一文了解抽脂术的局部并发症及处理

2021-09-20 医路坦克 MedSci原创

尽管吸脂术具有良好的安全性,但仍会出现需要对症处理的并发症。本文描述了吸脂术可能引起的局部并发症及其对应的处理措施。

     尽管吸脂术具有良好的安全性,但仍会出现需要对症处理的并发症。本文描述了吸脂术可能引起的局部并发症及其对应的处理措施。并发症流行病学要点有关抽脂的流行病学数据表明,抽脂是一种安全的手术,很少有严重的副作用。并发症的诊断早期识别并发症和随后的治疗对于减少并发症至关重要。医生必须告知患者并发症发生的可能性及原因,建议的治疗以及完全恢复前的持续时间。

长时间水肿和瘀斑

图1

      吸脂后预计会出现肿胀或水肿,这是组织对手术创伤的正常反应。手术后通常持续4至6周,尽管轻微肿胀可能需要6个月才能消退。在正常情况下,肿胀在手术后2周达到顶峰,然后是10到14天,质地变得更坚硬。当浸润液、脂肪酸和血清被重新吸收时,组织就会恢复其正常的柔韧性。

     极少数情况下,伴有疼痛的水肿可能持续6周以上。据推测,这是由过度的组织创伤引起的,导致内部烧灼样损伤。持续的水肿也可能导致瘢痕、纤维化和表面不规则的增加。导致这一现象的因素包括抽脂的位置、患者的基因构成和脂肪组织类型。水肿可能出现在贫血、血清蛋白降低和肾功能不全的患者身上。

     吸脂术后也会出现瘀斑,高峰在7天,4周后逐渐减弱。过度和严重的瘀斑可能与患者有关(烟草使用、药物治疗),也可能与手术有关(抽脂时静脉系统损伤)(图1)。可以最大限度地减少持续性水肿和加速消退的策略包括术后应用加压衣物、冰袋和手动淋巴引流。一些研究认为,动力辅助吸脂可以减少组织创伤,从而减少长时间水肿及瘀斑的风险。预防措施包括在吸脂过程中使用温和的技术,并确保患者遵守术前指导。

 

血清肿块
     吸脂区域浆液积聚可能是由侵袭性过度吸血后的创伤引起的,也可能是由严重的淋巴损伤引起的。吸脂后压迫不足和超声辅助吸脂(UAL)与血清瘤的发生有关。浆液瘤的常见部位是大腿外侧、后部和下腹。浆液性浆液瘤可以在手术后进行针吸和频繁的随访,直到液体消退。在引流管就位期间,可以使用预防性抗生素,以避免二次细菌污染。预防措施包括使用敷料敷料、充分引流和避免更换血小板药物。

血肿

     虽然肿胀技术已被证明可以减少手术和术后出血,但抽脂期间仍可能发生血肿。管内血液的存在应预先警告临床医生血肿的风险。其他迹象包括切口处流出鲜红的血液和手术后直立性低血压。未经治疗的血肿可形成浆液性肿块,然后形成慢性假性囊肿。

     血肿的治疗取决于血肿的大小。小的血肿可以自己解决,而中等大小的血肿可以液化和抽吸。较大的血肿需要从吸脂口引流,或在重复吸脂后通过吸引管引流。在后者的情况下,在局部麻醉下用11号手术刀在伤口边缘切开3到4毫米的皮肤切口。在一次性注射器上安装一个4毫米长的套管,用鲁尔锁连接,然后将其插入血肿中心的切口。建议在肿胀的溶液中加入肾上腺素(1:1,000,000),并使用尖端钝化的微导管(3 mm),以最大限度地减少出血。

感染

    据估计,抽脂术后的感染在门诊约为1%,在医院约为3%。主要与手术室无菌不良或未经治疗的血肿继发细菌污染有关。最常见的浅表感染类型,通常在切口附近,由葡萄球菌和链球菌引起。深度感染由非典型分枝杆菌引起。术后感染的诊断应及时进行,以防止出现严重症状,如坏死、败血症或中毒性休克综合征。感染通常出现在抽脂术后早期(10天至6周内),症状包括局部红斑和疼痛。

    诊断应通过培养确定致病菌。对于非典型分枝杆菌,标准革兰氏染色无效,因此需要在无菌条件下使用针吸或外科手术收集标本。获得皮肤活检标本后,组织病理学结果可以揭示细菌形态特征,可用于菌株鉴定。然而,仍然需要培养来识别特定微生物和确定抗微生物药物敏感性。通常,治疗包括广谱抗生素,如利福平(600 毫克,2-3 次/周),联合异烟肼、吡嗪酰胺、乙胺丁醇或链霉素 6 个月。如果患者对初始治疗没有反应,转诊给传染病专家可能是合适的,因为可能需要影像学或手术干预。 严格遵守手术原则,如正确洗手、无菌操作条件和良好的皮肤准备,是预防感染的关键。一些临床医生主张在围手术期使用可注射的广谱抗生素,然后预防性口服抗生素 5 至 7 天,在所有大容量( 5 L)吸脂病例,以防止感染。

度矫正

过度矫正要求吸力超过所需的等高线。这可能是由于术前检查不充分、患者位置不当以及使用较大的插管造成的。由于术后脂肪溶解,建议轮廓应该稍微矫正不足,而不是过度矫正。如果发生过度矫正,建议在翻修手术前等待6个月。这可以使水肿和瘀斑消退,并允许正确评估畸形。

像“脂移”这样的技术可以用在矫治过度的情况下。这涉及到将自体脂肪转移到受关注的区域。一些报告表明,自体脂肪移植在吸脂术后轮廓畸形中产生了美学上可以接受的结果。一些作者还建议在吸脂前常规采集几支注射器的脂肪,以便在矫治过度的情况下可以重新注射(图2)。限制这种风险的预防措施包括进行细致的术前评估、测量患者的解剖结构、使用微导管和适当的技术(图3)。

图2  脂肪转移技术。A,从下背部收集脂肪。B,准备脂肪注射器。C,臀部注射。

 

图3.防止不对称的术前测量。

 

表面不规则性
    表现为皮肤凹陷或波纹的表面不规则性可由过度吸脂、表面抽吸、预先存在的粘连、皮肤多余或压缩不足引起。皮肤弹性差、先前存在的脂肪团和疤痕的患者最有可能出现皮肤表面的不规则性。预防措施包括将最大真空压力设定在250至400毫米汞柱,并在低压下抽吸浅层。纠正不规则性的策略包括抽脂、注射、切除、脂肪转移和皮肤切除。

 

不对称

图4.吸脂前(A)和吸脂后(B)。不对称表现为左侧脂肪较多。

    不对称可能是由于脂肪去除量不平衡造成的,但也可能在术前出现(图4)。使用测量和临床摄影记录任何患者固有的不对称是至关重要的。在手术过程中,应注意并测量吸脂物的体积,以确保脂肪的均匀去除。术后手动和目测观察有助于识别不对称。如果不采取这些措施,患者很可能会不满意,并要求随后的矫正程序。

皮肤松弛

图5 .38岁男性,腹部抽脂7个月后出现松弛。

    抽脂后不完全的皮肤回缩会导致明显的皮肤松弛(图5)。易患此病的部位包括腹部、手臂和大腿内侧皮肤弹性差、肌肉筋膜过度松弛和大量脂肪沉积的患者尤其危险,因此不鼓励进行抽脂手术。术后12周使用加压服装可能会增强皮肤回缩。能量辅助抽脂,使用微导管,在四肢设置垂直的隧道而不是水平的隧道,可以提供更好的皮肤收缩。腹部成形术、肱骨成形术和大腿成形术等手术可以纠正抽脂后皮肤松弛。

 

皮肤色素沉着和疤痕

图6。(A)腹部抽脂5个月后的色素增多性瘢痕;(B)部分CO2激光治疗3个月后的瘢痕。

 

    皮肤色素沉着过度(图6)。自瘀斑的沉积,药物(米诺环素),术后恢复期间的阳光照射以及切口部位上方真皮的过度诱导及损伤也可能导致这种现象。虽然这种并发症通常在1年后消退,但它可以持续存在于大腿等部位。应相应告知患者避免过度浅表抽吸和阳光照射可防止色素沉着过度。对患处进行超声波按摩可以促进其恢复

    瘢痕形成不是抽吸辅助吸脂的常见并发症,但可能由于皮肤热损伤而发生。表面上使用大套管,对切口部位造成热损伤,并且反复通过会使皮肤瘀伤,导致色素沉着过度的疤痕。超声波按摩和自体脂肪注射可以减少疤痕。色素沉着过度的疤痕也可以用类固醇/氢醌乳膏或激光治疗。肥厚性瘢痕可以通过组合硅胶片,病灶内类固醇注射,压力疗法或再切除来治疗。使用微套管,小入口部位和保护切口边缘的塑料端口塞可以大大减少疤痕。

 

皮肤坏死

    靠近皮肤表面的抽脂和真皮下血管丛的破裂可导致组织坏死。坏死也与抽烟和不恰当的吸脂技术有关,例如向上使用靠近皮肤表面的尖锐套管。抽脂与另一种外科技术(如腹部整形)相结合,也被证明会增加皮肤坏死的风险。

    皮肤坏死的治疗包括外科清创、抗生素和二次伤口闭合翻修。高压氧和前列腺素可作为增加血液供应的辅助治疗。据报道,早期使用高压氧有助于限制坏死面积。预防措施包括避免表面抽吸、使用插管和温柔的手术操作技术。

 

神经后遗症

    感觉减退或感觉丧失是罕见的,几乎总是暂时的,症状在1年内消退。严重或慢性疼痛可能是由一个小的神经瘤引起的,但更多的是由潜在筋膜或肌肉的损伤引起的。除了术中损伤,超声辅助吸脂术后还有慢性感觉过敏的报道。这被归因于皮肤感觉神经的髓鞘损伤。抽脂后出现的慢性疼痛需要由神经科专家进行评估。局部麻醉药可能提供暂时的缓解,但推荐使用磁共振成像。磁共振成像可以确定神经损伤或瘢痕形成造成的压力的潜在位置,这需要手术干预。

文献来源:

Al Dujaili Z,  Karcher C,  Henry M, Fat reduction: Complications and management.J Am Acad Dermatol 2018 Aug;79(2)

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    2021-09-21 hb2008ye
  3. [GetPortalCommentsPageByObjectIdResponse(id=1758365, encodeId=01a11e5836595, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Mon Feb 28 22:49:36 CST 2022, time=2022-02-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1406093, encodeId=60701406093b3, content=<a href='/topic/show?id=a5404e589d7' target=_blank style='color:#2F92EE;'>#局部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47589, encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Tue Sep 21 23:49:36 CST 2021, time=2021-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1441730, encodeId=9f171441e3022, content=<a href='/topic/show?id=e24d561096c' target=_blank style='color:#2F92EE;'>#抽脂术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56109, encryptionId=e24d561096c, topicName=抽脂术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cf714881264, createdName=ms5106640509429053, createdTime=Tue Sep 21 23:49:36 CST 2021, time=2021-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1053407, encodeId=757c105340e7b, content=额咯玉人民天津图书馆课本剧我了个擦哦起咯, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Tue Sep 21 07:18:28 CST 2021, time=2021-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1053270, encodeId=c0fc10532e060, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7bec5611745, createdName=ms2000001764390960, createdTime=Mon Sep 20 15:07:41 CST 2021, time=2021-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1053206, encodeId=ec3b1053206a9, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d1e05489924, createdName=ms1000002136354097, createdTime=Mon Sep 20 10:15:45 CST 2021, time=2021-09-20, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1758365, encodeId=01a11e5836595, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Mon Feb 28 22:49:36 CST 2022, time=2022-02-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1406093, encodeId=60701406093b3, content=<a href='/topic/show?id=a5404e589d7' target=_blank style='color:#2F92EE;'>#局部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47589, encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Tue Sep 21 23:49:36 CST 2021, time=2021-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1441730, encodeId=9f171441e3022, content=<a href='/topic/show?id=e24d561096c' target=_blank style='color:#2F92EE;'>#抽脂术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56109, encryptionId=e24d561096c, topicName=抽脂术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cf714881264, createdName=ms5106640509429053, createdTime=Tue Sep 21 23:49:36 CST 2021, time=2021-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1053407, encodeId=757c105340e7b, content=额咯玉人民天津图书馆课本剧我了个擦哦起咯, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Tue Sep 21 07:18:28 CST 2021, time=2021-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1053270, encodeId=c0fc10532e060, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7bec5611745, createdName=ms2000001764390960, createdTime=Mon Sep 20 15:07:41 CST 2021, time=2021-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1053206, encodeId=ec3b1053206a9, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d1e05489924, createdName=ms1000002136354097, createdTime=Mon Sep 20 10:15:45 CST 2021, time=2021-09-20, status=1, ipAttribution=)]
    2021-09-21 查查佳佳

    额咯玉人民天津图书馆课本剧我了个擦哦起咯

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1758365, encodeId=01a11e5836595, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Mon Feb 28 22:49:36 CST 2022, time=2022-02-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1406093, encodeId=60701406093b3, content=<a href='/topic/show?id=a5404e589d7' target=_blank style='color:#2F92EE;'>#局部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47589, encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Tue Sep 21 23:49:36 CST 2021, time=2021-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1441730, encodeId=9f171441e3022, content=<a href='/topic/show?id=e24d561096c' target=_blank style='color:#2F92EE;'>#抽脂术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56109, encryptionId=e24d561096c, topicName=抽脂术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cf714881264, createdName=ms5106640509429053, createdTime=Tue Sep 21 23:49:36 CST 2021, time=2021-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1053407, encodeId=757c105340e7b, content=额咯玉人民天津图书馆课本剧我了个擦哦起咯, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Tue Sep 21 07:18:28 CST 2021, time=2021-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1053270, encodeId=c0fc10532e060, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7bec5611745, createdName=ms2000001764390960, createdTime=Mon Sep 20 15:07:41 CST 2021, time=2021-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1053206, encodeId=ec3b1053206a9, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d1e05489924, createdName=ms1000002136354097, createdTime=Mon Sep 20 10:15:45 CST 2021, time=2021-09-20, status=1, ipAttribution=)]
    2021-09-20 ms2000001764390960

    学习了

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1758365, encodeId=01a11e5836595, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Mon Feb 28 22:49:36 CST 2022, time=2022-02-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1406093, encodeId=60701406093b3, content=<a href='/topic/show?id=a5404e589d7' target=_blank style='color:#2F92EE;'>#局部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47589, encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Tue Sep 21 23:49:36 CST 2021, time=2021-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1441730, encodeId=9f171441e3022, content=<a href='/topic/show?id=e24d561096c' target=_blank style='color:#2F92EE;'>#抽脂术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56109, encryptionId=e24d561096c, topicName=抽脂术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cf714881264, createdName=ms5106640509429053, createdTime=Tue Sep 21 23:49:36 CST 2021, time=2021-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1053407, encodeId=757c105340e7b, content=额咯玉人民天津图书馆课本剧我了个擦哦起咯, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Tue Sep 21 07:18:28 CST 2021, time=2021-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1053270, encodeId=c0fc10532e060, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7bec5611745, createdName=ms2000001764390960, createdTime=Mon Sep 20 15:07:41 CST 2021, time=2021-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1053206, encodeId=ec3b1053206a9, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d1e05489924, createdName=ms1000002136354097, createdTime=Mon Sep 20 10:15:45 CST 2021, time=2021-09-20, status=1, ipAttribution=)]
    2021-09-20 ms1000002136354097

    学习了

    0