[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"$f65-g5LTUgHIk8dGZIHhGe2pKpxnfW0g-O4HGxk3yxcs":3,"$fzJq-L16BGiReZFdlp7_QsVhfGDPgHnTsfPGZXIGmFMw":8},{"code":4,"msg":5,"message":6,"data":6,"success":7},401,"认证失败，无法访问系统资源",null,false,{"code":9,"msg":10,"message":6,"data":11,"success":97},200,"操作成功",{"id":12,"name":13,"describes":6,"symptoms":6,"checkup":6,"treatment":6,"seoTitle":14,"seoKeywords":15,"seoDescription":16,"coverVertical":6,"coverAcross":6,"introduceClassifications":17,"departments":96},337," 糖尿病"," 糖尿病——症状、预防与治疗指南"," 糖尿病, 糖尿病症状, 糖尿病预防, 糖尿病治疗, 血糖控制, 糖尿病饮食, 糖尿病护理, 二型糖尿病, 一型糖尿病"," 了解糖尿病的症状、预防和治疗方法。本指南为您提供全面的糖尿病管理知识，帮助您有效控制血糖，保持健康。",[18,23,25,29,31,36,40,42,44,48,50,52,56,58,60,65,67,69,74,76,78,83,85,87,92,94],{"id":19,"classification":20,"description":21,"sort":22,"diseaseId":12},56890,"概述","\u003Cp>　　农药中毒性肾病(nephropathy due to pesticide intoxication)是指在农药生产、使用过程中经呼吸道、皮肤吸收或误服、自服农药所引起的肾脏损害。肾脏损害以肾小管变性为主，少数重症病例可至急性肾功能衰竭。临床上出现蛋白尿。\u003C/p>",0,{"id":24,"classification":20,"description":21,"sort":22,"diseaseId":12},82548,{"id":26,"classification":27,"description":28,"sort":22,"diseaseId":12},51774,"症状","\u003Cp>　　常见症状：咳嗽、咳痰、胸闷、气短、喘息、心悸、呼吸音减弱，偶有干湿性啰音或哮鸣音、心浊音界缩小或消失\u003C/p>",{"id":30,"classification":20,"description":21,"sort":22,"diseaseId":12},62363,{"id":32,"classification":33,"description":34,"sort":35,"diseaseId":12},51775,"检查","\u003Cp>　　检查项目：心脏血管超声检查、血液电解质检查、动脉血气分析、心电图、多普勒超声心动图、二维超声心动图、动态心电图（Holter监测）、血红蛋白浓度（HGB）、心音图检查、红细胞计数(RBC)、M型超声心动图（ME）、经食管超声心动图(TEE)\u003C/p>",1,{"id":37,"classification":38,"description":39,"sort":35,"diseaseId":12},56891,"病因","\u003Cp>　　因长时间或不当使用和接触各种农药均可引起中毒并导致肾脏损害。\u003C/p>\u003Cp>　　1.常用的有机磷农药\u003C/p>\u003Cp>　　有对硫磷、甲胺磷、敌敌畏、乐果、美曲膦脂、马拉硫磷等，其毒性作用依次降低。\u003C/p>\u003Cp>　　2.有机氯农药\u003C/p>\u003Cp>　　有机氯农药主要有DDT、六六六、氯丹等。此类农药主要引起中枢神经系统损害，出现癫痫样抽搐、昏迷，亦可发生肺炎、肺水肿。肾脏损害以肾小管变性为主，临床上出现蛋白尿，一般可恢复正常。治疗主要为保持呼吸道通畅，吸氧及应用安定抗惊厥。\u003C/p>\u003Cp>　　3.熏蒸类农药\u003C/p>\u003Cp>　　此类农药中卤代烃类熏蒸剂如溴甲烷、四氯化碳、1，2-二氯乙烷等中毒可引起中枢神经系统抑制作用，同时可引起肝、肾损害，严重者可发生急性肾衰竭。\u003C/p>\u003Cp>　　4.除草剂\u003C/p>\u003Cp>　　除草剂中含氮化合物为速效除草剂，主要有对草快(百草枯)、敌草快，有中等毒性，急性中毒时，早期出现胃肠道症状，继之出现肝、肾和心功能障碍。口服者可有口腔、咽部溃疡。肾脏损害以急性肾小管坏死常见，严重者可致中毒性肾病。\u003C/p>\u003Cp>\u003C/p>",{"id":41,"classification":38,"description":39,"sort":35,"diseaseId":12},82549,{"id":43,"classification":38,"description":39,"sort":35,"diseaseId":12},62364,{"id":45,"classification":27,"description":46,"sort":47,"diseaseId":12},56892,"\u003Cp>　　常见症状：呼吸气为蒜臭味、抽搐、大小便失禁、口吐白沫、眩晕、乏力、腹痛\u003C/p>\u003Cp>　　肾脏表现一般不重，主要为蛋白尿和镜下血尿，可有轻度的肾功能不全。肾外表现更为明显，主要为头晕、目眩，乏力、大汗淋漓、腹痛、震颤，重者出现全身抽搐，大小便失禁，肺水肿，可见两瞳孔缩小，口腔、鼻孔可见大量白色泡沫样分泌物及嗅到大蒜样气味等。 本病诊断不难，患者有农药接触史，出现有机磷中毒的典型临床表现，血中CHE活力显著降低，分泌物检查发现毒物即可确诊本病。\u003C/p>",2,{"id":49,"classification":27,"description":46,"sort":47,"diseaseId":12},82550,{"id":51,"classification":27,"description":46,"sort":47,"diseaseId":12},62365,{"id":53,"classification":33,"description":54,"sort":55,"diseaseId":12},62366,"\u003Cp>　　检查项目：胆碱酯酶、血清胆碱酯酶、尿液分析、尿道分泌物检查、血清尿素氮、碱性点彩红细胞计数\u003C/p>\u003Cp>　　1.尿液检查 可见蛋白尿及镜下血尿，偶有管型尿。\u003C/p>\u003Cp>　　2.血中胆碱酯酶(cholinesterase，CHE)活力测定 可发现CHE的活性降低，并可根据CHE活性的高低来判断中毒程度及预后。\u003C/p>\u003Cp>　　3.有机磷农药鉴定 可对患者呕吐物、分泌物及尿中的有机磷农药分解物进行测定，以发现毒物品种。 肾脏病理以肾小管损伤为主，可见肾小管细胞变性，肿胀和坏死。\u003C/p>",3,{"id":57,"classification":33,"description":54,"sort":55,"diseaseId":12},82551,{"id":59,"classification":33,"description":54,"sort":55,"diseaseId":12},56893,{"id":61,"classification":62,"description":63,"sort":64,"diseaseId":12},62367,"鉴别","\u003Cp>　　1.与阿片类药物中毒相鉴别\u003C/p>\u003Cp>　　阿片类药物常见的有阿片、吗啡、可待因、复方樟脑酊、罂粟碱、哌替啶、美沙酮、乙基吗啡，及毒品二醋吗啡等，此类药物具有镇痛、止咳、止泻、解痉、麻醉等作用，临床应用较广，但长期使用会产生依赖，一次性过量使用或频繁应用可引起中毒。\u003C/p>\u003Cp>　　轻度急性中毒患者表现为头晕、头痛、恶心、呕吐、兴奋或抑郁，或有幻觉、失去时间和空间感觉，还可伴便秘、尿潴留及血糖增高。重度中毒时有昏迷、针尖样瞳孔、高度呼吸抑制等三大特征。可先出现短暂兴奋症状，如呕吐、烦躁不安、谵妄、面色潮红、心动过速;但很快进入抑制期，面色苍白、发绀、感觉迟钝、肌肉无力、呼吸缓慢、昏睡、瞳孔明显缩小;进而昏迷，脊髓反射增强、常有惊厥、牙关紧闭、角弓反张，呼吸先变浅、慢，继之出现叹息样呼吸或潮式呼吸、肺水肿、发绀、四肢冷、体温下降、各种反射消失，锥体束征阳性;最后呼吸衰竭死亡。\u003C/p>\u003Cp>　　2.与生物毒素所致的急性肾小管坏死相鉴别\u003C/p>\u003Cp>　　引起急性肾小管坏死比较常见的生物毒素主要有：生鱼胆毒、毒蕈、蛇毒、蝎毒等。其主要临床表现与农药中毒近似，常引起神经及其他多系统改变，严重者导致急性肾小管坏死，应注意与本病相鉴别。\u003C/p>\u003Cp>　　3.与脑血管意外相鉴别\u003C/p>\u003Cp>　　多有高血压、动脉硬化病史，神经系统体征，头颅CT检查可助诊断。\u003C/p>",4,{"id":66,"classification":62,"description":63,"sort":64,"diseaseId":12},56894,{"id":68,"classification":62,"description":63,"sort":64,"diseaseId":12},82552,{"id":70,"classification":71,"description":72,"sort":73,"diseaseId":12},62368,"并发症","\u003Cp>　　主要并发全身多系统功能衰竭。\u003C/p>\u003Cp>　　多器官功能衰竭(MOF)是一种病因繁多、发病机制复杂、病死率极高的临床综合征。MOF是指机体在经受严重损害(如严重疾病、外伤、手术、感染、休克等)后，发生两个或两个以上器官功能障碍，甚至功能衰竭的综合征。MODS是与应激密切相关的急性全身性器官功能损害。\u003C/p>",5,{"id":75,"classification":71,"description":72,"sort":73,"diseaseId":12},56895,{"id":77,"classification":71,"description":72,"sort":73,"diseaseId":12},82553,{"id":79,"classification":80,"description":81,"sort":82,"diseaseId":12},62369,"预防","\u003Cp>　　严格掌握用药剂量及方法，并注意作好个人防护。用药期间要注意自我感觉，如有不适症状时应及时脱离现场，处理毒物并严密监测尿常规、尿酶、肾功能变化，以防发生肾毒性损害。注意检查尿，血，合理的的使用药物，治疗疾病养护肝肾，促进身体的功能性的恢复。积极预防疾病发生。\u003C/p>",6,{"id":84,"classification":80,"description":81,"sort":82,"diseaseId":12},56896,{"id":86,"classification":80,"description":81,"sort":82,"diseaseId":12},82554,{"id":88,"classification":89,"description":90,"sort":91,"diseaseId":12},56897,"治疗","\u003Cp>　　目前已有部分解毒药物可行特效治疗，但临床主要仍然是对症处理，如及时给予洗胃、加强利尿和用肾上腺皮质激素，必要时进行透析治疗。\u003C/p>\u003Cp>　　具体方法为：\u003C/p>\u003Cp>　　1.迅速去除毒物 立即离开中毒现场，大量清水或肥皂水冲洗污染的皮肤，反复洗胃、导泻等。\u003C/p>\u003Cp>　　2.解毒药物的使用 常用的有抗胆碱剂如阿托品，应大剂量、反复使用，肌注或静脉注射;胆碱酯酶复能剂如碘解磷定(解磷定)、氯解磷定(氯磷定)等均有效。\u003C/p>\u003Cp>　　3.对症治疗 维持呼吸功能，紧急处理休克、急性肺水肿及心脏骤停等，危重病人可输血或换血以补充胆碱酯酶及保证肾血流，防止肾衰的发生。对己发生肾功能衰竭者应按肾衰处理。\u003C/p>\u003Cp>　　\u003C/p>",7,{"id":93,"classification":89,"description":90,"sort":91,"diseaseId":12},62370,{"id":95,"classification":89,"description":90,"sort":91,"diseaseId":12},82555,[],true]