北医三院心外科研究称:小切口双侧乳内动脉不停跳多支血管搭桥近期效果良好

2018-02-27 xujing 中国循环杂志

北京大学第三医院凌云鹏等研究提示,经左前外侧小切口直视下可以成功获取双侧乳内动脉完成心脏不停跳多支CABG,近期临床效果良好。

北京大学第三医院凌云鹏等研究提示,经左前外侧小切口直视下可以成功获取双侧乳内动脉完成心脏不停跳多支CABG,近期临床效果良好。

研究者通过左前外侧小切口借助悬吊式乳内动脉牵开系统在直视下完成双侧乳内动脉获取,成功实施多支CABG,平均总手术时间[(332.2±45.3)min],略长于正中切口组[(246.7±56.2)min]。

而且小切口组术后呼吸机使用时间,监护室停留时间, 住院时间,围手术期死亡率、心肌梗死发生率以及切口愈合不良等并发症发生率均低于正中切口组。

小切口多支冠脉血管移植的切口位置选择非常重要,会影响术中血管的暴露。

研究者强调,在手术前需通过仔细阅读患者的X线胸片结合冠脉造影提示的LAD血管移植位置来选择合适的肋间入路,通常在左胸前外侧第4或5肋间,女性患者选择乳房下缘弧形切口,切开皮下组织和肌肉后根据情况选择第4或5肋间进入胸腔。

而且借助胸部CT 定位则更为精确,定好进胸的肋间之后,根据CT横断面上靶血管位置可以更为精确的定位切口在该肋间的具体位置及长度。

研究者采用的悬吊式乳内动脉牵开系统可多角度调整牵拉抬起左胸前壁,配合剑突下小切口置入的紧贴胸骨背面的牵引拉钩,通过对抗患者自身重量向上牵引胸壁,能获得较为良好的视野,使双侧乳内动脉近、远端均能得以显露。

原位右乳内动脉由于小切口下视野及操作受限用于右冠及左回旋支系统血管移植比较困难,对于单纯LAD、对角支病变,我们一般选择原位右乳内动脉-LAD、原位左乳内动脉-D 血管移植,较为方便。

但本研究38 例患者靶血管涉及LAD、第一对角支、第二对角支、钝圆支、左心室后支,冠脉血管移植方法有原位双乳内动脉桥、左乳内动脉-右乳内动脉“Y”形桥,左乳内动脉序贯桥。

两组的围手术期主要不良心脑血管事件发生率(0 % vs 1.69 %)、切口愈合不良发生率(0 % vs 0.84 %)无差异。

术后冠脉造影复查,两组均未见吻合口闭塞情况。平均随访3 个月,两组患者均无心绞痛或心肌梗死、死亡的发生。

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (6)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1813939, encodeId=5ff71813939f8, content=<a href='/topic/show?id=8010942e704' target=_blank style='color:#2F92EE;'>#近期效果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=15, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94277, encryptionId=8010942e704, topicName=近期效果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ed3112, createdName=echonoir, createdTime=Mon Apr 09 05:26:00 CST 2018, time=2018-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1943105, encodeId=bcc4194310582, content=<a href='/topic/show?id=ab47509385c' target=_blank style='color:#2F92EE;'>#心外科#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50938, encryptionId=ab47509385c, topicName=心外科)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6c32257, createdName=DEXTER3139, createdTime=Sun Apr 01 16:26:00 CST 2018, time=2018-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1663919, encodeId=c48c166391985, content=<a href='/topic/show?id=03a35691e2e' target=_blank style='color:#2F92EE;'>#搭桥#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56917, encryptionId=03a35691e2e, topicName=搭桥)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=557f25711234, createdName=12498b3em16(暂无昵称), createdTime=Fri Aug 24 22:26:00 CST 2018, time=2018-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2060928, encodeId=229e20609288b, content=<a href='/topic/show?id=fa39432e08b' target=_blank style='color:#2F92EE;'>#多支血管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43270, encryptionId=fa39432e08b, topicName=多支血管)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6105386, createdName=宋威, createdTime=Mon Oct 29 00:26:00 CST 2018, time=2018-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1457841, encodeId=d291145e8410d, content=<a href='/topic/show?id=e9053369ec1' target=_blank style='color:#2F92EE;'>#北医三院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33697, encryptionId=e9053369ec1, topicName=北医三院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e6115990449, createdName=amy0552, createdTime=Thu Mar 01 11:26:00 CST 2018, time=2018-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1522399, encodeId=84ff152239977, content=<a href='/topic/show?id=46223e39897' target=_blank style='color:#2F92EE;'>#双侧#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37398, encryptionId=46223e39897, topicName=双侧)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=741b11453403, createdName=wangbingxhy, createdTime=Thu Mar 01 11:26:00 CST 2018, time=2018-03-01, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1813939, encodeId=5ff71813939f8, content=<a href='/topic/show?id=8010942e704' target=_blank style='color:#2F92EE;'>#近期效果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=15, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94277, encryptionId=8010942e704, topicName=近期效果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ed3112, createdName=echonoir, createdTime=Mon Apr 09 05:26:00 CST 2018, time=2018-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1943105, encodeId=bcc4194310582, content=<a href='/topic/show?id=ab47509385c' target=_blank style='color:#2F92EE;'>#心外科#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50938, encryptionId=ab47509385c, topicName=心外科)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6c32257, createdName=DEXTER3139, createdTime=Sun Apr 01 16:26:00 CST 2018, time=2018-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1663919, encodeId=c48c166391985, content=<a href='/topic/show?id=03a35691e2e' target=_blank style='color:#2F92EE;'>#搭桥#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56917, encryptionId=03a35691e2e, topicName=搭桥)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=557f25711234, createdName=12498b3em16(暂无昵称), createdTime=Fri Aug 24 22:26:00 CST 2018, time=2018-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2060928, encodeId=229e20609288b, content=<a href='/topic/show?id=fa39432e08b' target=_blank style='color:#2F92EE;'>#多支血管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43270, encryptionId=fa39432e08b, topicName=多支血管)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6105386, createdName=宋威, createdTime=Mon Oct 29 00:26:00 CST 2018, time=2018-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1457841, encodeId=d291145e8410d, content=<a href='/topic/show?id=e9053369ec1' target=_blank style='color:#2F92EE;'>#北医三院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33697, encryptionId=e9053369ec1, topicName=北医三院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e6115990449, createdName=amy0552, createdTime=Thu Mar 01 11:26:00 CST 2018, time=2018-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1522399, encodeId=84ff152239977, content=<a href='/topic/show?id=46223e39897' target=_blank style='color:#2F92EE;'>#双侧#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37398, encryptionId=46223e39897, topicName=双侧)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=741b11453403, createdName=wangbingxhy, createdTime=Thu Mar 01 11:26:00 CST 2018, time=2018-03-01, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1813939, encodeId=5ff71813939f8, content=<a href='/topic/show?id=8010942e704' target=_blank style='color:#2F92EE;'>#近期效果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=15, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94277, encryptionId=8010942e704, topicName=近期效果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ed3112, createdName=echonoir, createdTime=Mon Apr 09 05:26:00 CST 2018, time=2018-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1943105, encodeId=bcc4194310582, content=<a href='/topic/show?id=ab47509385c' target=_blank style='color:#2F92EE;'>#心外科#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50938, encryptionId=ab47509385c, topicName=心外科)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6c32257, createdName=DEXTER3139, createdTime=Sun Apr 01 16:26:00 CST 2018, time=2018-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1663919, encodeId=c48c166391985, content=<a href='/topic/show?id=03a35691e2e' target=_blank style='color:#2F92EE;'>#搭桥#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56917, encryptionId=03a35691e2e, topicName=搭桥)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=557f25711234, createdName=12498b3em16(暂无昵称), createdTime=Fri Aug 24 22:26:00 CST 2018, time=2018-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2060928, encodeId=229e20609288b, content=<a href='/topic/show?id=fa39432e08b' target=_blank style='color:#2F92EE;'>#多支血管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43270, encryptionId=fa39432e08b, topicName=多支血管)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6105386, createdName=宋威, createdTime=Mon Oct 29 00:26:00 CST 2018, time=2018-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1457841, encodeId=d291145e8410d, content=<a href='/topic/show?id=e9053369ec1' target=_blank style='color:#2F92EE;'>#北医三院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33697, encryptionId=e9053369ec1, topicName=北医三院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e6115990449, createdName=amy0552, createdTime=Thu Mar 01 11:26:00 CST 2018, time=2018-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1522399, encodeId=84ff152239977, content=<a href='/topic/show?id=46223e39897' target=_blank style='color:#2F92EE;'>#双侧#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37398, encryptionId=46223e39897, topicName=双侧)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=741b11453403, createdName=wangbingxhy, createdTime=Thu Mar 01 11:26:00 CST 2018, time=2018-03-01, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1813939, encodeId=5ff71813939f8, content=<a href='/topic/show?id=8010942e704' target=_blank style='color:#2F92EE;'>#近期效果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=15, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94277, encryptionId=8010942e704, topicName=近期效果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ed3112, createdName=echonoir, createdTime=Mon Apr 09 05:26:00 CST 2018, time=2018-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1943105, encodeId=bcc4194310582, content=<a href='/topic/show?id=ab47509385c' target=_blank style='color:#2F92EE;'>#心外科#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50938, encryptionId=ab47509385c, topicName=心外科)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6c32257, createdName=DEXTER3139, createdTime=Sun Apr 01 16:26:00 CST 2018, time=2018-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1663919, encodeId=c48c166391985, content=<a href='/topic/show?id=03a35691e2e' target=_blank style='color:#2F92EE;'>#搭桥#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56917, encryptionId=03a35691e2e, topicName=搭桥)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=557f25711234, createdName=12498b3em16(暂无昵称), createdTime=Fri Aug 24 22:26:00 CST 2018, time=2018-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2060928, encodeId=229e20609288b, content=<a href='/topic/show?id=fa39432e08b' target=_blank style='color:#2F92EE;'>#多支血管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43270, encryptionId=fa39432e08b, topicName=多支血管)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6105386, createdName=宋威, createdTime=Mon Oct 29 00:26:00 CST 2018, time=2018-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1457841, encodeId=d291145e8410d, content=<a href='/topic/show?id=e9053369ec1' target=_blank style='color:#2F92EE;'>#北医三院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33697, encryptionId=e9053369ec1, topicName=北医三院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e6115990449, createdName=amy0552, createdTime=Thu Mar 01 11:26:00 CST 2018, time=2018-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1522399, encodeId=84ff152239977, content=<a href='/topic/show?id=46223e39897' target=_blank style='color:#2F92EE;'>#双侧#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37398, encryptionId=46223e39897, topicName=双侧)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=741b11453403, createdName=wangbingxhy, createdTime=Thu Mar 01 11:26:00 CST 2018, time=2018-03-01, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1813939, encodeId=5ff71813939f8, content=<a href='/topic/show?id=8010942e704' target=_blank style='color:#2F92EE;'>#近期效果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=15, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94277, encryptionId=8010942e704, topicName=近期效果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ed3112, createdName=echonoir, createdTime=Mon Apr 09 05:26:00 CST 2018, time=2018-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1943105, encodeId=bcc4194310582, content=<a href='/topic/show?id=ab47509385c' target=_blank style='color:#2F92EE;'>#心外科#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50938, encryptionId=ab47509385c, topicName=心外科)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6c32257, createdName=DEXTER3139, createdTime=Sun Apr 01 16:26:00 CST 2018, time=2018-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1663919, encodeId=c48c166391985, content=<a href='/topic/show?id=03a35691e2e' target=_blank style='color:#2F92EE;'>#搭桥#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56917, encryptionId=03a35691e2e, topicName=搭桥)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=557f25711234, createdName=12498b3em16(暂无昵称), createdTime=Fri Aug 24 22:26:00 CST 2018, time=2018-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2060928, encodeId=229e20609288b, content=<a href='/topic/show?id=fa39432e08b' target=_blank style='color:#2F92EE;'>#多支血管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43270, encryptionId=fa39432e08b, topicName=多支血管)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6105386, createdName=宋威, createdTime=Mon Oct 29 00:26:00 CST 2018, time=2018-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1457841, encodeId=d291145e8410d, content=<a href='/topic/show?id=e9053369ec1' target=_blank style='color:#2F92EE;'>#北医三院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33697, encryptionId=e9053369ec1, topicName=北医三院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e6115990449, createdName=amy0552, createdTime=Thu Mar 01 11:26:00 CST 2018, time=2018-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1522399, encodeId=84ff152239977, content=<a href='/topic/show?id=46223e39897' target=_blank style='color:#2F92EE;'>#双侧#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37398, encryptionId=46223e39897, topicName=双侧)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=741b11453403, createdName=wangbingxhy, createdTime=Thu Mar 01 11:26:00 CST 2018, time=2018-03-01, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1813939, encodeId=5ff71813939f8, content=<a href='/topic/show?id=8010942e704' target=_blank style='color:#2F92EE;'>#近期效果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=15, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94277, encryptionId=8010942e704, topicName=近期效果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ed3112, createdName=echonoir, createdTime=Mon Apr 09 05:26:00 CST 2018, time=2018-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1943105, encodeId=bcc4194310582, content=<a href='/topic/show?id=ab47509385c' target=_blank style='color:#2F92EE;'>#心外科#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50938, encryptionId=ab47509385c, topicName=心外科)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6c32257, createdName=DEXTER3139, createdTime=Sun Apr 01 16:26:00 CST 2018, time=2018-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1663919, encodeId=c48c166391985, content=<a href='/topic/show?id=03a35691e2e' target=_blank style='color:#2F92EE;'>#搭桥#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56917, encryptionId=03a35691e2e, topicName=搭桥)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=557f25711234, createdName=12498b3em16(暂无昵称), createdTime=Fri Aug 24 22:26:00 CST 2018, time=2018-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2060928, encodeId=229e20609288b, content=<a href='/topic/show?id=fa39432e08b' target=_blank style='color:#2F92EE;'>#多支血管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43270, encryptionId=fa39432e08b, topicName=多支血管)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6105386, createdName=宋威, createdTime=Mon Oct 29 00:26:00 CST 2018, time=2018-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1457841, encodeId=d291145e8410d, content=<a href='/topic/show?id=e9053369ec1' target=_blank style='color:#2F92EE;'>#北医三院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33697, encryptionId=e9053369ec1, topicName=北医三院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e6115990449, createdName=amy0552, createdTime=Thu Mar 01 11:26:00 CST 2018, time=2018-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1522399, encodeId=84ff152239977, content=<a href='/topic/show?id=46223e39897' target=_blank style='color:#2F92EE;'>#双侧#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37398, encryptionId=46223e39897, topicName=双侧)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=741b11453403, createdName=wangbingxhy, createdTime=Thu Mar 01 11:26:00 CST 2018, time=2018-03-01, status=1, ipAttribution=)]