明显,伴头昏、流涕等。
[ { "end_idx": 15, "entity": "咳嗽", "start_idx": 14, "type": "sym" }, { "end_idx": 18, "entity": "咳痰", "start_idx": 17, "type": "sym" }, { "end_idx": 18, "entity": "痰", "start_idx": 18, "type": "bod" }, { "end_idx": 21, "entity": "咯血", "start_idx": 20, "type": "sym" }, { "end_idx": 21, "entity": "血", "start_idx": 21, "type": "bod" }, { "end_idx": 32, "entity": "头昏", "start_idx": 31, "type": "sym" }, { "end_idx": 31, "entity": "头", "start_idx": 31, "type": "bod" }, { "end_idx": 35, "entity": "流涕", "start_idx": 34, "type": "sym" }, { "end_idx": 35, "entity": "涕", "start_idx": 35, "type": "bod" } ]
易患感冒及肺炎,出现呼吸困难、发绀、说话带鼻音,体格检查可发现杵状指趾、肺部啰音等。
[ { "end_idx": 3, "entity": "感冒", "start_idx": 2, "type": "dis" }, { "end_idx": 6, "entity": "肺炎", "start_idx": 5, "type": "dis" }, { "end_idx": 13, "entity": "呼吸困难", "start_idx": 10, "type": "dis" }, { "end_idx": 16, "entity": "发绀", "start_idx": 15, "type": "sym" }, { "end_idx": 22, "entity": "说话带鼻音", "start_idx": 18, "type": "sym" }, { "end_idx": 21, "entity": "鼻", "start_idx": 21, "type": "bod" }, { "end_idx": 27, "entity": "体格检查", "start_idx": 24, "type": "pro" }, { "end_idx": 39, "entity": "体格检查可发现杵状指趾、肺部啰音", "start_idx": 24, "type": "sym" }, { "end_idx": 34, "entity": "指趾", "start_idx": 33, "type": "bod" }, { "end_idx": 37, "entity": "肺部", "start_idx": 36, "type": "bod" } ]
胸片及支气管造影可协助诊断。
[ { "end_idx": 1, "entity": "胸片", "start_idx": 0, "type": "pro" }, { "end_idx": 7, "entity": "支气管造影", "start_idx": 3, "type": "pro" } ]
断层X线片有时可见到支气管扩张和变形。
[ { "end_idx": 4, "entity": "断层X线片", "start_idx": 0, "type": "pro" }, { "end_idx": 17, "entity": "断层X线片有时可见到支气管扩张和变形", "start_idx": 0, "type": "sym" }, { "end_idx": 12, "entity": "支气管", "start_idx": 10, "type": "bod" } ]
应鼓励咳嗽,肺部物理治疗有助于排痰。
[ { "end_idx": 4, "entity": "鼓励咳嗽", "start_idx": 1, "type": "pro" }, { "end_idx": 11, "entity": "肺部物理治疗", "start_idx": 6, "type": "pro" }, { "end_idx": 16, "entity": "排痰", "start_idx": 15, "type": "pro" } ]
随着分子生物学的进展,LGMD有了新的分类,主要分为两类:LGMD1为常染色体显性遗传,LGMD2为常染色体隐性遗传(表16-16)。
[ { "end_idx": 14, "entity": "LGMD", "start_idx": 11, "type": "dis" }, { "end_idx": 33, "entity": "LGMD1", "start_idx": 29, "type": "dis" }, { "end_idx": 38, "entity": "常染色体", "start_idx": 35, "type": "bod" }, { "end_idx": 48, "entity": "LGMD2", "start_idx": 44, "type": "dis" }, { "end_idx": 53, "entity": "常染色体", "start_idx": 50, "type": "bod" } ]
腓肠肌肥大是常染色体隐性遗传型的LGMD常见的表现。
[ { "end_idx": 4, "entity": "腓肠肌肥大", "start_idx": 0, "type": "dis" }, { "end_idx": 9, "entity": "常染色体", "start_idx": 6, "type": "bod" }, { "end_idx": 19, "entity": "LGMD", "start_idx": 16, "type": "dis" } ]
行走困难者可以使用轮椅,在有些伴有危及生命的心肌病患者中,需安装心脏起搏器,甚至心脏移植以挽救生命。
[ { "end_idx": 3, "entity": "行走困难", "start_idx": 0, "type": "dis" }, { "end_idx": 10, "entity": "轮椅", "start_idx": 9, "type": "equ" }, { "end_idx": 24, "entity": "心肌病", "start_idx": 22, "type": "dis" }, { "end_idx": 36, "entity": "心脏起搏器", "start_idx": 32, "type": "equ" }, { "end_idx": 43, "entity": "心脏移植", "start_idx": 40, "type": "pro" } ]
基因治疗LGMD的方法很多,与dystrophin缺陷相比,本病基因治疗有潜在的优势,例如在肌聚糖病中,基因较小且较易转入载体,重组腺病毒载体(rAAV)系统由于其能在非分裂细胞中有效地、长期地表达,因此具有很大的优势。
[ { "end_idx": 3, "entity": "基因治疗", "start_idx": 0, "type": "pro" }, { "end_idx": 7, "entity": "LGMD", "start_idx": 4, "type": "dis" }, { "end_idx": 26, "entity": "dystrophin缺陷", "start_idx": 15, "type": "dis" }, { "end_idx": 35, "entity": "基因治疗", "start_idx": 32, "type": "pro" }, { "end_idx": 49, "entity": "肌聚糖病", "start_idx": 46, "type": "dis" }, { "end_idx": 53, "entity": "基因", "start_idx": 52, "type": "dru" }, { "end_idx": 68, "entity": "重组腺病毒", "start_idx": 64, "type": "mic" }, { "end_idx": 75, "entity": "rAAV", "start_idx": 72, "type": "mic" }, { "end_idx": 88, "entity": "非分裂细胞", "start_idx": 84, "type": "bod" } ]
恙虫病在我国古代称为沙虱热,在西方国家常称为丛林斑疹伤寒。
[ { "end_idx": 2, "entity": "恙虫病", "start_idx": 0, "type": "dis" }, { "end_idx": 12, "entity": "沙虱热", "start_idx": 10, "type": "dis" }, { "end_idx": 27, "entity": "丛林斑疹伤寒", "start_idx": 22, "type": "dis" } ]
起病后患儿出现咽痛、高热、吞咽困难,常言语不清。
[ { "end_idx": 8, "entity": "咽痛", "start_idx": 7, "type": "sym" }, { "end_idx": 7, "entity": "咽", "start_idx": 7, "type": "bod" }, { "end_idx": 11, "entity": "高热", "start_idx": 10, "type": "sym" }, { "end_idx": 16, "entity": "吞咽困难", "start_idx": 13, "type": "sym" }, { "end_idx": 14, "entity": "咽", "start_idx": 14, "type": "bod" }, { "end_idx": 22, "entity": "言语不清", "start_idx": 19, "type": "sym" } ]
偶可导致斜颈。
[ { "end_idx": 5, "entity": "斜颈", "start_idx": 4, "type": "sym" }, { "end_idx": 5, "entity": "颈", "start_idx": 5, "type": "bod" } ]
年幼患儿需住院治疗。
[ { "end_idx": 8, "entity": "住院治疗", "start_idx": 5, "type": "pro" } ]
抗生素首选青霉素,常需切开引流,否则可发生破裂。
[ { "end_idx": 2, "entity": "抗生素", "start_idx": 0, "type": "dru" }, { "end_idx": 7, "entity": "青霉素", "start_idx": 5, "type": "dru" }, { "end_idx": 14, "entity": "切开引流", "start_idx": 11, "type": "pro" }, { "end_idx": 22, "entity": "破裂", "start_idx": 21, "type": "sym" } ]
颅内出血进行头颅B超或CT检查。
[ { "end_idx": 3, "entity": "颅内出血", "start_idx": 0, "type": "dis" }, { "end_idx": 7, "entity": "头颅", "start_idx": 6, "type": "bod" }, { "end_idx": 9, "entity": "B超", "start_idx": 8, "type": "pro" }, { "end_idx": 14, "entity": "CT检查", "start_idx": 11, "type": "pro" } ]
心脏骤停患儿,小儿呼吸、心搏骤停多由于气道阻塞和缺氧,先引起呼吸骤停,继而心搏骤停。
[ { "end_idx": 3, "entity": "心脏骤停", "start_idx": 0, "type": "sym" }, { "end_idx": 1, "entity": "心脏", "start_idx": 0, "type": "bod" }, { "end_idx": 15, "entity": "小儿呼吸、心搏骤停", "start_idx": 7, "type": "sym" }, { "end_idx": 12, "entity": "心", "start_idx": 12, "type": "bod" }, { "end_idx": 22, "entity": "气道阻塞", "start_idx": 19, "type": "sym" }, { "end_idx": 20, "entity": "气道", "start_idx": 19, "type": "bod" }, { "end_idx": 25, "entity": "缺氧", "start_idx": 24, "type": "sym" }, { "end_idx": 33, "entity": "呼吸骤停", "start_idx": 30, "type": "sym" }, { "end_idx": 40, "entity": "心搏骤停", "start_idx": 37, "type": "dis" } ]
从小儿呼吸心搏骤停的发生年龄来看,3~6个月小婴儿心搏骤停多见于窒息、呼吸道阻塞和婴儿猝死综合征,1~5岁多由心脏疾患、呼吸系统和中枢神经系统疾患引起,7~8岁多为意外事故,特别常见于外伤。
[ { "end_idx": 8, "entity": "小儿呼吸心搏骤停", "start_idx": 1, "type": "dis" }, { "end_idx": 28, "entity": "心搏骤停", "start_idx": 25, "type": "dis" }, { "end_idx": 33, "entity": "窒息", "start_idx": 32, "type": "dis" }, { "end_idx": 39, "entity": "呼吸道阻塞", "start_idx": 35, "type": "dis" }, { "end_idx": 47, "entity": "婴儿猝死综合征", "start_idx": 41, "type": "dis" }, { "end_idx": 58, "entity": "心脏疾患", "start_idx": 55, "type": "dis" }, { "end_idx": 72, "entity": "呼吸系统和中枢神经系统疾患", "start_idx": 60, "type": "dis" }, { "end_idx": 93, "entity": "外伤", "start_idx": 92, "type": "dis" } ]
分为上尿路和下尿路感染。
[ { "end_idx": 10, "entity": "上尿路和下尿路感染", "start_idx": 2, "type": "dis" } ]
前者指肾盂肾炎,后者指膀胱炎和尿道炎。
[ { "end_idx": 6, "entity": "肾盂肾炎", "start_idx": 3, "type": "dis" }, { "end_idx": 13, "entity": "膀胱炎", "start_idx": 11, "type": "dis" }, { "end_idx": 17, "entity": "尿道炎", "start_idx": 15, "type": "dis" } ]
有器械操作诱发尿感的细菌可为肠道细菌和绿脓杆菌。
[ { "end_idx": 8, "entity": "尿感", "start_idx": 7, "type": "dis" }, { "end_idx": 11, "entity": "细菌", "start_idx": 10, "type": "mic" }, { "end_idx": 17, "entity": "肠道细菌", "start_idx": 14, "type": "mic" }, { "end_idx": 22, "entity": "绿脓杆菌", "start_idx": 19, "type": "mic" } ]
在泌尿道梗阻、结构异常、尿路结石、膀胱输尿管反流和神经源性膀胱的基础上并发的尿感可为一种以上细菌的混合感染。
[ { "end_idx": 5, "entity": "泌尿道梗阻", "start_idx": 1, "type": "dis" }, { "end_idx": 10, "entity": "结构异常", "start_idx": 7, "type": "sym" }, { "end_idx": 15, "entity": "尿路结石", "start_idx": 12, "type": "dis" }, { "end_idx": 23, "entity": "膀胱输尿管反流", "start_idx": 17, "type": "dis" }, { "end_idx": 30, "entity": "神经源性膀胱", "start_idx": 25, "type": "dis" }, { "end_idx": 39, "entity": "尿感", "start_idx": 38, "type": "dis" }, { "end_idx": 47, "entity": "细菌", "start_idx": 46, "type": "mic" }, { "end_idx": 52, "entity": "感染", "start_idx": 51, "type": "dis" } ]
病毒感染,特别是腺病毒可引起出血性膀胱炎。
[ { "end_idx": 3, "entity": "病毒感染", "start_idx": 0, "type": "dis" }, { "end_idx": 10, "entity": "腺病毒", "start_idx": 8, "type": "mic" }, { "end_idx": 19, "entity": "出血性膀胱炎", "start_idx": 14, "type": "dis" } ]
真菌感染可能继发于糖尿病的留置导尿、免疫缺陷病或类固醇、广谱抗生素或其他免疫抑制剂的治疗过程中。
[ { "end_idx": 3, "entity": "真菌感染", "start_idx": 0, "type": "dis" }, { "end_idx": 11, "entity": "糖尿病", "start_idx": 9, "type": "dis" }, { "end_idx": 16, "entity": "留置导尿", "start_idx": 13, "type": "pro" }, { "end_idx": 22, "entity": "免疫缺陷病", "start_idx": 18, "type": "dis" }, { "end_idx": 26, "entity": "类固醇", "start_idx": 24, "type": "dru" }, { "end_idx": 32, "entity": "广谱抗生素", "start_idx": 28, "type": "dru" }, { "end_idx": 43, "entity": "免疫抑制剂的治疗", "start_idx": 36, "type": "pro" } ]
同时还有全身不适、精神萎靡、面色苍黄、呕吐、恶心及轻度腹泻,年长儿述胁肋部或腰痛,肾区叩击痛。
[ { "end_idx": 7, "entity": "全身不适", "start_idx": 4, "type": "sym" }, { "end_idx": 5, "entity": "全身", "start_idx": 4, "type": "bod" }, { "end_idx": 12, "entity": "精神萎靡", "start_idx": 9, "type": "sym" }, { "end_idx": 17, "entity": "面色苍黄", "start_idx": 14, "type": "sym" }, { "end_idx": 14, "entity": "面", "start_idx": 14, "type": "bod" }, { "end_idx": 20, "entity": "呕吐", "start_idx": 19, "type": "sym" }, { "end_idx": 23, "entity": "恶心", "start_idx": 22, "type": "sym" }, { "end_idx": 28, "entity": "轻度腹泻", "start_idx": 25, "type": "sym" }, { "end_idx": 27, "entity": "腹", "start_idx": 27, "type": "bod" }, { "end_idx": 39, "entity": "胁肋部或腰痛", "start_idx": 34, "type": "sym" }, { "end_idx": 36, "entity": "胁肋部", "start_idx": 34, "type": "bod" }, { "end_idx": 38, "entity": "腰", "start_idx": 38, "type": "bod" }, { "end_idx": 42, "entity": "肾区", "start_idx": 41, "type": "bod" }, { "end_idx": 45, "entity": "肾区叩击痛", "start_idx": 41, "type": "sym" } ]
新生儿表现如败血症,有体重下降、喂养困难、黄疸、激惹、发热或体温不升。
[ { "end_idx": 8, "entity": "败血症", "start_idx": 6, "type": "dis" }, { "end_idx": 14, "entity": "体重下降", "start_idx": 11, "type": "sym" }, { "end_idx": 19, "entity": "喂养困难", "start_idx": 16, "type": "sym" }, { "end_idx": 22, "entity": "黄疸", "start_idx": 21, "type": "dis" }, { "end_idx": 25, "entity": "激惹", "start_idx": 24, "type": "sym" }, { "end_idx": 28, "entity": "发热", "start_idx": 27, "type": "sym" }, { "end_idx": 33, "entity": "体温不升", "start_idx": 30, "type": "sym" } ]
对<5岁的第一次尿感应做排泄性膀胱尿道造影,以发现膀胱输尿管反流及后尿道瓣膜等尿感诱因。
[ { "end_idx": 9, "entity": "尿感", "start_idx": 8, "type": "dis" }, { "end_idx": 20, "entity": "排泄性膀胱尿道造影", "start_idx": 12, "type": "pro" }, { "end_idx": 31, "entity": "膀胱输尿管反流", "start_idx": 25, "type": "dis" }, { "end_idx": 37, "entity": "后尿道瓣膜", "start_idx": 33, "type": "dis" }, { "end_idx": 40, "entity": "尿感", "start_idx": 39, "type": "dis" } ]
上尿路感染者还应做泌尿系统B超检查,<5岁患儿应做(尿感控制后2~3周)排泄性膀胱造影,以了解有无UVR或尿道瓣膜致尿流淤滞的尿感诱因。
[ { "end_idx": 4, "entity": "上尿路感染", "start_idx": 0, "type": "dis" }, { "end_idx": 16, "entity": "泌尿系统B超检查", "start_idx": 9, "type": "pro" }, { "end_idx": 29, "entity": "尿感控制", "start_idx": 26, "type": "pro" }, { "end_idx": 42, "entity": "排泄性膀胱造影", "start_idx": 36, "type": "pro" }, { "end_idx": 51, "entity": "UVR", "start_idx": 49, "type": "sym" }, { "end_idx": 56, "entity": "尿道瓣膜", "start_idx": 53, "type": "dis" }, { "end_idx": 61, "entity": "尿流淤滞", "start_idx": 58, "type": "sym" }, { "end_idx": 58, "entity": "尿", "start_idx": 58, "type": "bod" }, { "end_idx": 64, "entity": "尿感", "start_idx": 63, "type": "dis" } ]
婴幼儿急性肾盂肾炎常以急性感染中毒症状为主要表现,而缺乏泌尿系统的特殊症状,故在发热性疾病的诊断过程中应警惕尿感的可能,并注意与其他系统的急性感染作鉴别。
[ { "end_idx": 8, "entity": "婴幼儿急性肾盂肾炎", "start_idx": 0, "type": "dis" }, { "end_idx": 16, "entity": "急性感染中毒", "start_idx": 11, "type": "dis" }, { "end_idx": 31, "entity": "泌尿系统", "start_idx": 28, "type": "bod" }, { "end_idx": 44, "entity": "发热性疾病", "start_idx": 40, "type": "dis" }, { "end_idx": 55, "entity": "尿感", "start_idx": 54, "type": "dis" }, { "end_idx": 72, "entity": "急性感染", "start_idx": 69, "type": "dis" } ]
除尿感外,急性肾小球肾炎病程中可有暂时性尿白细胞增多,但有血尿、水肿和高血压;急性间质性肾炎和狼疮性肾炎亦有白细胞尿,均应结合临床症状和相关检查作鉴别诊断。
[ { "end_idx": 2, "entity": "尿感", "start_idx": 1, "type": "dis" }, { "end_idx": 11, "entity": "急性肾小球肾炎", "start_idx": 5, "type": "dis" }, { "end_idx": 25, "entity": "暂时性尿白细胞增多", "start_idx": 17, "type": "sym" }, { "end_idx": 23, "entity": "尿白细胞", "start_idx": 20, "type": "bod" }, { "end_idx": 30, "entity": "血尿", "start_idx": 29, "type": "sym" }, { "end_idx": 29, "entity": "血", "start_idx": 29, "type": "bod" }, { "end_idx": 30, "entity": "尿", "start_idx": 30, "type": "bod" }, { "end_idx": 33, "entity": "水肿", "start_idx": 32, "type": "sym" }, { "end_idx": 37, "entity": "高血压", "start_idx": 35, "type": "dis" }, { "end_idx": 45, "entity": "急性间质性肾炎", "start_idx": 39, "type": "dis" }, { "end_idx": 51, "entity": "狼疮性肾炎", "start_idx": 47, "type": "dis" }, { "end_idx": 57, "entity": "白细胞尿", "start_idx": 54, "type": "sym" }, { "end_idx": 56, "entity": "白细胞", "start_idx": 54, "type": "bod" }, { "end_idx": 57, "entity": "尿", "start_idx": 57, "type": "bod" } ]
蛲虫病和无良好卫生护理的儿童,包茎及会阴炎症亦可出现尿频及尿急症状,但尿白细胞正常或只略为增多,尿培养结果不符合尿感。
[ { "end_idx": 2, "entity": "蛲虫病", "start_idx": 0, "type": "dis" }, { "end_idx": 10, "entity": "卫生护理", "start_idx": 7, "type": "pro" }, { "end_idx": 16, "entity": "包茎", "start_idx": 15, "type": "dis" }, { "end_idx": 21, "entity": "会阴炎症", "start_idx": 18, "type": "dis" }, { "end_idx": 27, "entity": "尿频", "start_idx": 26, "type": "dis" }, { "end_idx": 30, "entity": "尿急", "start_idx": 29, "type": "dis" }, { "end_idx": 38, "entity": "尿白细胞", "start_idx": 35, "type": "ite" }, { "end_idx": 50, "entity": "尿培养", "start_idx": 48, "type": "pro" }, { "end_idx": 57, "entity": "尿感", "start_idx": 56, "type": "dis" } ]
本病属血小板聚集功能障碍性疾病,为常染色体隐性遗传。
[ { "end_idx": 14, "entity": "血小板聚集功能障碍性疾病", "start_idx": 3, "type": "dis" }, { "end_idx": 20, "entity": "常染色体", "start_idx": 17, "type": "bod" } ]
这种血小板能正常地黏附到受损的血管内皮下组织,但不能进一步地正常延伸和形成血小板聚集。
[ { "end_idx": 4, "entity": "血小板", "start_idx": 2, "type": "bod" }, { "end_idx": 21, "entity": "血管内皮下组织", "start_idx": 15, "type": "bod" }, { "end_idx": 41, "entity": "不能进一步地正常延伸和形成血小板聚集", "start_idx": 24, "type": "sym" }, { "end_idx": 39, "entity": "血小板", "start_idx": 37, "type": "bod" } ]
临床上可分为三个亚型:Ⅰ型:GPⅡb/Ⅲa复合物的量少于正常的5%;Ⅱ型:相当于正常的5%~25%;Ⅲ型:相当于正常的40%~100%,量无明显减少而结构异常,属变异型。
[ { "end_idx": 23, "entity": "GPⅡb/Ⅲa复合物", "start_idx": 14, "type": "bod" } ]
杂合子出血症不明显,纯合子则可表现皮肤、黏膜的自发出血甚至内脏出血,如皮肤瘀点、瘀斑、鼻出血、牙龈出血、月经过多、血尿、胃肠道出血等,罕见颅内出血。
[ { "end_idx": 4, "entity": "出血", "start_idx": 3, "type": "sym" }, { "end_idx": 4, "entity": "血", "start_idx": 4, "type": "bod" }, { "end_idx": 26, "entity": "皮肤、黏膜的自发出血", "start_idx": 17, "type": "sym" }, { "end_idx": 18, "entity": "皮肤", "start_idx": 17, "type": "bod" }, { "end_idx": 21, "entity": "黏膜", "start_idx": 20, "type": "bod" }, { "end_idx": 26, "entity": "血", "start_idx": 26, "type": "bod" }, { "end_idx": 32, "entity": "内脏出血", "start_idx": 29, "type": "dis" }, { "end_idx": 38, "entity": "皮肤瘀点", "start_idx": 35, "type": "sym" }, { "end_idx": 36, "entity": "皮肤", "start_idx": 35, "type": "bod" }, { "end_idx": 41, "entity": "瘀斑", "start_idx": 40, "type": "sym" }, { "end_idx": 45, "entity": "鼻出血", "start_idx": 43, "type": "dis" }, { "end_idx": 50, "entity": "牙龈出血", "start_idx": 47, "type": "dis" }, { "end_idx": 55, "entity": "月经过多", "start_idx": 52, "type": "sym" }, { "end_idx": 53, "entity": "月经", "start_idx": 52, "type": "bod" }, { "end_idx": 58, "entity": "血尿", "start_idx": 57, "type": "sym" }, { "end_idx": 57, "entity": "血", "start_idx": 57, "type": "bod" }, { "end_idx": 58, "entity": "尿", "start_idx": 58, "type": "bod" }, { "end_idx": 64, "entity": "胃肠道出血", "start_idx": 60, "type": "dis" }, { "end_idx": 72, "entity": "颅内出血", "start_idx": 69, "type": "dis" } ]
血小板对ADP、胶原、肾上腺素、凝血酶诱导的聚集反应缺如或降低,但对瑞士托霉素和vWF的诱导的聚集反应正常。
[ { "end_idx": 2, "entity": "血小板", "start_idx": 0, "type": "bod" }, { "end_idx": 30, "entity": "血小板对ADP、胶原、肾上腺素、凝血酶诱导的聚集反应缺如或降低", "start_idx": 0, "type": "sym" }, { "end_idx": 6, "entity": "ADP", "start_idx": 4, "type": "bod" }, { "end_idx": 9, "entity": "胶原", "start_idx": 8, "type": "bod" }, { "end_idx": 14, "entity": "肾上腺素", "start_idx": 11, "type": "bod" }, { "end_idx": 18, "entity": "凝血酶", "start_idx": 16, "type": "bod" }, { "end_idx": 38, "entity": "瑞士托霉素", "start_idx": 34, "type": "bod" }, { "end_idx": 42, "entity": "vWF", "start_idx": 40, "type": "bod" } ]
2.自幼有出血症状,表现为中度或重度皮肤、黏膜出血,可有月经过多,外伤手术后出血不止。
[ { "end_idx": 6, "entity": "出血", "start_idx": 5, "type": "sym" }, { "end_idx": 6, "entity": "血", "start_idx": 6, "type": "bod" }, { "end_idx": 24, "entity": "中度或重度皮肤、黏膜出血", "start_idx": 13, "type": "sym" }, { "end_idx": 19, "entity": "皮肤", "start_idx": 18, "type": "bod" }, { "end_idx": 22, "entity": "黏膜", "start_idx": 21, "type": "bod" }, { "end_idx": 24, "entity": "血", "start_idx": 24, "type": "bod" }, { "end_idx": 31, "entity": "月经过多", "start_idx": 28, "type": "sym" }, { "end_idx": 29, "entity": "月经", "start_idx": 28, "type": "bod" }, { "end_idx": 41, "entity": "外伤手术后出血不止", "start_idx": 33, "type": "sym" }, { "end_idx": 36, "entity": "外伤手术", "start_idx": 33, "type": "pro" }, { "end_idx": 39, "entity": "血", "start_idx": 39, "type": "bod" } ]
4.血小板聚集试验:加ADP、肾上腺素、胶原、凝血酶、花生四烯酸均不引起聚集;少数加胶原、花生四烯酸、凝血酶有聚集反应。
[ { "end_idx": 8, "entity": "血小板聚集试验", "start_idx": 2, "type": "pro" }, { "end_idx": 13, "entity": "ADP", "start_idx": 11, "type": "bod" }, { "end_idx": 18, "entity": "肾上腺素", "start_idx": 15, "type": "bod" }, { "end_idx": 21, "entity": "胶原", "start_idx": 20, "type": "bod" }, { "end_idx": 25, "entity": "凝血酶", "start_idx": 23, "type": "bod" }, { "end_idx": 31, "entity": "花生四烯酸", "start_idx": 27, "type": "bod" }, { "end_idx": 43, "entity": "胶原", "start_idx": 42, "type": "bod" }, { "end_idx": 49, "entity": "花生四烯酸", "start_idx": 45, "type": "bod" }, { "end_idx": 53, "entity": "凝血酶", "start_idx": 51, "type": "bod" } ]
肿瘤多生长于皮下组织或横纹肌内,多见于下肢,尤其股部和腹股沟、头面部、纵隔、腹膜后和骨盆内也可发生。
[ { "end_idx": 1, "entity": "肿瘤", "start_idx": 0, "type": "dis" }, { "end_idx": 9, "entity": "皮下组织", "start_idx": 6, "type": "bod" }, { "end_idx": 14, "entity": "横纹肌内", "start_idx": 11, "type": "bod" }, { "end_idx": 20, "entity": "下肢", "start_idx": 19, "type": "bod" }, { "end_idx": 25, "entity": "股部", "start_idx": 24, "type": "bod" }, { "end_idx": 29, "entity": "腹股沟", "start_idx": 27, "type": "bod" }, { "end_idx": 33, "entity": "头面部", "start_idx": 31, "type": "bod" }, { "end_idx": 36, "entity": "纵隔", "start_idx": 35, "type": "bod" }, { "end_idx": 40, "entity": "腹膜后", "start_idx": 38, "type": "bod" }, { "end_idx": 44, "entity": "骨盆内", "start_idx": 42, "type": "bod" } ]
肿瘤为缓慢生长的无痛性肿块,血管丰富,故局部温度可略有增高,有时有微弱搏动,但上述情况很少引起注意,肿瘤可伴发低血糖、男性化表现,原因不明。
[ { "end_idx": 1, "entity": "肿瘤", "start_idx": 0, "type": "dis" }, { "end_idx": 12, "entity": "无痛性肿块", "start_idx": 8, "type": "sym" }, { "end_idx": 12, "entity": "肿块", "start_idx": 11, "type": "bod" }, { "end_idx": 15, "entity": "血管", "start_idx": 14, "type": "bod" }, { "end_idx": 28, "entity": "局部温度可略有增高", "start_idx": 20, "type": "sym" }, { "end_idx": 36, "entity": "有时有微弱搏动", "start_idx": 30, "type": "sym" }, { "end_idx": 51, "entity": "肿瘤", "start_idx": 50, "type": "dis" }, { "end_idx": 63, "entity": "伴发低血糖、男性化表现", "start_idx": 53, "type": "sym" } ]
对恶性的手术后要放、化疗,但其疗效无统一意见。
[ { "end_idx": 5, "entity": "手术", "start_idx": 4, "type": "pro" }, { "end_idx": 11, "entity": "放、化疗", "start_idx": 8, "type": "pro" } ]
临床特征为骨骼肌活动后容易疲劳,休息或使用胆碱酯酶抑制剂可以缓解。
[ { "end_idx": 14, "entity": "骨骼肌活动后容易疲劳", "start_idx": 5, "type": "sym" }, { "end_idx": 7, "entity": "骨骼肌", "start_idx": 5, "type": "bod" }, { "end_idx": 31, "entity": "休息或使用胆碱酯酶抑制剂可以缓解", "start_idx": 16, "type": "sym" }, { "end_idx": 27, "entity": "使用胆碱酯酶抑制剂", "start_idx": 19, "type": "pro" } ]
本病可见于任何年龄,既往认为有两个高峰年龄,第一个高峰年龄为20~40岁,女性多见;第二个高峰年龄在40~60岁,以男性多见,多合并胸腺瘤。
[ { "end_idx": 68, "entity": "胸腺瘤", "start_idx": 66, "type": "dis" } ]
其临床特征为唾液肿大,尤以腮腺肿大最常见,可并发脑膜脑炎、睾丸炎、胰腺炎和其他腺体受累。
[ { "end_idx": 9, "entity": "唾液肿大", "start_idx": 6, "type": "sym" }, { "end_idx": 7, "entity": "唾液", "start_idx": 6, "type": "bod" }, { "end_idx": 14, "entity": "腮腺", "start_idx": 13, "type": "bod" }, { "end_idx": 16, "entity": "腮腺肿大", "start_idx": 13, "type": "sym" }, { "end_idx": 27, "entity": "脑膜脑炎", "start_idx": 24, "type": "dis" }, { "end_idx": 31, "entity": "睾丸炎", "start_idx": 29, "type": "dis" }, { "end_idx": 35, "entity": "胰腺炎", "start_idx": 33, "type": "dis" }, { "end_idx": 42, "entity": "其他腺体受累", "start_idx": 37, "type": "sym" }, { "end_idx": 40, "entity": "腺体", "start_idx": 39, "type": "bod" } ]
腮腺导管口红肿有助诊断。
[ { "end_idx": 4, "entity": "腮腺导管口", "start_idx": 0, "type": "bod" }, { "end_idx": 6, "entity": "腮腺导管口红肿", "start_idx": 0, "type": "sym" } ]
发热多为中度,可为高热,热程一般3~7天,约20%体温正常。
[ { "end_idx": 5, "entity": "发热多为中度", "start_idx": 0, "type": "sym" }, { "end_idx": 10, "entity": "高热", "start_idx": 9, "type": "sym" } ]
表现为发热、头痛、呕吐、颈项强直,很少出现惊厥。
[ { "end_idx": 4, "entity": "发热", "start_idx": 3, "type": "sym" }, { "end_idx": 7, "entity": "头痛", "start_idx": 6, "type": "sym" }, { "end_idx": 6, "entity": "头", "start_idx": 6, "type": "bod" }, { "end_idx": 10, "entity": "呕吐", "start_idx": 9, "type": "sym" }, { "end_idx": 13, "entity": "颈项", "start_idx": 12, "type": "bod" }, { "end_idx": 15, "entity": "颈项强直", "start_idx": 12, "type": "sym" }, { "end_idx": 22, "entity": "惊厥", "start_idx": 21, "type": "dis" } ]
患者突起发热、寒战、头痛、恶心、呕吐和下腹痛。
[ { "end_idx": 5, "entity": "发热", "start_idx": 4, "type": "sym" }, { "end_idx": 8, "entity": "寒战", "start_idx": 7, "type": "sym" }, { "end_idx": 11, "entity": "头痛", "start_idx": 10, "type": "sym" }, { "end_idx": 10, "entity": "头", "start_idx": 10, "type": "bod" }, { "end_idx": 14, "entity": "恶心", "start_idx": 13, "type": "sym" }, { "end_idx": 17, "entity": "呕吐", "start_idx": 16, "type": "sym" }, { "end_idx": 21, "entity": "下腹痛", "start_idx": 19, "type": "sym" }, { "end_idx": 20, "entity": "下腹", "start_idx": 19, "type": "bod" } ]
睾丸肿胀、疼痛和变硬,随着体温消退疼痛和肿胀消失,而坚硬可持续较久。
[ { "end_idx": 1, "entity": "睾丸", "start_idx": 0, "type": "bod" }, { "end_idx": 9, "entity": "睾丸肿胀、疼痛和变硬", "start_idx": 0, "type": "sym" }, { "end_idx": 32, "entity": "随着体温消退疼痛和肿胀消失,而坚硬可持续较久", "start_idx": 11, "type": "sym" } ]
患者突起上腹疼痛和紧张感,伴发热、寒战、软弱、反复呕吐。
[ { "end_idx": 11, "entity": "突起上腹疼痛和紧张感", "start_idx": 2, "type": "sym" }, { "end_idx": 5, "entity": "上腹", "start_idx": 4, "type": "bod" }, { "end_idx": 15, "entity": "发热", "start_idx": 14, "type": "sym" }, { "end_idx": 18, "entity": "寒战", "start_idx": 17, "type": "sym" }, { "end_idx": 21, "entity": "软弱", "start_idx": 20, "type": "sym" }, { "end_idx": 26, "entity": "反复呕吐", "start_idx": 23, "type": "sym" } ]
还可见甲状腺炎、乳腺炎、泪腺炎、关节炎、肝炎、间质性肺炎、肾炎、心肌炎和神经炎等表现。
[ { "end_idx": 6, "entity": "甲状腺炎", "start_idx": 3, "type": "dis" }, { "end_idx": 10, "entity": "乳腺炎", "start_idx": 8, "type": "dis" }, { "end_idx": 14, "entity": "泪腺炎", "start_idx": 12, "type": "dis" }, { "end_idx": 18, "entity": "关节炎", "start_idx": 16, "type": "dis" }, { "end_idx": 21, "entity": "肝炎", "start_idx": 20, "type": "dis" }, { "end_idx": 27, "entity": "间质性肺炎", "start_idx": 23, "type": "dis" }, { "end_idx": 30, "entity": "肾炎", "start_idx": 29, "type": "dis" }, { "end_idx": 34, "entity": "心肌炎", "start_idx": 32, "type": "dis" }, { "end_idx": 38, "entity": "神经炎", "start_idx": 36, "type": "dis" } ]
病菌从腮腺口侵入,患者有高热,腮腺部位红肿、压痛,挤压后可见脓液自腮腺口流出。
[ { "end_idx": 1, "entity": "病菌", "start_idx": 0, "type": "mic" }, { "end_idx": 5, "entity": "腮腺口", "start_idx": 3, "type": "bod" }, { "end_idx": 13, "entity": "高热", "start_idx": 12, "type": "sym" }, { "end_idx": 37, "entity": "腮腺部位红肿、压痛,挤压后可见脓液自腮腺口流出", "start_idx": 15, "type": "sym" }, { "end_idx": 18, "entity": "腮腺部位", "start_idx": 15, "type": "bod" }, { "end_idx": 31, "entity": "脓液", "start_idx": 30, "type": "bod" }, { "end_idx": 35, "entity": "腮腺口", "start_idx": 33, "type": "bod" } ]
急性期注意休息,补充水分和营养,给予流质和软食,避免摄入酸性饮食;高热者给以退热剂或物理降温;腮腺肿痛时,给予镇痛剂,也可局部温敷(因人而异)。
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咯血是本病的重要症状,少数可咯出咖啡色颗粒状物,常为曲菌球脱落的碎片,此时镜检可找到菌丝。
[ { "end_idx": 1, "entity": "咯血", "start_idx": 0, "type": "dis" }, { "end_idx": 22, "entity": "少数可咯出咖啡色颗粒状物", "start_idx": 11, "type": "sym" }, { "end_idx": 33, "entity": "曲菌球脱落的碎片", "start_idx": 26, "type": "mic" }, { "end_idx": 43, "entity": "镜检可找到菌丝", "start_idx": 37, "type": "sym" }, { "end_idx": 38, "entity": "镜检", "start_idx": 37, "type": "pro" }, { "end_idx": 43, "entity": "菌丝", "start_idx": 42, "type": "mic" } ]
特征性的临床过程是咳黏液栓性痰、咯血、间断性发热、胸痛、反复肺炎。
[ { "end_idx": 14, "entity": "咳黏液栓性痰", "start_idx": 9, "type": "sym" }, { "end_idx": 14, "entity": "痰", "start_idx": 14, "type": "bod" }, { "end_idx": 17, "entity": "咯血", "start_idx": 16, "type": "dis" }, { "end_idx": 23, "entity": "间断性发热", "start_idx": 19, "type": "sym" }, { "end_idx": 26, "entity": "胸痛", "start_idx": 25, "type": "sym" }, { "end_idx": 25, "entity": "胸", "start_idx": 25, "type": "bod" }, { "end_idx": 31, "entity": "反复肺炎", "start_idx": 28, "type": "sym" }, { "end_idx": 30, "entity": "肺", "start_idx": 30, "type": "bod" } ]
X线表现为肺上野有短暂的浸润影,常伴有典型的黏液栓形成的分支状的阴影(指套征)和中心性支气管扩张征象。
[ { "end_idx": 1, "entity": "X线", "start_idx": 0, "type": "pro" }, { "end_idx": 14, "entity": "肺上野有短暂的浸润影", "start_idx": 5, "type": "sym" }, { "end_idx": 7, "entity": "肺上野", "start_idx": 5, "type": "bod" }, { "end_idx": 33, "entity": "典型的黏液栓形成的分支状的阴影", "start_idx": 19, "type": "sym" }, { "end_idx": 47, "entity": "中心性支气管扩张", "start_idx": 40, "type": "sym" }, { "end_idx": 45, "entity": "支气管", "start_idx": 43, "type": "bod" } ]
分为急性和慢性,急性和慢性肺部曲霉菌病的发生与机体免疫状态和基础疾病有关。
[ { "end_idx": 18, "entity": "急性和慢性肺部曲霉菌病", "start_idx": 8, "type": "dis" } ]
主要表现为发热、咳嗽,病变广泛或严重时可出现呼吸困难。
[ { "end_idx": 6, "entity": "发热", "start_idx": 5, "type": "sym" }, { "end_idx": 9, "entity": "咳嗽", "start_idx": 8, "type": "sym" }, { "end_idx": 25, "entity": "呼吸困难", "start_idx": 22, "type": "sym" } ]
慢性肺部曲霉菌病病程可长达数月甚至数年。
[ { "end_idx": 7, "entity": "慢性肺部曲霉菌病", "start_idx": 0, "type": "dis" } ]