Ann Emerg Med:皮肤脓肿切开引流后是否还需常规冲洗(附评论)?

2015-10-06 MedSci译 MedSci原创

Ann Emerg Med:皮肤脓肿切开引流后是否还需常规冲洗?据今日发表于《急诊医学年鉴》的一项新的研究(“皮肤脓肿冲洗并不会改善治疗的结果”)表明,皮肤脓肿紧急切开引流后常规冲洗脓腔并不会对下一步的治疗起到任何的作用,因此脓肿切开引流后没必要对脓腔进行冲洗。美国急诊部每年有100万余名皮肤脓肿患者需要接受切开引流治疗。“尽管并未有研究支持皮肤脓肿切开引流后应进行冲洗,但是脓腔冲洗早已成为脓肿切

据今日发表于《急诊医学年鉴》的一项新的研究(“皮肤脓肿冲洗并不会改善治疗的结果”)表明,皮肤脓肿紧急切开引流后常规冲洗脓腔并不会对下一步的治疗起到任何的作用,因此脓肿切开引流后没必要对脓腔进行冲洗。

美国急诊部每年有100万余名皮肤脓肿患者需要接受切开引流治疗。

“尽管并未有研究支持皮肤脓肿切开引流后应进行冲洗,但是脓腔冲洗早已成为脓肿切开引流治疗的常规部分,”该研究的第一作者Brian Chinnock说道,“接受切开引流后脓腔冲洗的患者与未接受脓腔冲洗的患者相比,二者在下一步的干预治疗上并无差别。”

该研究发现,15%接受切开引流后常规冲洗脓腔的皮肤脓肿患者需要接受进一步的干预治疗,而13%未接受常规冲洗的患者需要接受进一步的干预治疗。两组之间的疼痛得分并无显著差异。
“脓腔冲洗的缺点是增加了治疗的时间,提高了患者的医疗费用,也增加了伤口周围细菌感染的风险,” Dr. Chinnock说道,“基于本研究的结果,我们认为脓腔冲洗不应作为皮肤脓肿切开引流治疗标准的一部分。


梅斯医学(MedSci)小编后记——

看上去实在没有什么技术含量的研究,也能发表这样的期刊,原因何在?灵感何来?日常我们大量的“经验”“常规”,真的有必要吗,真的靠谱吗?医学是动态变化的过程,药物越来越好,治疗模式,理念与方法也会随之而变,经验可以随时被打破。例如,在2000年前冠心病患者是无药可医,最好的方式是冠脉搭桥(CABG),然而,2000年后,冠脉介入(PCI)大行其道,冠脉问题立时解决,一夜之间,风行全球。然后,随着深入研究发现,多支血管病变与单支病变时,CABG与PCI可能存在不同的适应症。然而,进一步发现,如今的很多冠心病患者,其实药物的疗效也不差也,可能并不比PCI差多少(AIM:冠心病患者治疗选择:介入还是药物?
)!同样争议,也会出现在脑卒中(Stroke:药物与介入联合药物治疗卒中 孰优?(SAMMPRIS试验亚组) )。这就是医学发展带来观念的改变。再如,胆囊术后,要不要掉一点抗生素,术后抗感染,是临床常规,但是偏偏有学者不信邪,做了个研究,发了个JAMA(JAMA:抗生素不降低胆囊切除术后感染发生风险),其实不仅仅是胆囊,其它手术也类似,如CMAJ:膝关节和髋关节术后应用抗生素真的有效吗?。再如,肿瘤早期筛查,以前认为越早越好,这样可以发现大量早期肿瘤,获得良好的治疗机会。后来发现,早期筛选对肺癌,结肠癌(JAMA:高质量的结肠镜筛查可降低死亡率)等有用,对于乳腺癌,前列腺癌,甲状腺癌的最终治疗并没有明显的帮助作用,因为这些肿瘤相对进展较慢,晚一点发现,可能少承受一些心里压力,结果是一样的,早期筛查,可能有过度筛查的嫌疑(停止PSA筛查后,前列腺癌诊断数量下降 )。然而,近来观念又变化了,对于乳腺癌,甲状腺癌中某些进展迅速的亚型应该早期筛查。同样,在心血管和内分泌领域,最佳的血压和血糖水平是多少,争吵了很多年,还没有定论。

总之,科学在发展,观念在更新和细化。所以,小问题不小,经验需要不断被打破,常规同样如此,临床灵感往往源于些。


原始出处:

Chinnock B, Hendey GW.Irrigation of Cutaneous Abscesses Does Not Improve Treatment Success. Ann Emerg Med. 2015 Sep 10. pii: S0196-0644(15)01188-9.

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    2015-10-08 I+am+super

    感觉还是冲洗下比较好

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1739920, encodeId=738d1e39920b9, content=<a href='/topic/show?id=f49c310e134' target=_blank style='color:#2F92EE;'>#冲洗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31071, encryptionId=f49c310e134, topicName=冲洗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4ec334602181, createdName=ms3892185887221420, createdTime=Tue Nov 17 06:32:00 CST 2015, time=2015-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1984560, encodeId=fa00198456088, content=<a href='/topic/show?id=f7ef3188935' target=_blank style='color:#2F92EE;'>#切开引流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31889, encryptionId=f7ef3188935, topicName=切开引流)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/6238544484D1FE65CCBBD849EAEE67C2/100, createdBy=47102500004, createdName=ms9651749636653578, createdTime=Mon Sep 05 13:32:00 CST 2016, time=2016-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=38071, encodeId=5472380e1d2, content=感觉还是冲洗下比较好, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=069c1625309, createdName=I+am+super, createdTime=Thu Oct 08 08:20:00 CST 2015, time=2015-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1537241, encodeId=fa2a153e24183, content=<a href='/topic/show?id=8a988520e74' target=_blank style='color:#2F92EE;'>#脓肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85207, encryptionId=8a988520e74, topicName=脓肿)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d01712842068, createdName=hunizi009, createdTime=Thu Oct 08 02:32:00 CST 2015, time=2015-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1606641, encodeId=e5f61606641f7, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Thu Oct 08 02:32:00 CST 2015, time=2015-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37835, encodeId=98e63e83544, content=有意思,然而并没有什么卵用, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160816/IMG57B2A27887E794424.jpg, createdBy=547199174, createdName=yushenfengzhan, createdTime=Wed Oct 07 11:28:00 CST 2015, time=2015-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37818, encodeId=b4783e81838, content=新资讯,好, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=df9e1651052, createdName=三三五五, createdTime=Wed Oct 07 09:04:00 CST 2015, time=2015-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37815, encodeId=d7533e8152f, content=看了, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151006/IMG5613E78605CC67531.jpg, createdBy=e2491654104, createdName=(wonder, createdTime=Tue Oct 06 23:27:00 CST 2015, time=2015-10-06, status=1, ipAttribution=)]
    2015-10-08 hunizi009
  5. [GetPortalCommentsPageByObjectIdResponse(id=1739920, encodeId=738d1e39920b9, content=<a href='/topic/show?id=f49c310e134' target=_blank style='color:#2F92EE;'>#冲洗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31071, encryptionId=f49c310e134, topicName=冲洗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4ec334602181, createdName=ms3892185887221420, createdTime=Tue Nov 17 06:32:00 CST 2015, time=2015-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1984560, encodeId=fa00198456088, content=<a href='/topic/show?id=f7ef3188935' target=_blank style='color:#2F92EE;'>#切开引流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31889, encryptionId=f7ef3188935, topicName=切开引流)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/6238544484D1FE65CCBBD849EAEE67C2/100, createdBy=47102500004, createdName=ms9651749636653578, createdTime=Mon Sep 05 13:32:00 CST 2016, time=2016-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=38071, encodeId=5472380e1d2, content=感觉还是冲洗下比较好, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=069c1625309, createdName=I+am+super, createdTime=Thu Oct 08 08:20:00 CST 2015, time=2015-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1537241, encodeId=fa2a153e24183, content=<a href='/topic/show?id=8a988520e74' target=_blank style='color:#2F92EE;'>#脓肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85207, encryptionId=8a988520e74, topicName=脓肿)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d01712842068, createdName=hunizi009, createdTime=Thu Oct 08 02:32:00 CST 2015, time=2015-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1606641, encodeId=e5f61606641f7, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Thu Oct 08 02:32:00 CST 2015, time=2015-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37835, encodeId=98e63e83544, content=有意思,然而并没有什么卵用, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160816/IMG57B2A27887E794424.jpg, createdBy=547199174, createdName=yushenfengzhan, createdTime=Wed Oct 07 11:28:00 CST 2015, time=2015-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37818, encodeId=b4783e81838, content=新资讯,好, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=df9e1651052, createdName=三三五五, createdTime=Wed Oct 07 09:04:00 CST 2015, time=2015-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37815, encodeId=d7533e8152f, content=看了, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151006/IMG5613E78605CC67531.jpg, createdBy=e2491654104, createdName=(wonder, createdTime=Tue Oct 06 23:27:00 CST 2015, time=2015-10-06, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1739920, encodeId=738d1e39920b9, content=<a href='/topic/show?id=f49c310e134' target=_blank style='color:#2F92EE;'>#冲洗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31071, encryptionId=f49c310e134, topicName=冲洗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4ec334602181, createdName=ms3892185887221420, createdTime=Tue Nov 17 06:32:00 CST 2015, time=2015-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1984560, encodeId=fa00198456088, content=<a href='/topic/show?id=f7ef3188935' target=_blank style='color:#2F92EE;'>#切开引流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31889, encryptionId=f7ef3188935, topicName=切开引流)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/6238544484D1FE65CCBBD849EAEE67C2/100, createdBy=47102500004, createdName=ms9651749636653578, createdTime=Mon Sep 05 13:32:00 CST 2016, time=2016-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=38071, encodeId=5472380e1d2, content=感觉还是冲洗下比较好, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=069c1625309, createdName=I+am+super, createdTime=Thu Oct 08 08:20:00 CST 2015, time=2015-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1537241, encodeId=fa2a153e24183, content=<a href='/topic/show?id=8a988520e74' target=_blank style='color:#2F92EE;'>#脓肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85207, encryptionId=8a988520e74, topicName=脓肿)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d01712842068, createdName=hunizi009, createdTime=Thu Oct 08 02:32:00 CST 2015, time=2015-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1606641, encodeId=e5f61606641f7, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Thu Oct 08 02:32:00 CST 2015, time=2015-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37835, encodeId=98e63e83544, content=有意思,然而并没有什么卵用, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160816/IMG57B2A27887E794424.jpg, createdBy=547199174, createdName=yushenfengzhan, createdTime=Wed Oct 07 11:28:00 CST 2015, time=2015-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37818, encodeId=b4783e81838, content=新资讯,好, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=df9e1651052, createdName=三三五五, createdTime=Wed Oct 07 09:04:00 CST 2015, time=2015-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37815, encodeId=d7533e8152f, content=看了, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151006/IMG5613E78605CC67531.jpg, createdBy=e2491654104, createdName=(wonder, createdTime=Tue Oct 06 23:27:00 CST 2015, time=2015-10-06, status=1, ipAttribution=)]
    2015-10-07 yushenfengzhan

    有意思,然而并没有什么卵用

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1739920, encodeId=738d1e39920b9, content=<a href='/topic/show?id=f49c310e134' target=_blank style='color:#2F92EE;'>#冲洗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31071, encryptionId=f49c310e134, topicName=冲洗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4ec334602181, createdName=ms3892185887221420, createdTime=Tue Nov 17 06:32:00 CST 2015, time=2015-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1984560, encodeId=fa00198456088, content=<a href='/topic/show?id=f7ef3188935' target=_blank style='color:#2F92EE;'>#切开引流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31889, encryptionId=f7ef3188935, topicName=切开引流)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/6238544484D1FE65CCBBD849EAEE67C2/100, createdBy=47102500004, createdName=ms9651749636653578, createdTime=Mon Sep 05 13:32:00 CST 2016, time=2016-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=38071, encodeId=5472380e1d2, content=感觉还是冲洗下比较好, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=069c1625309, createdName=I+am+super, createdTime=Thu Oct 08 08:20:00 CST 2015, time=2015-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1537241, encodeId=fa2a153e24183, content=<a href='/topic/show?id=8a988520e74' target=_blank style='color:#2F92EE;'>#脓肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85207, encryptionId=8a988520e74, topicName=脓肿)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d01712842068, createdName=hunizi009, createdTime=Thu Oct 08 02:32:00 CST 2015, time=2015-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1606641, encodeId=e5f61606641f7, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Thu Oct 08 02:32:00 CST 2015, time=2015-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37835, encodeId=98e63e83544, content=有意思,然而并没有什么卵用, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160816/IMG57B2A27887E794424.jpg, createdBy=547199174, createdName=yushenfengzhan, createdTime=Wed Oct 07 11:28:00 CST 2015, time=2015-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37818, encodeId=b4783e81838, content=新资讯,好, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=df9e1651052, createdName=三三五五, createdTime=Wed Oct 07 09:04:00 CST 2015, time=2015-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37815, encodeId=d7533e8152f, content=看了, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151006/IMG5613E78605CC67531.jpg, createdBy=e2491654104, createdName=(wonder, createdTime=Tue Oct 06 23:27:00 CST 2015, time=2015-10-06, status=1, ipAttribution=)]
    2015-10-07 三三五五

    新资讯,好

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1739920, encodeId=738d1e39920b9, content=<a href='/topic/show?id=f49c310e134' target=_blank style='color:#2F92EE;'>#冲洗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31071, encryptionId=f49c310e134, topicName=冲洗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4ec334602181, createdName=ms3892185887221420, createdTime=Tue Nov 17 06:32:00 CST 2015, time=2015-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1984560, encodeId=fa00198456088, content=<a href='/topic/show?id=f7ef3188935' target=_blank style='color:#2F92EE;'>#切开引流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31889, encryptionId=f7ef3188935, topicName=切开引流)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/6238544484D1FE65CCBBD849EAEE67C2/100, createdBy=47102500004, createdName=ms9651749636653578, createdTime=Mon Sep 05 13:32:00 CST 2016, time=2016-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=38071, encodeId=5472380e1d2, content=感觉还是冲洗下比较好, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=069c1625309, createdName=I+am+super, createdTime=Thu Oct 08 08:20:00 CST 2015, time=2015-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1537241, encodeId=fa2a153e24183, content=<a href='/topic/show?id=8a988520e74' target=_blank style='color:#2F92EE;'>#脓肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85207, encryptionId=8a988520e74, topicName=脓肿)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d01712842068, createdName=hunizi009, createdTime=Thu Oct 08 02:32:00 CST 2015, time=2015-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1606641, encodeId=e5f61606641f7, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Thu Oct 08 02:32:00 CST 2015, time=2015-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37835, encodeId=98e63e83544, content=有意思,然而并没有什么卵用, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160816/IMG57B2A27887E794424.jpg, createdBy=547199174, createdName=yushenfengzhan, createdTime=Wed Oct 07 11:28:00 CST 2015, time=2015-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37818, encodeId=b4783e81838, content=新资讯,好, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=df9e1651052, createdName=三三五五, createdTime=Wed Oct 07 09:04:00 CST 2015, time=2015-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37815, encodeId=d7533e8152f, content=看了, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151006/IMG5613E78605CC67531.jpg, createdBy=e2491654104, createdName=(wonder, createdTime=Tue Oct 06 23:27:00 CST 2015, time=2015-10-06, status=1, ipAttribution=)]
    2015-10-06 (wonder

    看了

    0