人工气道的气管内吸痰指南

2015-07-27 MedSci MedSci原创

关于人工气道的气管内吸痰操作,专家们经多方查找和总结后得到以下结论,希望这篇指南对于你我都大有裨益!我们以MEDLINE, CINAHL和Cochrane Library数据库为基础,进行电子文献检索,检索了1990年1月到2009年10月出版的文章。通过回顾有关气管内吸痰的114次临床试验,62篇综述及12篇整合分析,最终使得这篇临床实践指南得以更新。以下的推荐规范是依据

关于人工气道的气管内吸痰操作,专家们经多方查找和总结后得到以下结论,希望这篇指南对于你我都大有裨益!

我们以MEDLINE, CINAHL和Cochrane Library数据库为基础,进行电子文献检索,检索了1990年1月到2009年10月出版的文章。通过回顾有关气管内吸痰的114次临床试验,62篇综述及12篇整合分析,最终使得这篇临床实践指南得以更新。以下的推荐规范是依据等级推荐、判定、发展和评价(GRADE)标准完成的:

  (1)推荐只在分泌物存在时进行吸痰,并不进行常规吸痰。

  (2)如果病人在吸痰时有显著的血氧饱和度下降,建议应考虑预先氧和储备。

  (3)建议吸痰时不断开呼吸机管路。

  (4)基于婴幼儿研究的相关证据,推荐实施浅层吸痰而不是深层吸痰。

  (5)不推荐在气管内吸痰前常规实施生理盐水滴注。

  (6)对于需要高吸入氧浓度、高PEEP、肺不张及婴儿患者来说,建议使用封闭式吸痰。

  (7)建议婴儿实施不断开连接的气管内吸痰(封闭系统)。

  (8)ALI患者因吸痰诱发的肺不张时,建议避免管路断开连接同时进行肺复张。

  (9)建议儿童和成人使用的吸痰管粗细不超过气管插管内径的50%,婴儿不超过70%。

  (10)建议吸痰过程不超过15秒。

  1.描述

  气管内吸痰(ETS)是对建立人工气道的患者最常进行的操作,它是支气管卫生治疗和机械通气的一部分,同时机械通气包括机器吸引病人人工气道内肺分泌物,防止气道阻塞。这项操作包括病人准备,吸痰过程及后续治疗。

  目前有两种气管内吸痰的方法:开放式吸痰和封闭式吸痰。开放式吸痰技术要求断开呼吸机管路,而封闭式吸痰涉及与呼吸机管路相连的无菌、封闭、嵌入式的吸痰管,这种吸痰方式使吸痰管在不断开管路的条件下存在于管路之中。同样,根据吸痰过程中吸痰管进入深度的不同,也分成两种不同的吸痰方式:深层吸痰和浅层吸痰。深层吸痰的定义是,吸痰管插入直至遇到阻力,随后在进行负压吸引前撤出25px。而浅层吸痰是指吸痰管插入预先决定好的深度,通常是人工气道长度加上适配器长度。

  2.病人准备

  推荐在可能的情况下使用尽量细的吸痰管,因为吸痰压力与吸痰管粗细相比,对于肺容积丢失的影响更小。对于确定直径的气管内插管(ETT)来说,气道内负压水平由吸痰管粗细及吸引压力共同决定。吸痰管直径越大,吸气压力在气道内减少的越少。

  2.1对于成年人,吸痰管的直径不应超过人工气道内径的一半,规定成年人内外直径比为0.5,婴幼儿为0.5-0.66。

  2.2准备吸痰进行吸痰操作前,成人和儿童推荐吸入纯氧,婴儿推荐提高10%氧浓度30-60秒,特别是对于在吸痰前就已经有低氧血症的病人。也可以通过如下几个方法:

  2.2.1通过调节呼吸机吸入氧浓度

  2.2.2通过应用许多智能呼吸机上可用的temporary oxygen-enrichment暂时富氧程序

  2.2.3不推荐进行手动通气,因为证实这样不能提供100%的吸入氧浓度。如果没有其他方法能增加氧合,操作者必须确保维持PEEP。

  2.3进行吸痰操作前,在吸痰管与负压管相连之前,必须通过封闭负压管,检查科室内的负压。在能清除气道分泌物的前提下,吸痰压力设置的越低越好。最大负压的合适水平目前缺乏实验数据的支持。推荐婴儿使用80-100mmHg的负压,成人使用不超过150mmHg的负压。

  2.4封闭式吸痰技术有助于在吸痰操作过程中保持机械通气的持续进行及病人的氧合水平。

  2.4.1应用于更易氧合下降的病人中,可以预防与开放式吸痰操作相关的肺不张(早产儿)

  2.4.2应该考虑将之用于需要较高吸入氧浓度及高PEEP水平的病人中(ALI)

  2.4.3它既不能降低也不会增高VAP发生的风险

  2.4.4每天更换嵌入式吸痰管并不能降低VAP发生的的风险,这也是很不划算的。

  2.5病人应该应用脉搏血氧饱和度监测仪,借以监测吸痰中及吸痰后的氧合程度。

  3.吸痰步骤

  吸痰操作包括通过人工气道将吸痰管置入气管,及吸痰管撤出过程中的负压吸引。吸痰管每次经过人工气道都被认为是吸痰操作。

  3.1推荐使用浅层吸痰,这样可以预防对气管粘膜的损伤。

  3.2与浅层吸痰相比,深层吸痰并没有显示出优越性,同时也可能导致更多的副作用。

  3.3吸痰操作的持续时间不宜超过15s。

  3.4在开放式吸痰操作中鼓励使用无菌技术。

  3.5生理盐水滴注。滴入指的是通过人工气道直接向气管内滴入小滴的生理盐水。据猜测生理盐水的滴入能够松动分泌物,增加吸除分泌物的量,并且有助于粘性分泌物的吸除。

  然而,目前没有足够的证据支持这一假说。在成人中,生理盐水滴入似乎能通过刺激咳嗽增强分泌物的清除,最近的一篇报道指出,吸痰前的生理盐水滴入,与成人机械通气患者VAP的发生率有一定关系。用于更新这篇指南的大部分的参考文献指出生理盐水滴入不太可能有什么好处,事实上,更可能是有害的。因此,在吸痰操作前不应常规实施生理盐水滴入。

  4.后续治疗

  在吸痰操作之后:

  4.1在吸痰后,采用与预先氧合相同的技术,进行至少一分钟的过度氧合,尤其是对那些在吸痰前或者吸痰中血氧不足的患者。

  4.2不应常规使用过度通气。

  4.2.1肺复张可以尝试用于有明显肺不张证据的患者。

  4.3应监测病人的不良反应。

  5.地点

  气管内吸痰可由训练得当的人员在各种各样的环境实施,包括(但不限于):

  5.1医院

  5.2扩大医疗保健机构

  5.3家庭

  5.4门诊

  5.5医师办公室

  5.6运载设备

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 (10)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=957263, encodeId=6c5795e26353, content=可以用来规范临床实践, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=49a11912866, createdName=ms9852187465738680, createdTime=Thu Apr 15 13:25:01 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206697, encodeId=5c8d20669ed1, content=吸痰要严格无菌操作, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo4aQ9o3mwLf8g71RU8wyNNNCPdJSZhENIsqBjKUicL8BJXLqL2NMl0MlhjIRlv5Bpg0M3UZKuDlwhwLH8B3v2yNy/0, createdBy=11a82069421, createdName=136****3321, createdTime=Mon Jun 05 07:20:35 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1776536, encodeId=fa3a1e7653687, content=<a href='/topic/show?id=767d3943993' target=_blank style='color:#2F92EE;'>#吸痰#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39439, encryptionId=767d3943993, topicName=吸痰)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Sat Jun 25 13:36:00 CST 2016, time=2016-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42075, encodeId=6766420e53b, content=以后尝试一下。, beContent=null, objectType=article, channel=null, level=null, likeNumber=187, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=de721636603, createdName=byzl, createdTime=Sat Oct 31 19:57:00 CST 2015, time=2015-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=34783, encodeId=5db034e8318, content=xuexi, beContent=null, objectType=article, channel=null, level=null, likeNumber=186, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=761999770, createdName=wingjoy2009, createdTime=Thu Aug 06 11:21:00 CST 2015, time=2015-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=34499, encodeId=69af3449990, content=涨了知识学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=332823945, createdName=hlycom3356, createdTime=Wed Aug 05 11:24:00 CST 2015, time=2015-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=34500, encodeId=99713450094, content=对于那些多痰的朋友特别需要注意, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=332823945, createdName=hlycom3356, createdTime=Wed Aug 05 11:24:00 CST 2015, time=2015-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33688, encodeId=c6a0336886f, content=必学,实践, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fb661636334, createdName=1dd9556bm93(暂无匿称), createdTime=Tue Jul 28 22:41:00 CST 2015, time=2015-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33666, encodeId=0703336665e, content=有实践意义, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6e511627114, createdName=1dd7eb8am26(暂无匿称), createdTime=Tue Jul 28 17:17:00 CST 2015, time=2015-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33628, encodeId=a5c933628c3, content=非常好!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=db9f1636206, createdName=1dd94e59m38(暂无匿称), createdTime=Tue Jul 28 08:13:00 CST 2015, time=2015-07-28, status=1, ipAttribution=)]
    2021-04-15 ms9852187465738680

    可以用来规范临床实践

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=957263, encodeId=6c5795e26353, content=可以用来规范临床实践, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=49a11912866, createdName=ms9852187465738680, createdTime=Thu Apr 15 13:25:01 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206697, encodeId=5c8d20669ed1, content=吸痰要严格无菌操作, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo4aQ9o3mwLf8g71RU8wyNNNCPdJSZhENIsqBjKUicL8BJXLqL2NMl0MlhjIRlv5Bpg0M3UZKuDlwhwLH8B3v2yNy/0, createdBy=11a82069421, createdName=136****3321, createdTime=Mon Jun 05 07:20:35 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1776536, encodeId=fa3a1e7653687, content=<a href='/topic/show?id=767d3943993' target=_blank style='color:#2F92EE;'>#吸痰#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39439, encryptionId=767d3943993, topicName=吸痰)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Sat Jun 25 13:36:00 CST 2016, time=2016-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42075, encodeId=6766420e53b, content=以后尝试一下。, beContent=null, objectType=article, channel=null, level=null, likeNumber=187, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=de721636603, createdName=byzl, createdTime=Sat Oct 31 19:57:00 CST 2015, time=2015-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=34783, encodeId=5db034e8318, content=xuexi, beContent=null, objectType=article, channel=null, level=null, likeNumber=186, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=761999770, createdName=wingjoy2009, createdTime=Thu Aug 06 11:21:00 CST 2015, time=2015-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=34499, encodeId=69af3449990, content=涨了知识学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=332823945, createdName=hlycom3356, createdTime=Wed Aug 05 11:24:00 CST 2015, time=2015-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=34500, encodeId=99713450094, content=对于那些多痰的朋友特别需要注意, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=332823945, createdName=hlycom3356, createdTime=Wed Aug 05 11:24:00 CST 2015, time=2015-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33688, encodeId=c6a0336886f, content=必学,实践, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fb661636334, createdName=1dd9556bm93(暂无匿称), createdTime=Tue Jul 28 22:41:00 CST 2015, time=2015-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33666, encodeId=0703336665e, content=有实践意义, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6e511627114, createdName=1dd7eb8am26(暂无匿称), createdTime=Tue Jul 28 17:17:00 CST 2015, time=2015-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33628, encodeId=a5c933628c3, content=非常好!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=db9f1636206, createdName=1dd94e59m38(暂无匿称), createdTime=Tue Jul 28 08:13:00 CST 2015, time=2015-07-28, status=1, ipAttribution=)]
    2017-06-05 136****3321

    吸痰要严格无菌操作

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=957263, encodeId=6c5795e26353, content=可以用来规范临床实践, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=49a11912866, createdName=ms9852187465738680, createdTime=Thu Apr 15 13:25:01 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206697, encodeId=5c8d20669ed1, content=吸痰要严格无菌操作, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo4aQ9o3mwLf8g71RU8wyNNNCPdJSZhENIsqBjKUicL8BJXLqL2NMl0MlhjIRlv5Bpg0M3UZKuDlwhwLH8B3v2yNy/0, createdBy=11a82069421, createdName=136****3321, createdTime=Mon Jun 05 07:20:35 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1776536, encodeId=fa3a1e7653687, content=<a href='/topic/show?id=767d3943993' target=_blank style='color:#2F92EE;'>#吸痰#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39439, encryptionId=767d3943993, topicName=吸痰)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Sat Jun 25 13:36:00 CST 2016, time=2016-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42075, encodeId=6766420e53b, content=以后尝试一下。, beContent=null, objectType=article, channel=null, level=null, likeNumber=187, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=de721636603, createdName=byzl, createdTime=Sat Oct 31 19:57:00 CST 2015, time=2015-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=34783, encodeId=5db034e8318, content=xuexi, beContent=null, objectType=article, channel=null, level=null, likeNumber=186, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=761999770, createdName=wingjoy2009, createdTime=Thu Aug 06 11:21:00 CST 2015, time=2015-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=34499, encodeId=69af3449990, content=涨了知识学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=332823945, createdName=hlycom3356, createdTime=Wed Aug 05 11:24:00 CST 2015, time=2015-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=34500, encodeId=99713450094, content=对于那些多痰的朋友特别需要注意, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=332823945, createdName=hlycom3356, createdTime=Wed Aug 05 11:24:00 CST 2015, time=2015-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33688, encodeId=c6a0336886f, content=必学,实践, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fb661636334, createdName=1dd9556bm93(暂无匿称), createdTime=Tue Jul 28 22:41:00 CST 2015, time=2015-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33666, encodeId=0703336665e, content=有实践意义, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6e511627114, createdName=1dd7eb8am26(暂无匿称), createdTime=Tue Jul 28 17:17:00 CST 2015, time=2015-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33628, encodeId=a5c933628c3, content=非常好!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=db9f1636206, createdName=1dd94e59m38(暂无匿称), createdTime=Tue Jul 28 08:13:00 CST 2015, time=2015-07-28, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=957263, encodeId=6c5795e26353, content=可以用来规范临床实践, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=49a11912866, createdName=ms9852187465738680, createdTime=Thu Apr 15 13:25:01 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206697, encodeId=5c8d20669ed1, content=吸痰要严格无菌操作, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo4aQ9o3mwLf8g71RU8wyNNNCPdJSZhENIsqBjKUicL8BJXLqL2NMl0MlhjIRlv5Bpg0M3UZKuDlwhwLH8B3v2yNy/0, createdBy=11a82069421, createdName=136****3321, createdTime=Mon Jun 05 07:20:35 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1776536, encodeId=fa3a1e7653687, content=<a href='/topic/show?id=767d3943993' target=_blank style='color:#2F92EE;'>#吸痰#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39439, encryptionId=767d3943993, topicName=吸痰)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Sat Jun 25 13:36:00 CST 2016, time=2016-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42075, encodeId=6766420e53b, content=以后尝试一下。, beContent=null, objectType=article, channel=null, level=null, likeNumber=187, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=de721636603, createdName=byzl, createdTime=Sat Oct 31 19:57:00 CST 2015, time=2015-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=34783, encodeId=5db034e8318, content=xuexi, beContent=null, objectType=article, channel=null, level=null, likeNumber=186, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=761999770, createdName=wingjoy2009, createdTime=Thu Aug 06 11:21:00 CST 2015, time=2015-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=34499, encodeId=69af3449990, content=涨了知识学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=332823945, createdName=hlycom3356, createdTime=Wed Aug 05 11:24:00 CST 2015, time=2015-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=34500, encodeId=99713450094, content=对于那些多痰的朋友特别需要注意, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=332823945, createdName=hlycom3356, createdTime=Wed Aug 05 11:24:00 CST 2015, time=2015-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33688, encodeId=c6a0336886f, content=必学,实践, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fb661636334, createdName=1dd9556bm93(暂无匿称), createdTime=Tue Jul 28 22:41:00 CST 2015, time=2015-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33666, encodeId=0703336665e, content=有实践意义, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6e511627114, createdName=1dd7eb8am26(暂无匿称), createdTime=Tue Jul 28 17:17:00 CST 2015, time=2015-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33628, encodeId=a5c933628c3, content=非常好!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=db9f1636206, createdName=1dd94e59m38(暂无匿称), createdTime=Tue Jul 28 08:13:00 CST 2015, time=2015-07-28, status=1, ipAttribution=)]
    2015-10-31 byzl

    以后尝试一下。

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=957263, encodeId=6c5795e26353, content=可以用来规范临床实践, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=49a11912866, createdName=ms9852187465738680, createdTime=Thu Apr 15 13:25:01 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206697, encodeId=5c8d20669ed1, content=吸痰要严格无菌操作, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo4aQ9o3mwLf8g71RU8wyNNNCPdJSZhENIsqBjKUicL8BJXLqL2NMl0MlhjIRlv5Bpg0M3UZKuDlwhwLH8B3v2yNy/0, createdBy=11a82069421, createdName=136****3321, createdTime=Mon Jun 05 07:20:35 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1776536, encodeId=fa3a1e7653687, content=<a href='/topic/show?id=767d3943993' target=_blank style='color:#2F92EE;'>#吸痰#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39439, encryptionId=767d3943993, topicName=吸痰)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Sat Jun 25 13:36:00 CST 2016, time=2016-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42075, encodeId=6766420e53b, content=以后尝试一下。, beContent=null, objectType=article, channel=null, level=null, likeNumber=187, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=de721636603, createdName=byzl, createdTime=Sat Oct 31 19:57:00 CST 2015, time=2015-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=34783, encodeId=5db034e8318, content=xuexi, beContent=null, objectType=article, channel=null, level=null, likeNumber=186, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=761999770, createdName=wingjoy2009, createdTime=Thu Aug 06 11:21:00 CST 2015, time=2015-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=34499, encodeId=69af3449990, content=涨了知识学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=332823945, createdName=hlycom3356, createdTime=Wed Aug 05 11:24:00 CST 2015, time=2015-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=34500, encodeId=99713450094, content=对于那些多痰的朋友特别需要注意, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=332823945, createdName=hlycom3356, createdTime=Wed Aug 05 11:24:00 CST 2015, time=2015-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33688, encodeId=c6a0336886f, content=必学,实践, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fb661636334, createdName=1dd9556bm93(暂无匿称), createdTime=Tue Jul 28 22:41:00 CST 2015, time=2015-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33666, encodeId=0703336665e, content=有实践意义, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6e511627114, createdName=1dd7eb8am26(暂无匿称), createdTime=Tue Jul 28 17:17:00 CST 2015, time=2015-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33628, encodeId=a5c933628c3, content=非常好!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=db9f1636206, createdName=1dd94e59m38(暂无匿称), createdTime=Tue Jul 28 08:13:00 CST 2015, time=2015-07-28, status=1, ipAttribution=)]
    2015-08-06 wingjoy2009

    xuexi

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=957263, encodeId=6c5795e26353, content=可以用来规范临床实践, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=49a11912866, createdName=ms9852187465738680, createdTime=Thu Apr 15 13:25:01 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206697, encodeId=5c8d20669ed1, content=吸痰要严格无菌操作, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo4aQ9o3mwLf8g71RU8wyNNNCPdJSZhENIsqBjKUicL8BJXLqL2NMl0MlhjIRlv5Bpg0M3UZKuDlwhwLH8B3v2yNy/0, createdBy=11a82069421, createdName=136****3321, createdTime=Mon Jun 05 07:20:35 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1776536, encodeId=fa3a1e7653687, content=<a href='/topic/show?id=767d3943993' target=_blank style='color:#2F92EE;'>#吸痰#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39439, encryptionId=767d3943993, topicName=吸痰)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Sat Jun 25 13:36:00 CST 2016, time=2016-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42075, encodeId=6766420e53b, content=以后尝试一下。, beContent=null, objectType=article, channel=null, level=null, likeNumber=187, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=de721636603, createdName=byzl, createdTime=Sat Oct 31 19:57:00 CST 2015, time=2015-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=34783, encodeId=5db034e8318, content=xuexi, beContent=null, objectType=article, channel=null, level=null, likeNumber=186, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=761999770, createdName=wingjoy2009, createdTime=Thu Aug 06 11:21:00 CST 2015, time=2015-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=34499, encodeId=69af3449990, content=涨了知识学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=332823945, createdName=hlycom3356, createdTime=Wed Aug 05 11:24:00 CST 2015, time=2015-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=34500, encodeId=99713450094, content=对于那些多痰的朋友特别需要注意, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=332823945, createdName=hlycom3356, createdTime=Wed Aug 05 11:24:00 CST 2015, time=2015-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33688, encodeId=c6a0336886f, content=必学,实践, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fb661636334, createdName=1dd9556bm93(暂无匿称), createdTime=Tue Jul 28 22:41:00 CST 2015, time=2015-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33666, encodeId=0703336665e, content=有实践意义, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6e511627114, createdName=1dd7eb8am26(暂无匿称), createdTime=Tue Jul 28 17:17:00 CST 2015, time=2015-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33628, encodeId=a5c933628c3, content=非常好!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=db9f1636206, createdName=1dd94e59m38(暂无匿称), createdTime=Tue Jul 28 08:13:00 CST 2015, time=2015-07-28, status=1, ipAttribution=)]
    2015-08-05 hlycom3356

    涨了知识学习了

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=957263, encodeId=6c5795e26353, content=可以用来规范临床实践, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=49a11912866, createdName=ms9852187465738680, createdTime=Thu Apr 15 13:25:01 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206697, encodeId=5c8d20669ed1, content=吸痰要严格无菌操作, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo4aQ9o3mwLf8g71RU8wyNNNCPdJSZhENIsqBjKUicL8BJXLqL2NMl0MlhjIRlv5Bpg0M3UZKuDlwhwLH8B3v2yNy/0, createdBy=11a82069421, createdName=136****3321, createdTime=Mon Jun 05 07:20:35 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1776536, encodeId=fa3a1e7653687, content=<a href='/topic/show?id=767d3943993' target=_blank style='color:#2F92EE;'>#吸痰#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39439, encryptionId=767d3943993, topicName=吸痰)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Sat Jun 25 13:36:00 CST 2016, time=2016-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42075, encodeId=6766420e53b, content=以后尝试一下。, beContent=null, objectType=article, channel=null, level=null, likeNumber=187, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=de721636603, createdName=byzl, createdTime=Sat Oct 31 19:57:00 CST 2015, time=2015-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=34783, encodeId=5db034e8318, content=xuexi, beContent=null, objectType=article, channel=null, level=null, likeNumber=186, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=761999770, createdName=wingjoy2009, createdTime=Thu Aug 06 11:21:00 CST 2015, time=2015-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=34499, encodeId=69af3449990, content=涨了知识学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=332823945, createdName=hlycom3356, createdTime=Wed Aug 05 11:24:00 CST 2015, time=2015-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=34500, encodeId=99713450094, content=对于那些多痰的朋友特别需要注意, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=332823945, createdName=hlycom3356, createdTime=Wed Aug 05 11:24:00 CST 2015, time=2015-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33688, encodeId=c6a0336886f, content=必学,实践, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fb661636334, createdName=1dd9556bm93(暂无匿称), createdTime=Tue Jul 28 22:41:00 CST 2015, time=2015-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33666, encodeId=0703336665e, content=有实践意义, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6e511627114, createdName=1dd7eb8am26(暂无匿称), createdTime=Tue Jul 28 17:17:00 CST 2015, time=2015-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33628, encodeId=a5c933628c3, content=非常好!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=db9f1636206, createdName=1dd94e59m38(暂无匿称), createdTime=Tue Jul 28 08:13:00 CST 2015, time=2015-07-28, status=1, ipAttribution=)]
    2015-08-05 hlycom3356

    对于那些多痰的朋友特别需要注意

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=957263, encodeId=6c5795e26353, content=可以用来规范临床实践, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=49a11912866, createdName=ms9852187465738680, createdTime=Thu Apr 15 13:25:01 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206697, encodeId=5c8d20669ed1, content=吸痰要严格无菌操作, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo4aQ9o3mwLf8g71RU8wyNNNCPdJSZhENIsqBjKUicL8BJXLqL2NMl0MlhjIRlv5Bpg0M3UZKuDlwhwLH8B3v2yNy/0, createdBy=11a82069421, createdName=136****3321, createdTime=Mon Jun 05 07:20:35 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1776536, encodeId=fa3a1e7653687, content=<a href='/topic/show?id=767d3943993' target=_blank style='color:#2F92EE;'>#吸痰#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39439, encryptionId=767d3943993, topicName=吸痰)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Sat Jun 25 13:36:00 CST 2016, time=2016-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42075, encodeId=6766420e53b, content=以后尝试一下。, beContent=null, objectType=article, channel=null, level=null, likeNumber=187, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=de721636603, createdName=byzl, createdTime=Sat Oct 31 19:57:00 CST 2015, time=2015-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=34783, encodeId=5db034e8318, content=xuexi, beContent=null, objectType=article, channel=null, level=null, likeNumber=186, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=761999770, createdName=wingjoy2009, createdTime=Thu Aug 06 11:21:00 CST 2015, time=2015-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=34499, encodeId=69af3449990, content=涨了知识学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=332823945, createdName=hlycom3356, createdTime=Wed Aug 05 11:24:00 CST 2015, time=2015-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=34500, encodeId=99713450094, content=对于那些多痰的朋友特别需要注意, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=332823945, createdName=hlycom3356, createdTime=Wed Aug 05 11:24:00 CST 2015, time=2015-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33688, encodeId=c6a0336886f, content=必学,实践, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fb661636334, createdName=1dd9556bm93(暂无匿称), createdTime=Tue Jul 28 22:41:00 CST 2015, time=2015-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33666, encodeId=0703336665e, content=有实践意义, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6e511627114, createdName=1dd7eb8am26(暂无匿称), createdTime=Tue Jul 28 17:17:00 CST 2015, time=2015-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33628, encodeId=a5c933628c3, content=非常好!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=db9f1636206, createdName=1dd94e59m38(暂无匿称), createdTime=Tue Jul 28 08:13:00 CST 2015, time=2015-07-28, status=1, ipAttribution=)]
    2015-07-28 1dd9556bm93(暂无匿称)

    必学,实践

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=957263, encodeId=6c5795e26353, content=可以用来规范临床实践, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=49a11912866, createdName=ms9852187465738680, createdTime=Thu Apr 15 13:25:01 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206697, encodeId=5c8d20669ed1, content=吸痰要严格无菌操作, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo4aQ9o3mwLf8g71RU8wyNNNCPdJSZhENIsqBjKUicL8BJXLqL2NMl0MlhjIRlv5Bpg0M3UZKuDlwhwLH8B3v2yNy/0, createdBy=11a82069421, createdName=136****3321, createdTime=Mon Jun 05 07:20:35 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1776536, encodeId=fa3a1e7653687, content=<a href='/topic/show?id=767d3943993' target=_blank style='color:#2F92EE;'>#吸痰#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39439, encryptionId=767d3943993, topicName=吸痰)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Sat Jun 25 13:36:00 CST 2016, time=2016-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42075, encodeId=6766420e53b, content=以后尝试一下。, beContent=null, objectType=article, channel=null, level=null, likeNumber=187, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=de721636603, createdName=byzl, createdTime=Sat Oct 31 19:57:00 CST 2015, time=2015-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=34783, encodeId=5db034e8318, content=xuexi, beContent=null, objectType=article, channel=null, level=null, likeNumber=186, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=761999770, createdName=wingjoy2009, createdTime=Thu Aug 06 11:21:00 CST 2015, time=2015-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=34499, encodeId=69af3449990, content=涨了知识学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=332823945, createdName=hlycom3356, createdTime=Wed Aug 05 11:24:00 CST 2015, time=2015-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=34500, encodeId=99713450094, content=对于那些多痰的朋友特别需要注意, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=332823945, createdName=hlycom3356, createdTime=Wed Aug 05 11:24:00 CST 2015, time=2015-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33688, encodeId=c6a0336886f, content=必学,实践, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fb661636334, createdName=1dd9556bm93(暂无匿称), createdTime=Tue Jul 28 22:41:00 CST 2015, time=2015-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33666, encodeId=0703336665e, content=有实践意义, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6e511627114, createdName=1dd7eb8am26(暂无匿称), createdTime=Tue Jul 28 17:17:00 CST 2015, time=2015-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33628, encodeId=a5c933628c3, content=非常好!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=db9f1636206, createdName=1dd94e59m38(暂无匿称), createdTime=Tue Jul 28 08:13:00 CST 2015, time=2015-07-28, status=1, ipAttribution=)]
    2015-07-28 1dd7eb8am26(暂无匿称)

    有实践意义

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=957263, encodeId=6c5795e26353, content=可以用来规范临床实践, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=49a11912866, createdName=ms9852187465738680, createdTime=Thu Apr 15 13:25:01 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206697, encodeId=5c8d20669ed1, content=吸痰要严格无菌操作, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo4aQ9o3mwLf8g71RU8wyNNNCPdJSZhENIsqBjKUicL8BJXLqL2NMl0MlhjIRlv5Bpg0M3UZKuDlwhwLH8B3v2yNy/0, createdBy=11a82069421, createdName=136****3321, createdTime=Mon Jun 05 07:20:35 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1776536, encodeId=fa3a1e7653687, content=<a href='/topic/show?id=767d3943993' target=_blank style='color:#2F92EE;'>#吸痰#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39439, encryptionId=767d3943993, topicName=吸痰)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Sat Jun 25 13:36:00 CST 2016, time=2016-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42075, encodeId=6766420e53b, content=以后尝试一下。, beContent=null, objectType=article, channel=null, level=null, likeNumber=187, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=de721636603, createdName=byzl, createdTime=Sat Oct 31 19:57:00 CST 2015, time=2015-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=34783, encodeId=5db034e8318, content=xuexi, beContent=null, objectType=article, channel=null, level=null, likeNumber=186, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=761999770, createdName=wingjoy2009, createdTime=Thu Aug 06 11:21:00 CST 2015, time=2015-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=34499, encodeId=69af3449990, content=涨了知识学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=332823945, createdName=hlycom3356, createdTime=Wed Aug 05 11:24:00 CST 2015, time=2015-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=34500, encodeId=99713450094, content=对于那些多痰的朋友特别需要注意, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=332823945, createdName=hlycom3356, createdTime=Wed Aug 05 11:24:00 CST 2015, time=2015-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33688, encodeId=c6a0336886f, content=必学,实践, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fb661636334, createdName=1dd9556bm93(暂无匿称), createdTime=Tue Jul 28 22:41:00 CST 2015, time=2015-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33666, encodeId=0703336665e, content=有实践意义, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6e511627114, createdName=1dd7eb8am26(暂无匿称), createdTime=Tue Jul 28 17:17:00 CST 2015, time=2015-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33628, encodeId=a5c933628c3, content=非常好!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=db9f1636206, createdName=1dd94e59m38(暂无匿称), createdTime=Tue Jul 28 08:13:00 CST 2015, time=2015-07-28, status=1, ipAttribution=)]
    2015-07-28 1dd94e59m38(暂无匿称)

    非常好!!

    0

相关资讯

J Virol:华中师范大学李毅等体外模拟HBoV1病毒感染人类气道上皮细胞

不同感染复数的HBoV1感染HAE后上皮的屏障功能监测 Journal of Virology(《病毒学杂志》)在2013年1月23日在线发表了我国武汉华中师范大学生命科学学院李毅教授等人的一项最新研究结果,他们通过体外模拟的方法,对人类博卡病毒1(HBoV1)感染人类原代气道上皮细胞进行了表征。HBoV1是一种新出现的人类病原体,为呼吸道病毒。研究人员对HBoV1感染极化的人类原代气道上皮(H

人工气道并发症的预防与护理

  典型病例   患者男,70岁,2004年8月被诊断为“左肺上叶腺癌”,并行左肺全切术、放化疗治疗。   2008年4月,因脑转移压迫呼吸中枢,给予经鼻气管插管呼吸机辅助通气。9月,气管切开并持续机械通气。12月,机械通气期间患者出现喘憋抽搐30多次,给予松气囊、吸痰或移