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NEJM：食管贲门失弛缓症-案例报道

2015-12-17 chenshuo译 MedSci原创

食管CT胃镜食管贲门失弛缓症
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男性，63岁，既往有甲状腺功能减退病史，今因出现吞咽困难（固体食物或流质）10余年来未来院就诊。

男性，63岁，既往有甲状腺功能减退病史，今因出现吞咽困难（固体食物或流质）10余年来未来院就诊。




据该患者主诉，6个月前他的症状开始出现加重，并伴有体重下降约27Kg（60磅）。

胸部X线检查结果如图A所示（患者直立体位内部纵隔结构）。

CT成像扫描显示近端食管至胃食管交界处（图B为冠状面扫描，图C为截面视图，图D为矢状面扫描）。

胃镜检查显示食管内大量食物潴留并伴有明显地食管扩张，但未发现有狭窄或肿块的迹象。

根据该患者的临床症状及检查结果，会诊医师诊断其为食管贲门失弛缓症。

食管贲门失弛缓症一般是由食管下括约肌松弛受损引起的，最常见的临床症状为吞咽固体食物和流质食物出现困难。

针对该患者的情况，主治医生决定对其进行手术治疗并放置空肠营养管给予肠内营养支持。8个月后，该患者恢复良好，逐步开始自行进食，不久随即拔出空肠营养管。

原始出处：

Chinemerem Okwara, M.D，and David Cangemi, M.D.Achalasia with Megaesophagus.NEJM.2015


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    2015-12-28 gostraight

    #贲门#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1747126, encodeId=3c9b1e4712660, content=<a href='/topic/show?id=d9d192468dd' target=_blank style='color:#2F92EE;'>#贲门#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92468, encryptionId=d9d192468dd, topicName=贲门)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d50035925343, createdName=gostraight, createdTime=Mon Dec 28 17:26:00 CST 2015, time=2015-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60561, encodeId=e555605615f, content=是一篇不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:26:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60562, encodeId=b8f36056261, content=值得进一步关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=155, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:26:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60558, encodeId=620f6055844, content=不错，赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:25:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60559, encodeId=55a56055994, content=这篇文章有一定深度, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:25:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1821051, encodeId=a81a182105183, content=<a href='/topic/show?id=1f9110112431' target=_blank style='color:#2F92EE;'>#食管贲门失弛缓症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101124, encryptionId=1f9110112431, topicName=食管贲门失弛缓症)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKnILSXam1GxPwj04ylEzibYLFA2eGl5Ev02klt80JA0xejMPqrn0mYHNNnLEgyqYTPbicXpY3tn6SA/132, createdBy=38fd2500059, createdName=新生儿张玉军, createdTime=Wed Apr 13 03:26:00 CST 2016, time=2016-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=51881, encodeId=8f9751881da, content=吓到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fe261399236, createdName=xyfg98, createdTime=Mon Jan 04 22:17:00 CST 2016, time=2016-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=50192, encodeId=efaf50192ea, content=赞?, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fe261399236, createdName=xyfg98, createdTime=Tue Dec 29 15:16:00 CST 2015, time=2015-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=48297, encodeId=bb8e4829e2f, content=好文章，值得看。, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sat Dec 26 16:22:00 CST 2015, time=2015-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=46911, encodeId=0f5146911e8, content=赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Mon Dec 21 01:47:00 CST 2015, time=2015-12-21, status=1, ipAttribution=)]
    2016-01-27 doctording1

    是一篇不错的文章

    0

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    2016-01-27 doctording1

    值得进一步关注

    0

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    2016-01-27 doctording1

    不错，赞一个

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1747126, encodeId=3c9b1e4712660, content=<a href='/topic/show?id=d9d192468dd' target=_blank style='color:#2F92EE;'>#贲门#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92468, encryptionId=d9d192468dd, topicName=贲门)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d50035925343, createdName=gostraight, createdTime=Mon Dec 28 17:26:00 CST 2015, time=2015-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60561, encodeId=e555605615f, content=是一篇不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:26:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60562, encodeId=b8f36056261, content=值得进一步关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=155, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:26:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60558, encodeId=620f6055844, content=不错，赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:25:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60559, encodeId=55a56055994, content=这篇文章有一定深度, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:25:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1821051, encodeId=a81a182105183, content=<a href='/topic/show?id=1f9110112431' target=_blank style='color:#2F92EE;'>#食管贲门失弛缓症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101124, encryptionId=1f9110112431, topicName=食管贲门失弛缓症)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKnILSXam1GxPwj04ylEzibYLFA2eGl5Ev02klt80JA0xejMPqrn0mYHNNnLEgyqYTPbicXpY3tn6SA/132, createdBy=38fd2500059, createdName=新生儿张玉军, createdTime=Wed Apr 13 03:26:00 CST 2016, time=2016-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=51881, encodeId=8f9751881da, content=吓到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fe261399236, createdName=xyfg98, createdTime=Mon Jan 04 22:17:00 CST 2016, time=2016-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=50192, encodeId=efaf50192ea, content=赞?, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fe261399236, createdName=xyfg98, createdTime=Tue Dec 29 15:16:00 CST 2015, time=2015-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=48297, encodeId=bb8e4829e2f, content=好文章，值得看。, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sat Dec 26 16:22:00 CST 2015, time=2015-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=46911, encodeId=0f5146911e8, content=赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Mon Dec 21 01:47:00 CST 2015, time=2015-12-21, status=1, ipAttribution=)]
    2016-01-27 doctording1

    这篇文章有一定深度

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1747126, encodeId=3c9b1e4712660, content=<a href='/topic/show?id=d9d192468dd' target=_blank style='color:#2F92EE;'>#贲门#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92468, encryptionId=d9d192468dd, topicName=贲门)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d50035925343, createdName=gostraight, createdTime=Mon Dec 28 17:26:00 CST 2015, time=2015-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60561, encodeId=e555605615f, content=是一篇不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:26:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60562, encodeId=b8f36056261, content=值得进一步关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=155, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:26:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60558, encodeId=620f6055844, content=不错，赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:25:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60559, encodeId=55a56055994, content=这篇文章有一定深度, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:25:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1821051, encodeId=a81a182105183, content=<a href='/topic/show?id=1f9110112431' target=_blank style='color:#2F92EE;'>#食管贲门失弛缓症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101124, encryptionId=1f9110112431, topicName=食管贲门失弛缓症)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKnILSXam1GxPwj04ylEzibYLFA2eGl5Ev02klt80JA0xejMPqrn0mYHNNnLEgyqYTPbicXpY3tn6SA/132, createdBy=38fd2500059, createdName=新生儿张玉军, createdTime=Wed Apr 13 03:26:00 CST 2016, time=2016-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=51881, encodeId=8f9751881da, content=吓到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fe261399236, createdName=xyfg98, createdTime=Mon Jan 04 22:17:00 CST 2016, time=2016-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=50192, encodeId=efaf50192ea, content=赞?, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fe261399236, createdName=xyfg98, createdTime=Tue Dec 29 15:16:00 CST 2015, time=2015-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=48297, encodeId=bb8e4829e2f, content=好文章，值得看。, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sat Dec 26 16:22:00 CST 2015, time=2015-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=46911, encodeId=0f5146911e8, content=赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Mon Dec 21 01:47:00 CST 2015, time=2015-12-21, status=1, ipAttribution=)]
    2016-04-13 新生儿张玉军

    #食管贲门失弛缓症#

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1747126, encodeId=3c9b1e4712660, content=<a href='/topic/show?id=d9d192468dd' target=_blank style='color:#2F92EE;'>#贲门#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92468, encryptionId=d9d192468dd, topicName=贲门)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d50035925343, createdName=gostraight, createdTime=Mon Dec 28 17:26:00 CST 2015, time=2015-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60561, encodeId=e555605615f, content=是一篇不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:26:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60562, encodeId=b8f36056261, content=值得进一步关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=155, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:26:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60558, encodeId=620f6055844, content=不错，赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:25:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60559, encodeId=55a56055994, content=这篇文章有一定深度, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:25:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1821051, encodeId=a81a182105183, content=<a href='/topic/show?id=1f9110112431' target=_blank style='color:#2F92EE;'>#食管贲门失弛缓症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101124, encryptionId=1f9110112431, topicName=食管贲门失弛缓症)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKnILSXam1GxPwj04ylEzibYLFA2eGl5Ev02klt80JA0xejMPqrn0mYHNNnLEgyqYTPbicXpY3tn6SA/132, createdBy=38fd2500059, createdName=新生儿张玉军, createdTime=Wed Apr 13 03:26:00 CST 2016, time=2016-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=51881, encodeId=8f9751881da, content=吓到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fe261399236, createdName=xyfg98, createdTime=Mon Jan 04 22:17:00 CST 2016, time=2016-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=50192, encodeId=efaf50192ea, content=赞?, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fe261399236, createdName=xyfg98, createdTime=Tue Dec 29 15:16:00 CST 2015, time=2015-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=48297, encodeId=bb8e4829e2f, content=好文章，值得看。, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sat Dec 26 16:22:00 CST 2015, time=2015-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=46911, encodeId=0f5146911e8, content=赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Mon Dec 21 01:47:00 CST 2015, time=2015-12-21, status=1, ipAttribution=)]
    2016-01-04 xyfg98

    吓到了

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1747126, encodeId=3c9b1e4712660, content=<a href='/topic/show?id=d9d192468dd' target=_blank style='color:#2F92EE;'>#贲门#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92468, encryptionId=d9d192468dd, topicName=贲门)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d50035925343, createdName=gostraight, createdTime=Mon Dec 28 17:26:00 CST 2015, time=2015-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60561, encodeId=e555605615f, content=是一篇不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:26:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60562, encodeId=b8f36056261, content=值得进一步关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=155, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:26:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60558, encodeId=620f6055844, content=不错，赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:25:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60559, encodeId=55a56055994, content=这篇文章有一定深度, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:25:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1821051, encodeId=a81a182105183, content=<a href='/topic/show?id=1f9110112431' target=_blank style='color:#2F92EE;'>#食管贲门失弛缓症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101124, encryptionId=1f9110112431, topicName=食管贲门失弛缓症)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKnILSXam1GxPwj04ylEzibYLFA2eGl5Ev02klt80JA0xejMPqrn0mYHNNnLEgyqYTPbicXpY3tn6SA/132, createdBy=38fd2500059, createdName=新生儿张玉军, createdTime=Wed Apr 13 03:26:00 CST 2016, time=2016-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=51881, encodeId=8f9751881da, content=吓到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fe261399236, createdName=xyfg98, createdTime=Mon Jan 04 22:17:00 CST 2016, time=2016-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=50192, encodeId=efaf50192ea, content=赞?, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fe261399236, createdName=xyfg98, createdTime=Tue Dec 29 15:16:00 CST 2015, time=2015-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=48297, encodeId=bb8e4829e2f, content=好文章，值得看。, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sat Dec 26 16:22:00 CST 2015, time=2015-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=46911, encodeId=0f5146911e8, content=赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Mon Dec 21 01:47:00 CST 2015, time=2015-12-21, status=1, ipAttribution=)]
    2015-12-29 xyfg98

    赞?

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1747126, encodeId=3c9b1e4712660, content=<a href='/topic/show?id=d9d192468dd' target=_blank style='color:#2F92EE;'>#贲门#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92468, encryptionId=d9d192468dd, topicName=贲门)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d50035925343, createdName=gostraight, createdTime=Mon Dec 28 17:26:00 CST 2015, time=2015-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60561, encodeId=e555605615f, content=是一篇不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:26:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60562, encodeId=b8f36056261, content=值得进一步关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=155, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:26:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60558, encodeId=620f6055844, content=不错，赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:25:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60559, encodeId=55a56055994, content=这篇文章有一定深度, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:25:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1821051, encodeId=a81a182105183, content=<a href='/topic/show?id=1f9110112431' target=_blank style='color:#2F92EE;'>#食管贲门失弛缓症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101124, encryptionId=1f9110112431, topicName=食管贲门失弛缓症)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKnILSXam1GxPwj04ylEzibYLFA2eGl5Ev02klt80JA0xejMPqrn0mYHNNnLEgyqYTPbicXpY3tn6SA/132, createdBy=38fd2500059, createdName=新生儿张玉军, createdTime=Wed Apr 13 03:26:00 CST 2016, time=2016-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=51881, encodeId=8f9751881da, content=吓到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fe261399236, createdName=xyfg98, createdTime=Mon Jan 04 22:17:00 CST 2016, time=2016-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=50192, encodeId=efaf50192ea, content=赞?, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fe261399236, createdName=xyfg98, createdTime=Tue Dec 29 15:16:00 CST 2015, time=2015-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=48297, encodeId=bb8e4829e2f, content=好文章，值得看。, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sat Dec 26 16:22:00 CST 2015, time=2015-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=46911, encodeId=0f5146911e8, content=赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Mon Dec 21 01:47:00 CST 2015, time=2015-12-21, status=1, ipAttribution=)]
    2015-12-26 hixiaoluo

    好文章，值得看。

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=1747126, encodeId=3c9b1e4712660, content=<a href='/topic/show?id=d9d192468dd' target=_blank style='color:#2F92EE;'>#贲门#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92468, encryptionId=d9d192468dd, topicName=贲门)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d50035925343, createdName=gostraight, createdTime=Mon Dec 28 17:26:00 CST 2015, time=2015-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60561, encodeId=e555605615f, content=是一篇不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:26:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60562, encodeId=b8f36056261, content=值得进一步关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=155, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:26:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60558, encodeId=620f6055844, content=不错，赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:25:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=60559, encodeId=55a56055994, content=这篇文章有一定深度, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59121683644, createdName=doctording1, createdTime=Wed Jan 27 12:25:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1821051, encodeId=a81a182105183, content=<a href='/topic/show?id=1f9110112431' target=_blank style='color:#2F92EE;'>#食管贲门失弛缓症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101124, encryptionId=1f9110112431, topicName=食管贲门失弛缓症)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKnILSXam1GxPwj04ylEzibYLFA2eGl5Ev02klt80JA0xejMPqrn0mYHNNnLEgyqYTPbicXpY3tn6SA/132, createdBy=38fd2500059, createdName=新生儿张玉军, createdTime=Wed Apr 13 03:26:00 CST 2016, time=2016-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=51881, encodeId=8f9751881da, content=吓到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fe261399236, createdName=xyfg98, createdTime=Mon Jan 04 22:17:00 CST 2016, time=2016-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=50192, encodeId=efaf50192ea, content=赞?, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fe261399236, createdName=xyfg98, createdTime=Tue Dec 29 15:16:00 CST 2015, time=2015-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=48297, encodeId=bb8e4829e2f, content=好文章，值得看。, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sat Dec 26 16:22:00 CST 2015, time=2015-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=46911, encodeId=0f5146911e8, content=赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Mon Dec 21 01:47:00 CST 2015, time=2015-12-21, status=1, ipAttribution=)]
    2015-12-21 dhzzm

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