Dis Colon Rectum: 腹腔镜直肠固定术与吻合器经肛门直肠切除术对治疗有排便障碍的老人的治疗效果比较

2018-12-15 MedSci MedSci原创

排便障碍是肛肠科最常见的问题,临床工作中一般采用经肛门,腹部或腹腔镜手术来纠正这样的问题,本研究的目的是比较腹腔镜下直肠固定术和经肛门直肠切除术治疗排便障碍的长期功能结果,复发率和生活质量。

背景及目的:
排便障碍是肛肠科最常见的问题,临床工作中一般采用经肛门,腹部或腹腔镜手术来纠正这样的问题,本研究的目的是比较腹腔镜下直肠固定术和经肛门直肠切除术治疗排便障碍的长期功能结果,复发率和生活质量。

方法: 
这是一项前瞻性随机研究,纳入的患者为由于骨盆结构异常导致排便受阻而需要进行手术治疗的患者,患者被随机分配到腹腔镜腹侧直肠固定术(第1组)或经肛门直肠切除术(第2组)。主要观察指标: 主要结局指标是阻塞性排便改善的评分,并在3年后的复发率。次要结果是术后并发症,使用Wexner尿失禁评分的节制状态,以及使用患者便秘评估 - 生活质量问卷调查的生活质量。

结果: 
该研究共纳入了112名患者(每组56名)。在32名患者中报告了ASA评分II(组1中18名,组2中14名; p = 0.12),而每组中3名患者具有ASA评分III。1组11例(20%)和2组14例(25%; p = 0.65)出现轻微的术后并发症。在随访期间,3例患者在经肛门直肠切除术后出现粪便紧迫感,但两种手术均无性功能障碍。6个月后,第 1组改良阻塞排便评分改善> 50%报告为73%,而第2组为82%(p = 0.36)。平均随访41个月后,第1组报告的症状复发率为7%,而第2组为24%(p = 0.04)。术后6个月,第1组80%的患者会阴部血流下降> 50%,而第2组无明显改善.6个月后两组患者的生活质量均有显着改善; 然而,仅在第2组中出现显着的长期下降。

结论:
在老年患者中,即使伴有合并症,腹腔镜下直肠固定术和经肛门直肠切除术都是安全的,并且可以改善因结构异常导致排便阻塞的患者的肛门直肠功能。与经肛门直肠切除术相比,腹腔镜下腹直肠固定术具有更好的长期功能结果,并发症少,复发率低。

原始出处:

本文系梅斯医学(MedSci)原创编译整理,转载需授权!


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    2019-11-03 kkunny
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  4. 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createdName=kkunny, createdTime=Sun Nov 03 07:57:00 CST 2019, time=2019-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1877101, encodeId=fc8e18e7101f4, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Fri Aug 16 22:57:00 CST 2019, time=2019-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1693730, encodeId=e4591693e30cc, content=<a href='/topic/show?id=c8168114412' target=_blank style='color:#2F92EE;'>#肛门#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81144, encryptionId=c8168114412, topicName=肛门)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=39bc29444908, createdName=hxj0127, createdTime=Thu Aug 22 06:57:00 CST 2019, time=2019-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1894088, encodeId=ec9a189408890, content=<a href='/topic/show?id=5e456463eee' target=_blank style='color:#2F92EE;'>#治疗效果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64637, encryptionId=5e456463eee, topicName=治疗效果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373a131, createdName=jxrzshh, createdTime=Tue Sep 10 15:57:00 CST 2019, time=2019-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1276428, encodeId=504512e64283e, content=<a href='/topic/show?id=768685612db' target=_blank style='color:#2F92EE;'>#腹腔镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85612, encryptionId=768685612db, topicName=腹腔镜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=xinxin088, createdTime=Mon Dec 17 01:57:00 CST 2018, time=2018-12-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1595653, encodeId=aeac1595653c7, content=<a href='/topic/show?id=b5445001b9' target=_blank style='color:#2F92EE;'>#Colon#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5001, encryptionId=b5445001b9, topicName=Colon)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=84ac18287555, createdName=hxzhang, createdTime=Mon Dec 17 01:57:00 CST 2018, time=2018-12-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032004, encodeId=ebfe1032004d7, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Sat Dec 15 13:57:00 CST 2018, time=2018-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046696, encodeId=bbf81046696b3, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sat Dec 15 13:57:00 CST 2018, time=2018-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=355480, encodeId=f10a355480c1, content=好文,值得点赞!认真学习了,把经验应用于实践,为患者解除病痛。, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30251637888, createdName=lietome15, createdTime=Sat Dec 15 11:04:38 CST 2018, time=2018-12-15, status=1, ipAttribution=)]
    2019-08-22 hxj0127
  5. [GetPortalCommentsPageByObjectIdResponse(id=2012874, encodeId=5b6320128e43a, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Thu Nov 28 14:57:00 CST 2019, time=2019-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1634601, encodeId=e9601634601f7, content=<a href='/topic/show?id=8d3d5661e2b' target=_blank style='color:#2F92EE;'>#排便#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56617, encryptionId=8d3d5661e2b, topicName=排便)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a25722217738, createdName=kkunny, createdTime=Sun Nov 03 07:57:00 CST 2019, time=2019-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1877101, encodeId=fc8e18e7101f4, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Fri Aug 16 22:57:00 CST 2019, time=2019-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1693730, encodeId=e4591693e30cc, content=<a href='/topic/show?id=c8168114412' target=_blank style='color:#2F92EE;'>#肛门#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81144, encryptionId=c8168114412, topicName=肛门)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=39bc29444908, createdName=hxj0127, createdTime=Thu Aug 22 06:57:00 CST 2019, time=2019-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1894088, encodeId=ec9a189408890, content=<a href='/topic/show?id=5e456463eee' target=_blank style='color:#2F92EE;'>#治疗效果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64637, encryptionId=5e456463eee, topicName=治疗效果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373a131, createdName=jxrzshh, createdTime=Tue Sep 10 15:57:00 CST 2019, time=2019-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1276428, encodeId=504512e64283e, content=<a href='/topic/show?id=768685612db' target=_blank style='color:#2F92EE;'>#腹腔镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85612, encryptionId=768685612db, topicName=腹腔镜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=xinxin088, createdTime=Mon Dec 17 01:57:00 CST 2018, time=2018-12-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1595653, encodeId=aeac1595653c7, content=<a href='/topic/show?id=b5445001b9' target=_blank style='color:#2F92EE;'>#Colon#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5001, encryptionId=b5445001b9, topicName=Colon)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=84ac18287555, createdName=hxzhang, createdTime=Mon Dec 17 01:57:00 CST 2018, time=2018-12-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032004, encodeId=ebfe1032004d7, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Sat Dec 15 13:57:00 CST 2018, time=2018-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046696, encodeId=bbf81046696b3, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sat Dec 15 13:57:00 CST 2018, time=2018-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=355480, encodeId=f10a355480c1, content=好文,值得点赞!认真学习了,把经验应用于实践,为患者解除病痛。, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30251637888, createdName=lietome15, createdTime=Sat Dec 15 11:04:38 CST 2018, time=2018-12-15, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=2012874, encodeId=5b6320128e43a, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Thu Nov 28 14:57:00 CST 2019, time=2019-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1634601, encodeId=e9601634601f7, content=<a href='/topic/show?id=8d3d5661e2b' target=_blank style='color:#2F92EE;'>#排便#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56617, encryptionId=8d3d5661e2b, topicName=排便)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a25722217738, createdName=kkunny, createdTime=Sun Nov 03 07:57:00 CST 2019, time=2019-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1877101, encodeId=fc8e18e7101f4, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Fri Aug 16 22:57:00 CST 2019, time=2019-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1693730, encodeId=e4591693e30cc, content=<a href='/topic/show?id=c8168114412' target=_blank style='color:#2F92EE;'>#肛门#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81144, encryptionId=c8168114412, topicName=肛门)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=39bc29444908, createdName=hxj0127, createdTime=Thu Aug 22 06:57:00 CST 2019, time=2019-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1894088, encodeId=ec9a189408890, content=<a href='/topic/show?id=5e456463eee' target=_blank style='color:#2F92EE;'>#治疗效果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64637, encryptionId=5e456463eee, topicName=治疗效果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373a131, createdName=jxrzshh, createdTime=Tue Sep 10 15:57:00 CST 2019, time=2019-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1276428, encodeId=504512e64283e, content=<a href='/topic/show?id=768685612db' target=_blank style='color:#2F92EE;'>#腹腔镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85612, encryptionId=768685612db, topicName=腹腔镜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=xinxin088, createdTime=Mon Dec 17 01:57:00 CST 2018, time=2018-12-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1595653, encodeId=aeac1595653c7, content=<a href='/topic/show?id=b5445001b9' target=_blank style='color:#2F92EE;'>#Colon#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5001, encryptionId=b5445001b9, topicName=Colon)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=84ac18287555, createdName=hxzhang, createdTime=Mon Dec 17 01:57:00 CST 2018, time=2018-12-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032004, encodeId=ebfe1032004d7, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Sat Dec 15 13:57:00 CST 2018, time=2018-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046696, encodeId=bbf81046696b3, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sat Dec 15 13:57:00 CST 2018, time=2018-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=355480, encodeId=f10a355480c1, content=好文,值得点赞!认真学习了,把经验应用于实践,为患者解除病痛。, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30251637888, createdName=lietome15, createdTime=Sat Dec 15 11:04:38 CST 2018, time=2018-12-15, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=2012874, encodeId=5b6320128e43a, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Thu Nov 28 14:57:00 CST 2019, time=2019-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1634601, encodeId=e9601634601f7, content=<a href='/topic/show?id=8d3d5661e2b' target=_blank style='color:#2F92EE;'>#排便#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56617, encryptionId=8d3d5661e2b, topicName=排便)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a25722217738, createdName=kkunny, createdTime=Sun Nov 03 07:57:00 CST 2019, time=2019-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1877101, encodeId=fc8e18e7101f4, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Fri Aug 16 22:57:00 CST 2019, time=2019-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1693730, encodeId=e4591693e30cc, content=<a href='/topic/show?id=c8168114412' target=_blank style='color:#2F92EE;'>#肛门#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81144, encryptionId=c8168114412, topicName=肛门)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=39bc29444908, createdName=hxj0127, createdTime=Thu Aug 22 06:57:00 CST 2019, time=2019-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1894088, encodeId=ec9a189408890, content=<a href='/topic/show?id=5e456463eee' target=_blank style='color:#2F92EE;'>#治疗效果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64637, encryptionId=5e456463eee, topicName=治疗效果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373a131, createdName=jxrzshh, createdTime=Tue Sep 10 15:57:00 CST 2019, time=2019-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1276428, encodeId=504512e64283e, content=<a href='/topic/show?id=768685612db' target=_blank style='color:#2F92EE;'>#腹腔镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85612, encryptionId=768685612db, topicName=腹腔镜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=xinxin088, createdTime=Mon Dec 17 01:57:00 CST 2018, time=2018-12-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1595653, encodeId=aeac1595653c7, content=<a href='/topic/show?id=b5445001b9' target=_blank style='color:#2F92EE;'>#Colon#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5001, encryptionId=b5445001b9, topicName=Colon)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=84ac18287555, createdName=hxzhang, createdTime=Mon Dec 17 01:57:00 CST 2018, time=2018-12-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032004, encodeId=ebfe1032004d7, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Sat Dec 15 13:57:00 CST 2018, time=2018-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046696, encodeId=bbf81046696b3, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sat Dec 15 13:57:00 CST 2018, time=2018-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=355480, encodeId=f10a355480c1, content=好文,值得点赞!认真学习了,把经验应用于实践,为患者解除病痛。, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30251637888, createdName=lietome15, createdTime=Sat Dec 15 11:04:38 CST 2018, time=2018-12-15, status=1, ipAttribution=)]
    2018-12-17 hxzhang
  8. [GetPortalCommentsPageByObjectIdResponse(id=2012874, encodeId=5b6320128e43a, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Thu Nov 28 14:57:00 CST 2019, time=2019-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1634601, encodeId=e9601634601f7, content=<a href='/topic/show?id=8d3d5661e2b' target=_blank style='color:#2F92EE;'>#排便#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56617, encryptionId=8d3d5661e2b, topicName=排便)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a25722217738, 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channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85612, encryptionId=768685612db, topicName=腹腔镜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=xinxin088, createdTime=Mon Dec 17 01:57:00 CST 2018, time=2018-12-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1595653, encodeId=aeac1595653c7, content=<a href='/topic/show?id=b5445001b9' target=_blank style='color:#2F92EE;'>#Colon#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5001, encryptionId=b5445001b9, topicName=Colon)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=84ac18287555, createdName=hxzhang, createdTime=Mon Dec 17 01:57:00 CST 2018, time=2018-12-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032004, encodeId=ebfe1032004d7, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Sat Dec 15 13:57:00 CST 2018, time=2018-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046696, encodeId=bbf81046696b3, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sat Dec 15 13:57:00 CST 2018, time=2018-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=355480, encodeId=f10a355480c1, content=好文,值得点赞!认真学习了,把经验应用于实践,为患者解除病痛。, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30251637888, createdName=lietome15, createdTime=Sat Dec 15 11:04:38 CST 2018, time=2018-12-15, status=1, ipAttribution=)]
    2018-12-15 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0

  9. 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channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85612, encryptionId=768685612db, topicName=腹腔镜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=xinxin088, createdTime=Mon Dec 17 01:57:00 CST 2018, time=2018-12-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1595653, encodeId=aeac1595653c7, content=<a href='/topic/show?id=b5445001b9' target=_blank style='color:#2F92EE;'>#Colon#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5001, encryptionId=b5445001b9, topicName=Colon)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=84ac18287555, createdName=hxzhang, createdTime=Mon Dec 17 01:57:00 CST 2018, time=2018-12-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032004, encodeId=ebfe1032004d7, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Sat Dec 15 13:57:00 CST 2018, time=2018-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046696, encodeId=bbf81046696b3, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sat Dec 15 13:57:00 CST 2018, time=2018-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=355480, encodeId=f10a355480c1, content=好文,值得点赞!认真学习了,把经验应用于实践,为患者解除病痛。, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30251637888, createdName=lietome15, createdTime=Sat Dec 15 11:04:38 CST 2018, time=2018-12-15, status=1, ipAttribution=)]
    2018-12-15 CHANGE

    疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的

    0

  10. 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encryptionId=c8168114412, topicName=肛门)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=39bc29444908, createdName=hxj0127, createdTime=Thu Aug 22 06:57:00 CST 2019, time=2019-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1894088, encodeId=ec9a189408890, content=<a href='/topic/show?id=5e456463eee' target=_blank style='color:#2F92EE;'>#治疗效果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64637, encryptionId=5e456463eee, topicName=治疗效果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373a131, createdName=jxrzshh, createdTime=Tue Sep 10 15:57:00 CST 2019, time=2019-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1276428, encodeId=504512e64283e, content=<a href='/topic/show?id=768685612db' target=_blank style='color:#2F92EE;'>#腹腔镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85612, encryptionId=768685612db, topicName=腹腔镜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=xinxin088, createdTime=Mon Dec 17 01:57:00 CST 2018, time=2018-12-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1595653, encodeId=aeac1595653c7, content=<a href='/topic/show?id=b5445001b9' target=_blank style='color:#2F92EE;'>#Colon#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5001, encryptionId=b5445001b9, topicName=Colon)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=84ac18287555, createdName=hxzhang, createdTime=Mon Dec 17 01:57:00 CST 2018, time=2018-12-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032004, encodeId=ebfe1032004d7, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Sat Dec 15 13:57:00 CST 2018, time=2018-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046696, encodeId=bbf81046696b3, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sat Dec 15 13:57:00 CST 2018, time=2018-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=355480, encodeId=f10a355480c1, content=好文,值得点赞!认真学习了,把经验应用于实践,为患者解除病痛。, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30251637888, createdName=lietome15, createdTime=Sat Dec 15 11:04:38 CST 2018, time=2018-12-15, status=1, ipAttribution=)]
    2018-12-15 lietome15

    好文,值得点赞!认真学习了,把经验应用于实践,为患者解除病痛。

    0

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