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曾有学者使用泼尼松治疗8例FSHD患者，但结果显示并无多大益处。 | [
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【预后】肌无力发展呈下降型，首先累及面部肌肉然后下移至肩胛肌及肱肌最后影响骨盆肢带肌，对患者的寿命无明显影响。 | [
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二、哮喘的诱因（一）呼吸道感染1.呼吸道病毒感染在婴幼儿期主要有呼吸道合胞病毒（RSV），其次为副流感病毒、流感病毒和腺病毒，其他如麻疹病毒、腮腺炎病毒、肠道病毒、脊髓灰质炎病毒偶尔可见。 | [
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年长儿多见鼻病毒感染。 | [
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2.支原体感染由于婴幼儿免疫系统不成熟，支原体可以引起婴幼儿呼吸道慢性感染，若处理不恰当，可以导致反复不愈的咳嗽和喘息。 | [
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3.呼吸道局灶性感染慢性鼻窦炎、鼻炎、中耳炎、慢性扁桃体炎，是常见的儿童上呼吸道慢性局灶性病变，一方面可以引起反复的感染，另一方面又可以通过神经反射引起反复的咳喘，需要对这些病灶进行及时处理。 | [
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（二）吸入过敏物质持续低浓度变应原吸入可以诱发慢性气道变应性炎症，促进气道高反应形成，但短时间吸入高浓度变应原可以诱发急性哮喘发作。 | [
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这类诱因诱发的哮喘发作较为突然，无上呼吸道感染症状，多数在环境中过敏原浓度较高的季节发作。 | [
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（三）胃食管反流由于解剖结构的原因，也有医源性因素（如应用氨茶碱、β受体兴奋药等）可以引起胃食管反流，在婴幼儿尤为多见，它是导致喘息反复不愈的重要原因之一。 | [
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临床上多表现为入睡中出现剧烈的咳嗽、喘息，平时有回奶或呕吐现象。 | [
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（四）其他吸入刺激性气体或剧烈运动、哭闹，以及油漆、煤烟、冷空气吸入均可作为非特异性刺激物诱发哮喘发作，其中油漆散发的气体可触发严重而持续的咳喘发作，应尽量避免。 | [
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剧烈运动、哭闹使呼吸运动加快，呼吸道温度降低或呼吸道内液体渗透压改变，而诱发哮喘发作。 | [
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三、抗胆碱能药物正常人的气道有静态张力，主要受胆碱能神经（迷走神经）的控制。 | [
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哮喘患儿可能由于气道上皮破坏，神经末梢暴露或其他原因，使胆碱能神经的张力及反射加强，是引起气道高反应的重要因素之一；临床常用的抗胆碱能药物主要为阿托品和溴化异丙托品。 | [
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阿托品为叔胺类复合物，脂溶性强，容易从黏膜吸收，可以口服给药；但由于其体内分布广泛，系统性不良反应较多；而且可以进入血脑屏障，引起疲劳、烦躁、头痛症状，目前已很少用于哮喘的治疗。 | [
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溴化异丙托品为季胺类化合物，水溶性强，不容易吸收，全身不良反应小，但局部作用强；而且对支气管平滑肌M受体的选择性强，对分泌腺的影响小，不易出现气道分泌物干结现象。 | [
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由于胆碱能神经在气道的分布不均匀，在大气道分布多，而在小气道分布少，因此应用抗胆碱药后，主要使大气道松弛；当大气道收缩明显时，才有一定的松弛作用。 | [
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β肾上腺素受体激动药则对大、小气道均有明显的松弛作用，这与抗胆碱药有所不同。 | [
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一般在哮喘治疗中抗胆碱药与β<sub>2</sub>受体激动剂合用而起到相互协同作用。 | [
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现有剂型为：①爱全乐pMDI：20μg/揿，1～2揿/次，3～4次/天；②爱全乐溶液：0.025%溶液，＜2岁0.5ml，＞2岁1ml，＜4次/天，喷射雾化吸入。 | [
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第八节新生儿呕吐呕吐是新生儿期常见症状，是一系列复杂的神经反射活动。 | [
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新生儿胃容量小、胃呈横位、贲门括约肌发育不完善、幽门括约肌发育较好、肠道蠕动的神经调节功能较差，由于这些解剖生理特点，新生儿容易发生呕吐。 | [
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【病因】（一）消化系统疾病各种消化系统疾病都可引起呕吐，主要有消化道先天畸形、梗阻、炎症、感染、出血、功能失调等。 | [
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"entity": "消化道先天畸形",
"start_idx": 31,
"type": "dis"
},
{
"end_idx": 40,
"entity": "梗阻",
"start_idx": 39,
"type": "dis"
},
{
"end_idx": 43,
"entity": "炎症",
"start_idx": 42,
"type": "dis"
},
{
"end_idx": 46,
"entity": "感染",
"start_idx": 45,
"type": "dis"
},
{
"end_idx": 49,
"entity": "出血",
"start_idx": 48,
"type": "sym"
},
{
"end_idx": 49,
"entity": "血",
"start_idx": 49,
"type": "bod"
},
{
"end_idx": 54,
"entity": "功能失调",
"start_idx": 51,
"type": "dis"
}
] |
1.消化系统功能紊乱如吞咽功能不协调、胃食管反流、贲门失弛缓症、幽门痉挛、胎粪性便秘、胎粪排出延迟等。 | [
{
"end_idx": 9,
"entity": "消化系统功能紊乱",
"start_idx": 2,
"type": "dis"
},
{
"end_idx": 17,
"entity": "吞咽功能不协调",
"start_idx": 11,
"type": "sym"
},
{
"end_idx": 23,
"entity": "胃食管反流",
"start_idx": 19,
"type": "dis"
},
{
"end_idx": 30,
"entity": "贲门失弛缓症",
"start_idx": 25,
"type": "dis"
},
{
"end_idx": 35,
"entity": "幽门痉挛",
"start_idx": 32,
"type": "dis"
},
{
"end_idx": 41,
"entity": "胎粪性便秘",
"start_idx": 37,
"type": "dis"
},
{
"end_idx": 48,
"entity": "胎粪排出延迟",
"start_idx": 43,
"type": "sym"
},
{
"end_idx": 44,
"entity": "胎粪",
"start_idx": 43,
"type": "bod"
}
] |
2.消化道黏膜受刺激如咽下综合征、胃出血、应激性溃疡、牛奶过敏等。 | [
{
"end_idx": 6,
"entity": "消化道黏膜",
"start_idx": 2,
"type": "bod"
},
{
"end_idx": 15,
"entity": "咽下综合征",
"start_idx": 11,
"type": "dis"
},
{
"end_idx": 19,
"entity": "胃出血",
"start_idx": 17,
"type": "dis"
},
{
"end_idx": 25,
"entity": "应激性溃疡",
"start_idx": 21,
"type": "dis"
},
{
"end_idx": 30,
"entity": "牛奶过敏",
"start_idx": 27,
"type": "sym"
}
] |
3.消化系统感染及炎症如急性胃炎、急性肠炎、坏死性小肠结肠炎、腹膜炎等。 | [
{
"end_idx": 7,
"entity": "消化系统感染",
"start_idx": 2,
"type": "dis"
},
{
"end_idx": 10,
"entity": "炎症",
"start_idx": 9,
"type": "dis"
},
{
"end_idx": 15,
"entity": "急性胃炎",
"start_idx": 12,
"type": "dis"
},
{
"end_idx": 20,
"entity": "急性肠炎",
"start_idx": 17,
"type": "dis"
},
{
"end_idx": 29,
"entity": "坏死性小肠结肠炎",
"start_idx": 22,
"type": "dis"
},
{
"end_idx": 33,
"entity": "腹膜炎",
"start_idx": 31,
"type": "dis"
}
] |
4.消化道梗阻多数为先天畸形所致。 | [
{
"end_idx": 6,
"entity": "消化道梗阻",
"start_idx": 2,
"type": "dis"
},
{
"end_idx": 13,
"entity": "先天畸形",
"start_idx": 10,
"type": "dis"
}
] |
少见疾病有嵌顿疝、肠套叠等。 | [
{
"end_idx": 7,
"entity": "嵌顿疝",
"start_idx": 5,
"type": "dis"
},
{
"end_idx": 11,
"entity": "肠套叠",
"start_idx": 9,
"type": "dis"
}
] |
（二）全身性疾病许多全身性疾病可引起呕吐，常见的有以下几方面：1.感染新生儿感染常引起呕吐，如败血症、呼吸道感染、泌尿系统感染等。 | [
{
"end_idx": 7,
"entity": "全身性疾病",
"start_idx": 3,
"type": "dis"
},
{
"end_idx": 14,
"entity": "全身性疾病",
"start_idx": 10,
"type": "dis"
},
{
"end_idx": 19,
"entity": "呕吐",
"start_idx": 18,
"type": "sym"
},
{
"end_idx": 34,
"entity": "感染",
"start_idx": 33,
"type": "dis"
},
{
"end_idx": 39,
"entity": "新生儿感染",
"start_idx": 35,
"type": "dis"
},
{
"end_idx": 44,
"entity": "呕吐",
"start_idx": 43,
"type": "sym"
},
{
"end_idx": 49,
"entity": "败血症",
"start_idx": 47,
"type": "dis"
},
{
"end_idx": 55,
"entity": "呼吸道感染",
"start_idx": 51,
"type": "dis"
},
{
"end_idx": 62,
"entity": "泌尿系统感染",
"start_idx": 57,
"type": "dis"
}
] |
2.颅内压增高引起颅内压增高的疾病多会导致呕吐，如中枢神经系统感染、脑水肿、脑积水、颅内出血、颅内肿瘤等。 | [
{
"end_idx": 6,
"entity": "颅内压增高",
"start_idx": 2,
"type": "dis"
},
{
"end_idx": 13,
"entity": "颅内压增高",
"start_idx": 9,
"type": "dis"
},
{
"end_idx": 22,
"entity": "呕吐",
"start_idx": 21,
"type": "sym"
},
{
"end_idx": 32,
"entity": "中枢神经系统感染",
"start_idx": 25,
"type": "dis"
},
{
"end_idx": 36,
"entity": "脑水肿",
"start_idx": 34,
"type": "dis"
},
{
"end_idx": 40,
"entity": "脑积水",
"start_idx": 38,
"type": "dis"
},
{
"end_idx": 45,
"entity": "颅内出血",
"start_idx": 42,
"type": "dis"
},
{
"end_idx": 50,
"entity": "颅内肿瘤",
"start_idx": 47,
"type": "dis"
}
] |
3.先天性代谢性疾病一些先天性代谢性疾病由于代谢紊乱而导致呕吐，如氨基酸代谢疾病（高氨血症、苯丙酮尿症、甘氨酸血症）、糖代谢疾病（半乳糖血症、枫糖尿症）、肾上腺皮质增生症等。 | [
{
"end_idx": 9,
"entity": "先天性代谢性疾病",
"start_idx": 2,
"type": "dis"
},
{
"end_idx": 19,
"entity": "先天性代谢性疾病",
"start_idx": 12,
"type": "dis"
},
{
"end_idx": 25,
"entity": "代谢紊乱",
"start_idx": 22,
"type": "dis"
},
{
"end_idx": 30,
"entity": "呕吐",
"start_idx": 29,
"type": "sym"
},
{
"end_idx": 39,
"entity": "氨基酸代谢疾病",
"start_idx": 33,
"type": "dis"
},
{
"end_idx": 44,
"entity": "高氨血症",
"start_idx": 41,
"type": "dis"
},
{
"end_idx": 50,
"entity": "苯丙酮尿症",
"start_idx": 46,
"type": "dis"
},
{
"end_idx": 56,
"entity": "甘氨酸血症",
"start_idx": 52,
"type": "dis"
},
{
"end_idx": 63,
"entity": "糖代谢疾病",
"start_idx": 59,
"type": "dis"
},
{
"end_idx": 69,
"entity": "半乳糖血症",
"start_idx": 65,
"type": "dis"
},
{
"end_idx": 74,
"entity": "枫糖尿症",
"start_idx": 71,
"type": "dis"
},
{
"end_idx": 84,
"entity": "肾上腺皮质增生症",
"start_idx": 77,
"type": "dis"
}
] |
（三）其他因素一些疾病因素也可引起新生儿呕吐。 | [
{
"end_idx": 21,
"entity": "呕吐",
"start_idx": 20,
"type": "sym"
}
] |
2.药物许多药物可引起消化道反应，发生呕吐，如红霉素、两性霉素B等。 | [
{
"end_idx": 13,
"entity": "消化道",
"start_idx": 11,
"type": "bod"
},
{
"end_idx": 15,
"entity": "消化道反应",
"start_idx": 11,
"type": "sym"
},
{
"end_idx": 20,
"entity": "呕吐",
"start_idx": 19,
"type": "sym"
},
{
"end_idx": 25,
"entity": "红霉素",
"start_idx": 23,
"type": "dru"
},
{
"end_idx": 31,
"entity": "两性霉素B",
"start_idx": 27,
"type": "dru"
}
] |
【临床特点】（一）溢乳和喂养不当1.溢乳新生儿溢乳比较常见，但溢乳没有神经反射参与，不属于真正的呕吐。 | [
{
"end_idx": 10,
"entity": "溢乳",
"start_idx": 9,
"type": "sym"
},
{
"end_idx": 19,
"entity": "溢乳",
"start_idx": 18,
"type": "sym"
},
{
"end_idx": 24,
"entity": "溢乳",
"start_idx": 23,
"type": "sym"
},
{
"end_idx": 32,
"entity": "溢乳",
"start_idx": 31,
"type": "sym"
},
{
"end_idx": 36,
"entity": "神经",
"start_idx": 35,
"type": "bod"
},
{
"end_idx": 49,
"entity": "呕吐",
"start_idx": 48,
"type": "sym"
}
] |
溢乳的原因与食管弹力组织和肌肉发育不完善有关。 | [
{
"end_idx": 1,
"entity": "溢乳",
"start_idx": 0,
"type": "sym"
},
{
"end_idx": 11,
"entity": "食管弹力组织",
"start_idx": 6,
"type": "bod"
},
{
"end_idx": 19,
"entity": "食管弹力组织和肌肉发育不完善",
"start_idx": 6,
"type": "sym"
},
{
"end_idx": 14,
"entity": "肌肉",
"start_idx": 13,
"type": "bod"
}
] |
溢乳多发生在喂奶后不久，乳汁从口角边溢出，喂奶后体位改变可引起溢乳。 | [
{
"end_idx": 1,
"entity": "溢乳",
"start_idx": 0,
"type": "sym"
},
{
"end_idx": 7,
"entity": "奶",
"start_idx": 7,
"type": "bod"
},
{
"end_idx": 13,
"entity": "乳汁",
"start_idx": 12,
"type": "bod"
},
{
"end_idx": 19,
"entity": "乳汁从口角边溢出",
"start_idx": 12,
"type": "sym"
},
{
"end_idx": 17,
"entity": "口角边",
"start_idx": 15,
"type": "bod"
},
{
"end_idx": 24,
"entity": "体",
"start_idx": 24,
"type": "bod"
},
{
"end_idx": 32,
"entity": "溢乳",
"start_idx": 31,
"type": "sym"
}
] |
2.喂养不当新生儿喂养不当非常多见，主要原因有：喂奶次数过于频繁，喂奶量太多，浓度不适合，牛乳太热或太凉，配方乳多变；奶嘴孔过大或过小，乳母乳头下陷；喂奶后平卧，体位多动。 | [
{
"end_idx": 73,
"entity": "乳头下陷",
"start_idx": 70,
"type": "sym"
},
{
"end_idx": 71,
"entity": "乳头",
"start_idx": 70,
"type": "bod"
}
] |
（二）与内科疾病有关的呕吐1.吞咽功能不协调喂奶时即呕吐，常伴有呛咳或吸入，一部分乳汁从鼻孔流出。 | [
{
"end_idx": 5,
"entity": "内科",
"start_idx": 4,
"type": "dep"
},
{
"end_idx": 12,
"entity": "呕吐",
"start_idx": 11,
"type": "sym"
},
{
"end_idx": 21,
"entity": "吞咽功能不协调",
"start_idx": 15,
"type": "sym"
},
{
"end_idx": 27,
"entity": "喂奶时即呕吐",
"start_idx": 22,
"type": "sym"
},
{
"end_idx": 33,
"entity": "呛咳",
"start_idx": 32,
"type": "sym"
},
{
"end_idx": 36,
"entity": "吸入",
"start_idx": 35,
"type": "sym"
},
{
"end_idx": 45,
"entity": "鼻孔",
"start_idx": 44,
"type": "bod"
}
] |
2.胃食管反流（GER）是新生儿呕吐的常见原因，尤其是早产儿。 | [
{
"end_idx": 6,
"entity": "胃食管反流",
"start_idx": 2,
"type": "dis"
},
{
"end_idx": 10,
"entity": "GER",
"start_idx": 8,
"type": "dis"
},
{
"end_idx": 17,
"entity": "呕吐",
"start_idx": 16,
"type": "sym"
},
{
"end_idx": 29,
"entity": "早产儿",
"start_idx": 27,
"type": "dis"
}
] |
主要与新生儿食管下端括约肌较松弛、胃排空延迟、腹内压增高等因素有关。 | [
{
"end_idx": 12,
"entity": "食管下端括约肌",
"start_idx": 6,
"type": "bod"
},
{
"end_idx": 17,
"entity": "胃",
"start_idx": 17,
"type": "bod"
},
{
"end_idx": 27,
"entity": "腹内压增高",
"start_idx": 23,
"type": "dis"
}
] |
常在喂奶后不久出现呕吐或表现为溢乳，呕吐物常为不带胆汁的奶液。 | [
{
"end_idx": 10,
"entity": "呕吐",
"start_idx": 9,
"type": "sym"
},
{
"end_idx": 16,
"entity": "溢乳",
"start_idx": 15,
"type": "sym"
},
{
"end_idx": 20,
"entity": "呕吐物",
"start_idx": 18,
"type": "bod"
}
] |
3.胃黏膜受刺激出生时咽下羊水或产道血液，刺激胃黏膜引起呕吐。 | [
{
"end_idx": 4,
"entity": "胃黏膜",
"start_idx": 2,
"type": "bod"
},
{
"end_idx": 14,
"entity": "羊水",
"start_idx": 13,
"type": "bod"
},
{
"end_idx": 19,
"entity": "产道血液",
"start_idx": 16,
"type": "bod"
},
{
"end_idx": 25,
"entity": "胃黏膜",
"start_idx": 23,
"type": "bod"
},
{
"end_idx": 29,
"entity": "呕吐",
"start_idx": 28,
"type": "sym"
}
] |
未开奶前即可出现呕吐，开奶后呕吐加重，呕吐物为泡沫样黏液或带血性，用生理盐水洗胃1～2次，呕吐即可停止。 | [
{
"end_idx": 9,
"entity": "呕吐",
"start_idx": 8,
"type": "sym"
},
{
"end_idx": 17,
"entity": "呕吐加重",
"start_idx": 14,
"type": "sym"
},
{
"end_idx": 31,
"entity": "呕吐物为泡沫样黏液或带血性",
"start_idx": 19,
"type": "sym"
},
{
"end_idx": 21,
"entity": "呕吐物",
"start_idx": 19,
"type": "bod"
},
{
"end_idx": 27,
"entity": "黏液",
"start_idx": 26,
"type": "bod"
},
{
"end_idx": 30,
"entity": "血",
"start_idx": 30,
"type": "bod"
},
{
"end_idx": 37,
"entity": "生理盐水",
"start_idx": 34,
"type": "dru"
},
{
"end_idx": 39,
"entity": "洗胃",
"start_idx": 38,
"type": "pro"
},
{
"end_idx": 46,
"entity": "呕吐",
"start_idx": 45,
"type": "sym"
}
] |
4.幽门痉挛为幽门神经肌肉功能暂时性失调所致，解剖结构无异常。 | [
{
"end_idx": 5,
"entity": "幽门痉挛",
"start_idx": 2,
"type": "dis"
},
{
"end_idx": 19,
"entity": "为幽门神经肌肉功能暂时性失调",
"start_idx": 6,
"type": "sym"
},
{
"end_idx": 12,
"entity": "幽门神经肌肉",
"start_idx": 7,
"type": "bod"
}
] |
呕吐常发生在生后2～3周，呈间隙性，可为喷射状，呕吐物不含胆汁，与幽门肥厚性狭窄较难鉴别，试用1∶1000阿托品可缓解。 | [
{
"end_idx": 1,
"entity": "呕吐",
"start_idx": 0,
"type": "sym"
},
{
"end_idx": 22,
"entity": "喷射状",
"start_idx": 20,
"type": "sym"
},
{
"end_idx": 30,
"entity": "呕吐物不含胆汁",
"start_idx": 24,
"type": "sym"
},
{
"end_idx": 26,
"entity": "呕吐物",
"start_idx": 24,
"type": "bod"
},
{
"end_idx": 39,
"entity": "幽门肥厚性狭窄",
"start_idx": 33,
"type": "dis"
},
{
"end_idx": 55,
"entity": "1∶1000阿托品",
"start_idx": 47,
"type": "dru"
}
] |
5.胎粪延迟排出正常新生儿在生后24小时内开始排胎粪，3天排完。 | [
{
"end_idx": 7,
"entity": "胎粪延迟排出",
"start_idx": 2,
"type": "sym"
},
{
"end_idx": 3,
"entity": "胎粪",
"start_idx": 2,
"type": "bod"
},
{
"end_idx": 25,
"entity": "胎粪",
"start_idx": 24,
"type": "bod"
}
] |
6.感染性疾病肠道内感染或肠道外感染均可引起新生儿呕吐，常伴有感染表现如神萎、食欲缺乏，肠道内感染伴有腹泻、腹胀。 | [
{
"end_idx": 6,
"entity": "感染性疾病",
"start_idx": 2,
"type": "dis"
},
{
"end_idx": 11,
"entity": "肠道内感染",
"start_idx": 7,
"type": "dis"
},
{
"end_idx": 17,
"entity": "肠道外感染",
"start_idx": 13,
"type": "dis"
},
{
"end_idx": 26,
"entity": "呕吐",
"start_idx": 25,
"type": "sym"
},
{
"end_idx": 32,
"entity": "感染",
"start_idx": 31,
"type": "dis"
},
{
"end_idx": 37,
"entity": "神萎",
"start_idx": 36,
"type": "sym"
},
{
"end_idx": 42,
"entity": "食欲缺乏",
"start_idx": 39,
"type": "sym"
},
{
"end_idx": 48,
"entity": "肠道内感染",
"start_idx": 44,
"type": "dis"
},
{
"end_idx": 52,
"entity": "腹泻",
"start_idx": 51,
"type": "sym"
},
{
"end_idx": 51,
"entity": "腹",
"start_idx": 51,
"type": "bod"
},
{
"end_idx": 55,
"entity": "腹胀",
"start_idx": 54,
"type": "sym"
},
{
"end_idx": 54,
"entity": "腹",
"start_idx": 54,
"type": "bod"
}
] |
7.先天性代谢性疾病发生呕吐时间无规律性，一般呕吐较频繁和剧烈，常伴有其他代谢病的临床表现，如酸中毒、电解质紊乱、脱水、肝脾大等。 | [
{
"end_idx": 9,
"entity": "先天性代谢性疾病",
"start_idx": 2,
"type": "dis"
},
{
"end_idx": 13,
"entity": "呕吐",
"start_idx": 12,
"type": "sym"
},
{
"end_idx": 30,
"entity": "呕吐较频繁和剧烈",
"start_idx": 23,
"type": "sym"
},
{
"end_idx": 39,
"entity": "代谢病",
"start_idx": 37,
"type": "dis"
},
{
"end_idx": 49,
"entity": "酸中毒",
"start_idx": 47,
"type": "dis"
},
{
"end_idx": 55,
"entity": "电解质紊乱",
"start_idx": 51,
"type": "dis"
},
{
"end_idx": 58,
"entity": "脱水",
"start_idx": 57,
"type": "sym"
},
{
"end_idx": 62,
"entity": "肝脾大",
"start_idx": 60,
"type": "sym"
},
{
"end_idx": 60,
"entity": "肝",
"start_idx": 60,
"type": "bod"
},
{
"end_idx": 61,
"entity": "脾",
"start_idx": 61,
"type": "bod"
}
] |
（三）与外科疾病有关的呕吐1.食管闭锁和食管气管瘘食管闭锁者第一次喂奶（或喂水）时即发生呕吐，伴食管气管瘘者喂奶时出现呼吸困难、青紫，肺部闻湿啰音，每次喂奶时均出现类似情况。 | [
{
"end_idx": 5,
"entity": "外科",
"start_idx": 4,
"type": "dep"
},
{
"end_idx": 12,
"entity": "呕吐",
"start_idx": 11,
"type": "sym"
},
{
"end_idx": 18,
"entity": "食管闭锁",
"start_idx": 15,
"type": "dis"
},
{
"end_idx": 24,
"entity": "食管气管瘘",
"start_idx": 20,
"type": "dis"
},
{
"end_idx": 28,
"entity": "食管闭锁",
"start_idx": 25,
"type": "dis"
},
{
"end_idx": 45,
"entity": "呕吐",
"start_idx": 44,
"type": "sym"
},
{
"end_idx": 53,
"entity": "食管气管瘘者",
"start_idx": 48,
"type": "dis"
},
{
"end_idx": 62,
"entity": "呼吸困难",
"start_idx": 59,
"type": "sym"
},
{
"end_idx": 65,
"entity": "青紫",
"start_idx": 64,
"type": "sym"
},
{
"end_idx": 68,
"entity": "肺部",
"start_idx": 67,
"type": "bod"
},
{
"end_idx": 72,
"entity": "肺部闻湿啰音",
"start_idx": 67,
"type": "sym"
}
] |
2.幽门肥厚性狭窄常于生后第2周左右开始出现呕吐，呕吐量多，呕吐物为乳汁或乳凝块，酸臭味，无胆汁。 | [
{
"end_idx": 8,
"entity": "幽门肥厚性狭窄",
"start_idx": 2,
"type": "dis"
},
{
"end_idx": 23,
"entity": "呕吐",
"start_idx": 22,
"type": "sym"
},
{
"end_idx": 28,
"entity": "呕吐量多",
"start_idx": 25,
"type": "sym"
},
{
"end_idx": 32,
"entity": "呕吐物",
"start_idx": 30,
"type": "bod"
},
{
"end_idx": 47,
"entity": "呕吐物为乳汁或乳凝块，酸臭味，无胆汁",
"start_idx": 30,
"type": "sym"
},
{
"end_idx": 47,
"entity": "胆汁",
"start_idx": 46,
"type": "bod"
}
] |
呕吐常呈进行性加重，伴脱水、电解质紊乱、营养不良。 | [
{
"end_idx": 8,
"entity": "呕吐常呈进行性加重",
"start_idx": 0,
"type": "sym"
},
{
"end_idx": 12,
"entity": "脱水",
"start_idx": 11,
"type": "sym"
},
{
"end_idx": 18,
"entity": "电解质紊乱",
"start_idx": 14,
"type": "dis"
},
{
"end_idx": 23,
"entity": "营养不良",
"start_idx": 20,
"type": "dis"
}
] |
腹部可见明显的胃型，右上腹可触及枣核大小的肿块。 | [
{
"end_idx": 1,
"entity": "腹部",
"start_idx": 0,
"type": "bod"
},
{
"end_idx": 8,
"entity": "腹部可见明显的胃型",
"start_idx": 0,
"type": "sym"
},
{
"end_idx": 7,
"entity": "胃",
"start_idx": 7,
"type": "bod"
},
{
"end_idx": 12,
"entity": "右上腹",
"start_idx": 10,
"type": "bod"
},
{
"end_idx": 22,
"entity": "右上腹可触及枣核大小的肿块",
"start_idx": 10,
"type": "sym"
}
] |
3.十二指肠和小肠疾病患儿常有严重呕吐，呕吐物有绿色胆汁，位置较高者生后不久即呕吐，腹胀不明显，位置较低者呕吐出现晚一些，呕吐物为棕色粪便样物质，混有深色胆汁，腹胀明显，肠鸣音活跃，可见肠型、肠蠕动波。 | [
{
"end_idx": 10,
"entity": "十二指肠和小肠疾病",
"start_idx": 2,
"type": "dis"
},
{
"end_idx": 18,
"entity": "严重呕吐",
"start_idx": 15,
"type": "sym"
},
{
"end_idx": 27,
"entity": "呕吐物有绿色胆汁",
"start_idx": 20,
"type": "sym"
},
{
"end_idx": 22,
"entity": "呕吐物",
"start_idx": 20,
"type": "bod"
},
{
"end_idx": 27,
"entity": "胆汁",
"start_idx": 26,
"type": "bod"
},
{
"end_idx": 40,
"entity": "呕吐",
"start_idx": 39,
"type": "sym"
},
{
"end_idx": 46,
"entity": "腹胀不明显",
"start_idx": 42,
"type": "sym"
},
{
"end_idx": 42,
"entity": "腹",
"start_idx": 42,
"type": "bod"
},
{
"end_idx": 54,
"entity": "呕吐",
"start_idx": 53,
"type": "sym"
},
{
"end_idx": 71,
"entity": "呕吐物为棕色粪便样物质",
"start_idx": 61,
"type": "sym"
},
{
"end_idx": 63,
"entity": "呕吐物",
"start_idx": 61,
"type": "bod"
},
{
"end_idx": 68,
"entity": "粪便",
"start_idx": 67,
"type": "bod"
},
{
"end_idx": 78,
"entity": "混有深色胆汁",
"start_idx": 73,
"type": "sym"
},
{
"end_idx": 78,
"entity": "胆汁",
"start_idx": 77,
"type": "bod"
},
{
"end_idx": 83,
"entity": "腹胀明显",
"start_idx": 80,
"type": "sym"
},
{
"end_idx": 80,
"entity": "腹",
"start_idx": 80,
"type": "bod"
},
{
"end_idx": 89,
"entity": "肠鸣音活跃",
"start_idx": 85,
"type": "sym"
},
{
"end_idx": 85,
"entity": "肠",
"start_idx": 85,
"type": "bod"
},
{
"end_idx": 99,
"entity": "可见肠型、肠蠕动波",
"start_idx": 91,
"type": "sym"
},
{
"end_idx": 93,
"entity": "肠",
"start_idx": 93,
"type": "bod"
},
{
"end_idx": 96,
"entity": "肠",
"start_idx": 96,
"type": "bod"
}
] |
4.直肠肛门疾病一般先有腹胀，后出现呕吐，肠鸣音活跃，腹部平片显示肠腔扩张，多个液平。 | [
{
"end_idx": 7,
"entity": "直肠肛门疾病",
"start_idx": 2,
"type": "dis"
},
{
"end_idx": 13,
"entity": "腹胀",
"start_idx": 12,
"type": "sym"
},
{
"end_idx": 12,
"entity": "腹",
"start_idx": 12,
"type": "bod"
},
{
"end_idx": 19,
"entity": "呕吐",
"start_idx": 18,
"type": "sym"
},
{
"end_idx": 25,
"entity": "肠鸣音活跃",
"start_idx": 21,
"type": "sym"
},
{
"end_idx": 21,
"entity": "肠",
"start_idx": 21,
"type": "bod"
},
{
"end_idx": 30,
"entity": "腹部平片",
"start_idx": 27,
"type": "pro"
},
{
"end_idx": 41,
"entity": "腹部平片显示肠腔扩张，多个液平",
"start_idx": 27,
"type": "sym"
},
{
"end_idx": 34,
"entity": "肠腔",
"start_idx": 33,
"type": "bod"
}
] |
先天性巨结肠患儿生后便秘，灌肠后腹胀减轻。 | [
{
"end_idx": 5,
"entity": "先天性巨结肠",
"start_idx": 0,
"type": "dis"
},
{
"end_idx": 11,
"entity": "便秘",
"start_idx": 10,
"type": "sym"
},
{
"end_idx": 14,
"entity": "灌肠",
"start_idx": 13,
"type": "pro"
},
{
"end_idx": 19,
"entity": "腹胀减轻",
"start_idx": 16,
"type": "sym"
},
{
"end_idx": 16,
"entity": "腹",
"start_idx": 16,
"type": "bod"
}
] |
（四）呕吐所致的并发症新生儿呕吐时常发生一些并发症，需密切注意。 | [
{
"end_idx": 4,
"entity": "呕吐",
"start_idx": 3,
"type": "sym"
},
{
"end_idx": 15,
"entity": "呕吐",
"start_idx": 14,
"type": "sym"
}
] |
1.窒息与猝死新生儿呕吐会使呕吐物进入呼吸道，发生窒息，如呕吐物多、没有及时发现可导致猝死。 | [
{
"end_idx": 3,
"entity": "窒息",
"start_idx": 2,
"type": "dis"
},
{
"end_idx": 6,
"entity": "猝死",
"start_idx": 5,
"type": "dis"
},
{
"end_idx": 11,
"entity": "呕吐",
"start_idx": 10,
"type": "sym"
},
{
"end_idx": 16,
"entity": "呕吐物",
"start_idx": 14,
"type": "bod"
},
{
"end_idx": 21,
"entity": "呕吐物进入呼吸道",
"start_idx": 14,
"type": "sym"
},
{
"end_idx": 21,
"entity": "呼吸道",
"start_idx": 19,
"type": "bod"
},
{
"end_idx": 26,
"entity": "窒息",
"start_idx": 25,
"type": "dis"
},
{
"end_idx": 31,
"entity": "呕吐物",
"start_idx": 29,
"type": "bod"
},
{
"end_idx": 32,
"entity": "呕吐物多",
"start_idx": 29,
"type": "sym"
},
{
"end_idx": 44,
"entity": "猝死",
"start_idx": 43,
"type": "dis"
}
] |
2.吸入综合征呕吐物进入气道可发生吸入性肺炎，出现咳嗽、呼吸困难，长时间反复吸入可使吸入性肺炎迁延不愈。 | [
{
"end_idx": 6,
"entity": "吸入综合征",
"start_idx": 2,
"type": "dis"
},
{
"end_idx": 9,
"entity": "呕吐物",
"start_idx": 7,
"type": "bod"
},
{
"end_idx": 13,
"entity": "呕吐物进入气道",
"start_idx": 7,
"type": "sym"
},
{
"end_idx": 13,
"entity": "气道",
"start_idx": 12,
"type": "bod"
},
{
"end_idx": 21,
"entity": "吸入性肺炎",
"start_idx": 17,
"type": "dis"
},
{
"end_idx": 26,
"entity": "咳嗽",
"start_idx": 25,
"type": "sym"
},
{
"end_idx": 31,
"entity": "呼吸困难",
"start_idx": 28,
"type": "sym"
},
{
"end_idx": 46,
"entity": "吸入性肺炎",
"start_idx": 42,
"type": "dis"
}
] |
3.呼吸暂停早产儿呕吐可发生呼吸暂停。 | [
{
"end_idx": 5,
"entity": "呼吸暂停",
"start_idx": 2,
"type": "dis"
},
{
"end_idx": 8,
"entity": "早产儿",
"start_idx": 6,
"type": "dis"
},
{
"end_idx": 10,
"entity": "呕吐",
"start_idx": 9,
"type": "sym"
},
{
"end_idx": 17,
"entity": "呼吸暂停",
"start_idx": 14,
"type": "dis"
}
] |
4.出血剧烈呕吐可导致胃黏膜损伤，发生出血，呕吐物呈血性。 | [
{
"end_idx": 3,
"entity": "出血",
"start_idx": 2,
"type": "sym"
},
{
"end_idx": 3,
"entity": "血",
"start_idx": 3,
"type": "bod"
},
{
"end_idx": 7,
"entity": "剧烈呕吐",
"start_idx": 4,
"type": "sym"
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{
"end_idx": 15,
"entity": "胃黏膜损伤",
"start_idx": 11,
"type": "dis"
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{
"end_idx": 20,
"entity": "出血",
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"type": "sym"
},
{
"end_idx": 20,
"entity": "血",
"start_idx": 20,
"type": "bod"
},
{
"end_idx": 27,
"entity": "呕吐物呈血性",
"start_idx": 22,
"type": "sym"
},
{
"end_idx": 24,
"entity": "呕吐物",
"start_idx": 22,
"type": "bod"
},
{
"end_idx": 26,
"entity": "血",
"start_idx": 26,
"type": "bod"
}
] |
5.水电解质紊乱呕吐较频繁者，因丧失大量水分和电解质，导致水电解质平衡紊乱，患儿出现脱水、酸中毒、低钠血症等。 | [
{
"end_idx": 7,
"entity": "水电解质紊乱",
"start_idx": 2,
"type": "dis"
},
{
"end_idx": 12,
"entity": "呕吐较频繁",
"start_idx": 8,
"type": "sym"
},
{
"end_idx": 25,
"entity": "丧失大量水分和电解质",
"start_idx": 16,
"type": "sym"
},
{
"end_idx": 25,
"entity": "电解质",
"start_idx": 23,
"type": "bod"
},
{
"end_idx": 36,
"entity": "水电解质平衡紊乱",
"start_idx": 29,
"type": "dis"
},
{
"end_idx": 43,
"entity": "脱水",
"start_idx": 42,
"type": "sym"
},
{
"end_idx": 47,
"entity": "酸中毒",
"start_idx": 45,
"type": "dis"
},
{
"end_idx": 52,
"entity": "低钠血症",
"start_idx": 49,
"type": "dis"
}
] |
【诊断与鉴别诊断】要详细询问病史，了解分娩时情况、发生呕吐的时间、呕吐特点、伴随症状等，仔细体格检查，初步考虑呕吐的定位和性质，并做进一步的检查，以明确诊断。 | [
{
"end_idx": 28,
"entity": "呕吐",
"start_idx": 27,
"type": "sym"
},
{
"end_idx": 34,
"entity": "呕吐",
"start_idx": 33,
"type": "sym"
},
{
"end_idx": 49,
"entity": "体格检查",
"start_idx": 46,
"type": "pro"
},
{
"end_idx": 56,
"entity": "呕吐",
"start_idx": 55,
"type": "sym"
}
] |
（一）定位根据呕吐发生的时间、呕吐特点、呕吐物、是否有腹胀、肠型、便秘等情况，初步判断消化道疾病的位置。 | [
{
"end_idx": 8,
"entity": "呕吐",
"start_idx": 7,
"type": "sym"
},
{
"end_idx": 16,
"entity": "呕吐",
"start_idx": 15,
"type": "sym"
},
{
"end_idx": 22,
"entity": "呕吐物",
"start_idx": 20,
"type": "bod"
},
{
"end_idx": 28,
"entity": "腹胀",
"start_idx": 27,
"type": "sym"
},
{
"end_idx": 27,
"entity": "腹",
"start_idx": 27,
"type": "bod"
},
{
"end_idx": 31,
"entity": "肠型",
"start_idx": 30,
"type": "sym"
},
{
"end_idx": 30,
"entity": "肠",
"start_idx": 30,
"type": "bod"
},
{
"end_idx": 34,
"entity": "便秘",
"start_idx": 33,
"type": "sym"
},
{
"end_idx": 47,
"entity": "消化道疾病",
"start_idx": 43,
"type": "dis"
}
] |
1.上消化道呕吐出现时间早，呕吐物为乳汁或乳凝块，不含胆汁，腹胀不明显。 | [
{
"end_idx": 5,
"entity": "上消化道",
"start_idx": 2,
"type": "bod"
},
{
"end_idx": 7,
"entity": "上消化道呕吐",
"start_idx": 2,
"type": "sym"
},
{
"end_idx": 23,
"entity": "呕吐物为乳汁或乳凝块",
"start_idx": 14,
"type": "sym"
},
{
"end_idx": 16,
"entity": "呕吐物",
"start_idx": 14,
"type": "bod"
},
{
"end_idx": 19,
"entity": "乳汁",
"start_idx": 18,
"type": "bod"
},
{
"end_idx": 23,
"entity": "乳凝块",
"start_idx": 21,
"type": "bod"
},
{
"end_idx": 28,
"entity": "胆汁",
"start_idx": 27,
"type": "bod"
},
{
"end_idx": 34,
"entity": "腹胀不明显",
"start_idx": 30,
"type": "sym"
},
{
"end_idx": 30,
"entity": "腹",
"start_idx": 30,
"type": "bod"
}
] |
2.下消化道生后1～2天即呕吐，呕吐物含较多胆汁，腹胀不明显，提示病变在十二指肠或空肠上段。 | [
{
"end_idx": 5,
"entity": "下消化道",
"start_idx": 2,
"type": "bod"
},
{
"end_idx": 14,
"entity": "呕吐",
"start_idx": 13,
"type": "sym"
},
{
"end_idx": 23,
"entity": "呕吐物含较多胆汁",
"start_idx": 16,
"type": "sym"
},
{
"end_idx": 18,
"entity": "呕吐物",
"start_idx": 16,
"type": "bod"
},
{
"end_idx": 23,
"entity": "胆汁",
"start_idx": 22,
"type": "bod"
},
{
"end_idx": 29,
"entity": "腹胀不明显",
"start_idx": 25,
"type": "sym"
},
{
"end_idx": 25,
"entity": "腹",
"start_idx": 25,
"type": "bod"
},
{
"end_idx": 44,
"entity": "病变在十二指肠或空肠上段",
"start_idx": 33,
"type": "sym"
},
{
"end_idx": 39,
"entity": "十二指肠",
"start_idx": 36,
"type": "bod"
},
{
"end_idx": 44,
"entity": "空肠上段",
"start_idx": 41,
"type": "bod"
}
] |
如呕吐物含黄绿色粪便样物质，腹部有较细的肠型和肠蠕动，提示病变在空肠下段或回肠。 | [
{
"end_idx": 12,
"entity": "呕吐物含黄绿色粪便样物质",
"start_idx": 1,
"type": "sym"
},
{
"end_idx": 3,
"entity": "呕吐物",
"start_idx": 1,
"type": "bod"
},
{
"end_idx": 9,
"entity": "粪便",
"start_idx": 8,
"type": "bod"
},
{
"end_idx": 25,
"entity": "腹部有较细的肠型和肠蠕动",
"start_idx": 14,
"type": "sym"
},
{
"end_idx": 15,
"entity": "腹部",
"start_idx": 14,
"type": "bod"
},
{
"end_idx": 20,
"entity": "肠",
"start_idx": 20,
"type": "bod"
},
{
"end_idx": 23,
"entity": "肠",
"start_idx": 23,
"type": "bod"
},
{
"end_idx": 38,
"entity": "病变在空肠下段或回肠",
"start_idx": 29,
"type": "sym"
},
{
"end_idx": 35,
"entity": "空肠下段",
"start_idx": 32,
"type": "bod"
},
{
"end_idx": 38,
"entity": "回肠",
"start_idx": 37,
"type": "bod"
}
] |
而直肠病变的呕吐常发生在出生3天以后，呕吐物含棕色粪便样物质，腹胀明显，肠型较粗大，可触及粪块。 | [
{
"end_idx": 4,
"entity": "直肠病变",
"start_idx": 1,
"type": "dis"
},
{
"end_idx": 7,
"entity": "呕吐",
"start_idx": 6,
"type": "sym"
},
{
"end_idx": 29,
"entity": "呕吐物含棕色粪便样物质",
"start_idx": 19,
"type": "sym"
},
{
"end_idx": 21,
"entity": "呕吐物",
"start_idx": 19,
"type": "bod"
},
{
"end_idx": 26,
"entity": "粪便",
"start_idx": 25,
"type": "bod"
},
{
"end_idx": 34,
"entity": "腹胀明显",
"start_idx": 31,
"type": "sym"
},
{
"end_idx": 31,
"entity": "腹",
"start_idx": 31,
"type": "bod"
},
{
"end_idx": 40,
"entity": "肠型较粗大",
"start_idx": 36,
"type": "sym"
},
{
"end_idx": 36,
"entity": "肠",
"start_idx": 36,
"type": "bod"
},
{
"end_idx": 46,
"entity": "可触及粪块",
"start_idx": 42,
"type": "sym"
},
{
"end_idx": 46,
"entity": "粪块",
"start_idx": 45,
"type": "bod"
}
] |
（二）定性为使呕吐原发病得到及时治疗，要鉴别是内科疾病还是外科疾病所致。 | [
{
"end_idx": 11,
"entity": "呕吐原发病",
"start_idx": 7,
"type": "dis"
},
{
"end_idx": 24,
"entity": "内科",
"start_idx": 23,
"type": "dep"
},
{
"end_idx": 30,
"entity": "外科",
"start_idx": 29,
"type": "dep"
}
] |
1.内科疾病呕吐症状不剧烈，呕吐次数不频繁，呕吐物常不含胆汁或粪便，有较明显的消化系统以外的症状和体征，常提示呕吐为内科疾病所致。 | [
{
"end_idx": 3,
"entity": "内科",
"start_idx": 2,
"type": "dep"
},
{
"end_idx": 12,
"entity": "呕吐症状不剧烈",
"start_idx": 6,
"type": "sym"
},
{
"end_idx": 20,
"entity": "呕吐次数不频繁",
"start_idx": 14,
"type": "sym"
},
{
"end_idx": 32,
"entity": "呕吐物常不含胆汁或粪便",
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},
{
"end_idx": 24,
"entity": "呕吐物",
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{
"end_idx": 29,
"entity": "胆汁",
"start_idx": 28,
"type": "bod"
},
{
"end_idx": 32,
"entity": "粪便",
"start_idx": 31,
"type": "bod"
},
{
"end_idx": 42,
"entity": "消化系统",
"start_idx": 39,
"type": "bod"
},
{
"end_idx": 56,
"entity": "呕吐",
"start_idx": 55,
"type": "sym"
},
{
"end_idx": 59,
"entity": "内科",
"start_idx": 58,
"type": "dep"
}
] |
2.外科疾病呕吐出现早，频繁，较剧烈，呕吐物含胆汁、血液或粪便，伴脱水和电解质紊乱，常提示呕吐为外科疾病所致。 | [
{
"end_idx": 3,
"entity": "外科",
"start_idx": 2,
"type": "dep"
},
{
"end_idx": 17,
"entity": "呕吐出现早，频繁，较剧烈",
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},
{
"end_idx": 30,
"entity": "呕吐物含胆汁、血液或粪便",
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},
{
"end_idx": 21,
"entity": "呕吐物",
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{
"end_idx": 24,
"entity": "胆汁",
"start_idx": 23,
"type": "bod"
},
{
"end_idx": 27,
"entity": "血液",
"start_idx": 26,
"type": "bod"
},
{
"end_idx": 30,
"entity": "粪便",
"start_idx": 29,
"type": "bod"
},
{
"end_idx": 34,
"entity": "脱水",
"start_idx": 33,
"type": "sym"
},
{
"end_idx": 40,
"entity": "电解质紊乱",
"start_idx": 36,
"type": "dis"
},
{
"end_idx": 46,
"entity": "呕吐",
"start_idx": 45,
"type": "sym"
},
{
"end_idx": 49,
"entity": "外科",
"start_idx": 48,
"type": "dep"
}
] |
（三）进一步检查对呕吐原发病的位置和性质有初步判断后，应及时做进一步的检查，以明确诊断。 | [
{
"end_idx": 13,
"entity": "呕吐原发病",
"start_idx": 9,
"type": "dis"
}
] |
1.消化道影像学检查对消化道先天畸形的诊断有很大的帮助。 | [
{
"end_idx": 9,
"entity": "消化道影像学检查",
"start_idx": 2,
"type": "pro"
},
{
"end_idx": 17,
"entity": "消化道先天畸形",
"start_idx": 11,
"type": "dis"
}
] |
对胃食管反流，可做放射性核素检查。 | [
{
"end_idx": 5,
"entity": "胃食管反流",
"start_idx": 1,
"type": "dis"
},
{
"end_idx": 15,
"entity": "放射性核素检查",
"start_idx": 9,
"type": "pro"
}
] |
对胃十二指肠、小肠部位的先天畸形，钡餐造影可帮助诊断，须注意检查结束时应洗胃，将胃内钡剂洗出，防止呕吐时钡剂。 | [
{
"end_idx": 15,
"entity": "胃十二指肠、小肠部位的先天畸形",
"start_idx": 1,
"type": "dis"
},
{
"end_idx": 20,
"entity": "钡餐造影",
"start_idx": 17,
"type": "pro"
},
{
"end_idx": 37,
"entity": "洗胃",
"start_idx": 36,
"type": "pro"
},
{
"end_idx": 41,
"entity": "胃内",
"start_idx": 40,
"type": "bod"
},
{
"end_idx": 43,
"entity": "钡剂",
"start_idx": 42,
"type": "dru"
},
{
"end_idx": 50,
"entity": "呕吐",
"start_idx": 49,
"type": "sym"
},
{
"end_idx": 53,
"entity": "钡剂",
"start_idx": 52,
"type": "dru"
}
] |
2.中枢神经系统检查如怀疑中枢感染，应查脑脊液，对颅内出血或其他占位病变，应做头颅B超或CT检查。 | [
{
"end_idx": 9,
"entity": "中枢神经系统检查",
"start_idx": 2,
"type": "pro"
},
{
"end_idx": 16,
"entity": "中枢感染",
"start_idx": 13,
"type": "dis"
},
{
"end_idx": 22,
"entity": "脑脊液",
"start_idx": 20,
"type": "bod"
},
{
"end_idx": 28,
"entity": "颅内出血",
"start_idx": 25,
"type": "dis"
},
{
"end_idx": 35,
"entity": "其他占位病变",
"start_idx": 30,
"type": "dis"
},
{
"end_idx": 42,
"entity": "头颅B超",
"start_idx": 39,
"type": "pro"
},
{
"end_idx": 47,
"entity": "CT检查",
"start_idx": 44,
"type": "pro"
}
] |
3.血气分析及生化检查可了解患儿是否存在酸中毒、电解质紊乱。 | [
{
"end_idx": 5,
"entity": "血气分析",
"start_idx": 2,
"type": "pro"
},
{
"end_idx": 10,
"entity": "生化检查",
"start_idx": 7,
"type": "ite"
},
{
"end_idx": 22,
"entity": "酸中毒",
"start_idx": 20,
"type": "dis"
},
{
"end_idx": 28,
"entity": "电解质紊乱",
"start_idx": 24,
"type": "dis"
}
] |
4.内分泌及遗传代谢病检查如已排除消化道、中枢神经等疾病，而患儿仍然频繁呕吐，应进一步做内分泌、代谢病方面检查，如血氨、血糖等。 | [
{
"end_idx": 12,
"entity": "内分泌及遗传代谢病检查",
"start_idx": 2,
"type": "pro"
},
{
"end_idx": 19,
"entity": "消化道",
"start_idx": 17,
"type": "bod"
},
{
"end_idx": 24,
"entity": "中枢神经",
"start_idx": 21,
"type": "bod"
},
{
"end_idx": 37,
"entity": "频繁呕吐",
"start_idx": 34,
"type": "sym"
},
{
"end_idx": 54,
"entity": "内分泌、代谢病方面检查",
"start_idx": 44,
"type": "pro"
},
{
"end_idx": 58,
"entity": "血氨",
"start_idx": 57,
"type": "ite"
},
{
"end_idx": 61,
"entity": "血糖",
"start_idx": 60,
"type": "ite"
}
] |
【治疗】（一）对症治疗1.禁食对一些病因未清楚、怀疑外科疾病、消化道出血，可先行禁食，以免加重病情，同时给予补液，保证营养供给。 | [
{
"end_idx": 14,
"entity": "禁食",
"start_idx": 13,
"type": "pro"
},
{
"end_idx": 27,
"entity": "外科",
"start_idx": 26,
"type": "dep"
},
{
"end_idx": 35,
"entity": "消化道出血",
"start_idx": 31,
"type": "dis"
},
{
"end_idx": 41,
"entity": "禁食",
"start_idx": 40,
"type": "pro"
},
{
"end_idx": 55,
"entity": "给予补液",
"start_idx": 52,
"type": "pro"
},
{
"end_idx": 62,
"entity": "保证营养供给",
"start_idx": 57,
"type": "pro"
}
] |
2.洗胃对咽下综合征可先洗胃，用温生理盐水，一般洗2～3次即可，如洗胃后仍呕吐，应考虑其他疾病。 | [
{
"end_idx": 3,
"entity": "洗胃",
"start_idx": 2,
"type": "pro"
},
{
"end_idx": 9,
"entity": "咽下综合征",
"start_idx": 5,
"type": "dis"
},
{
"end_idx": 13,
"entity": "洗胃",
"start_idx": 12,
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},
{
"end_idx": 20,
"entity": "温生理盐水",
"start_idx": 16,
"type": "dru"
},
{
"end_idx": 34,
"entity": "洗胃",
"start_idx": 33,
"type": "pro"
},
{
"end_idx": 38,
"entity": "呕吐",
"start_idx": 37,
"type": "sym"
}
] |
3.胃肠减压对外科疾病、呕吐较频繁、腹胀者，可先行胃肠减压，缓解症状，同时做有关检查。 | [
{
"end_idx": 5,
"entity": "胃肠减压",
"start_idx": 2,
"type": "pro"
},
{
"end_idx": 8,
"entity": "外科",
"start_idx": 7,
"type": "dep"
},
{
"end_idx": 16,
"entity": "呕吐较频繁",
"start_idx": 12,
"type": "sym"
},
{
"end_idx": 19,
"entity": "腹胀",
"start_idx": 18,
"type": "sym"
},
{
"end_idx": 18,
"entity": "腹",
"start_idx": 18,
"type": "bod"
},
{
"end_idx": 28,
"entity": "胃肠减压",
"start_idx": 25,
"type": "pro"
}
] |
4.解痉止吐对病因诊断为胃食管反流，可用胃动力制剂或解痉剂。 | [
{
"end_idx": 5,
"entity": "解痉止吐",
"start_idx": 2,
"type": "pro"
},
{
"end_idx": 16,
"entity": "胃食管反流",
"start_idx": 12,
"type": "dis"
},
{
"end_idx": 24,
"entity": "胃动力制剂",
"start_idx": 20,
"type": "dru"
},
{
"end_idx": 28,
"entity": "解痉剂",
"start_idx": 26,
"type": "dru"
}
] |
5.体位对呕吐患儿，应提高头部和上身的体位，一般30°左右。 | [
{
"end_idx": 6,
"entity": "呕吐",
"start_idx": 5,
"type": "sym"
},
{
"end_idx": 20,
"entity": "提高头部和上身的体位",
"start_idx": 11,
"type": "pro"
}
] |
6.纠正水、电解质紊乱呕吐导致水、电解质紊乱，应及时纠正。 | [
{
"end_idx": 10,
"entity": "水、电解质紊乱",
"start_idx": 4,
"type": "dis"
},
{
"end_idx": 12,
"entity": "呕吐",
"start_idx": 11,
"type": "sym"
},
{
"end_idx": 21,
"entity": "水、电解质紊乱",
"start_idx": 15,
"type": "dis"
}
] |
（二）病因治疗1.手术对外科疾病需手术治疗，手术时机根据病情而定。 | [
{
"end_idx": 10,
"entity": "手术",
"start_idx": 9,
"type": "pro"
},
{
"end_idx": 13,
"entity": "外科",
"start_idx": 12,
"type": "dep"
},
{
"end_idx": 20,
"entity": "手术治疗",
"start_idx": 17,
"type": "pro"
},
{
"end_idx": 23,
"entity": "手术",
"start_idx": 22,
"type": "pro"
}
] |
2.抗感染对消化道感染或其他部位感染所致者，应给抗生素治疗。 | [
{
"end_idx": 4,
"entity": "抗感染",
"start_idx": 2,
"type": "pro"
},
{
"end_idx": 10,
"entity": "消化道感染",
"start_idx": 6,
"type": "dis"
},
{
"end_idx": 17,
"entity": "感染",
"start_idx": 16,
"type": "dis"
},
{
"end_idx": 28,
"entity": "抗生素治疗",
"start_idx": 24,
"type": "pro"
}
] |
3.止血消化道出血者，可用维生素K<sub>1</sub>、酚磺乙胺等止血。 | [
{
"end_idx": 3,
"entity": "止血",
"start_idx": 2,
"type": "pro"
},
{
"end_idx": 8,
"entity": "消化道出血",
"start_idx": 4,
"type": "dis"
},
{
"end_idx": 16,
"entity": "维生素K",
"start_idx": 13,
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},
{
"end_idx": 33,
"entity": "酚磺乙胺",
"start_idx": 30,
"type": "dru"
},
{
"end_idx": 36,
"entity": "止血",
"start_idx": 35,
"type": "pro"
}
] |
4.解除颅内高压脑水肿者用20%甘露醇每次0.5g/kg，每6～8小时1次，呋塞米每次0.5mg/kg，每天1～2次。 | [
{
"end_idx": 7,
"entity": "解除颅内高压",
"start_idx": 2,
"type": "pro"
},
{
"end_idx": 10,
"entity": "脑水肿",
"start_idx": 8,
"type": "dis"
},
{
"end_idx": 18,
"entity": "20%甘露醇",
"start_idx": 13,
"type": "dru"
},
{
"end_idx": 40,
"entity": "呋塞米",
"start_idx": 38,
"type": "dru"
}
] |
颅内占位病变行手术治疗，脑积水行引流术。 | [
{
"end_idx": 5,
"entity": "颅内占位病变",
"start_idx": 0,
"type": "dis"
},
{
"end_idx": 10,
"entity": "手术治疗",
"start_idx": 7,
"type": "pro"
},
{
"end_idx": 14,
"entity": "脑积水",
"start_idx": 12,
"type": "dis"
},
{
"end_idx": 18,
"entity": "引流术",
"start_idx": 16,
"type": "pro"
}
] |
十、L型菌肺炎L型菌肺炎是临床上难治性呼吸道感染的病原体之一。 | [
{
"end_idx": 6,
"entity": "L型菌肺炎",
"start_idx": 2,
"type": "dis"
},
{
"end_idx": 11,
"entity": "L型菌肺炎",
"start_idx": 7,
"type": "dis"
},
{
"end_idx": 23,
"entity": "难治性呼吸道感染",
"start_idx": 16,
"type": "dis"
},
{
"end_idx": 27,
"entity": "病原体",
"start_idx": 25,
"type": "mic"
}
] |
患儿常有肺炎不能解释的迁延发热，或原发病已愈，找不到继续发热的原因。 | [
{
"end_idx": 5,
"entity": "肺炎",
"start_idx": 4,
"type": "dis"
},
{
"end_idx": 14,
"entity": "迁延发热",
"start_idx": 11,
"type": "sym"
},
{
"end_idx": 29,
"entity": "发热",
"start_idx": 28,
"type": "sym"
}
] |
病情多不重，β-内酰胺类抗生素治疗无效。 | [
{
"end_idx": 16,
"entity": "β-内酰胺类抗生素治疗",
"start_idx": 6,
"type": "pro"
}
] |
X线改变无特异性，多呈间质性肺炎改变。 | [
{
"end_idx": 1,
"entity": "X线",
"start_idx": 0,
"type": "pro"
},
{
"end_idx": 15,
"entity": "间质性肺炎",
"start_idx": 11,
"type": "dis"
}
] |
三、各型结核的治疗方案（表7-7）表7-1各型结核的治疗方案 | [
{
"end_idx": 10,
"entity": "结核的治疗方案",
"start_idx": 4,
"type": "pro"
},
{
"end_idx": 29,
"entity": "结核的治疗方案",
"start_idx": 23,
"type": "pro"
}
] |
第六章风湿性疾病相关的实验室检查风湿性疾病（rheumaticdiseases）包含一大类慢性全身性疾病，人们认识这类疾病经历了漫长的实践、变迁过程。 | [
{
"end_idx": 7,
"entity": "风湿性疾病",
"start_idx": 3,
"type": "dis"
},
{
"end_idx": 15,
"entity": "实验室检查",
"start_idx": 11,
"type": "pro"
},
{
"end_idx": 20,
"entity": "风湿性疾病",
"start_idx": 16,
"type": "dis"
},
{
"end_idx": 38,
"entity": "rheumaticdiseases",
"start_idx": 22,
"type": "dis"
},
{
"end_idx": 51,
"entity": "慢性全身性疾病",
"start_idx": 45,
"type": "dis"
}
] |
在命名上，西方与中国古代医学早有“风湿病”的名称，但两者在概念及内容上大相径庭，不可类比。 | [
{
"end_idx": 19,
"entity": "风湿病",
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}
] |
本章中“风湿性疾病”仅涉及现代医学的“风湿病”范畴。 | [
{
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西方医学中，经典称谓的风湿病泛指“以疼痛为核心的骨、关节及肌肉等慢性疾病”。 | [
{
"end_idx": 13,
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{
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"entity": "疼痛",
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},
{
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"entity": "骨",
"start_idx": 24,
"type": "bod"
},
{
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"entity": "关节",
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"type": "bod"
},
{
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"entity": "肌肉",
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"type": "bod"
},
{
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"entity": "慢性疾病",
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"type": "dis"
}
] |
至1941年Klemperer总结了系统性红斑狼疮和硬皮病经验以及Klinge的研究成果，认为风湿性疾病均为机体胶原组织病理损伤的结果，因此提出“胶原性疾病”的概念。 | [
{
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"entity": "系统性红斑狼疮",
"start_idx": 18,
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},
{
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"entity": "硬皮病",
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"type": "dis"
},
{
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"entity": "风湿性疾病",
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},
{
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"entity": "机体胶原组织病理损伤",
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},
{
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"entity": "机体胶原组织",
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},
{
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"entity": "胶原性疾病",
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但后来多数人认为风湿性疾病并不仅限于累及胶原组织，它可以是更广泛的结缔组织损伤。 | [
{
"end_idx": 12,
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{
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{
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},
{
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"entity": "结缔组织损伤",
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"type": "dis"
}
] |
为此Ehrich建议将“胶原性疾病”更名为“结缔组织病”，故此命名又沿用了几十年。 | [
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{
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"entity": "结缔组织病",
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] |