妇产科

订阅

MedSci主页 / 所有栏目 / 妇产科

Gastrointest Endosc：宫颈出血 内镜下止血钳行不行

2015-01-16 清晨111 丁香园

止血钳内镜治疗内窥镜阴道检查凝血试验
关注

宫颈癌是最常见的妇科恶性肿瘤。目前，放化疗已成为世界各国治疗子宫颈癌的主要方法。而宫颈癌放化疗后出现的宫颈出血通常需要手术或动脉栓塞进行治疗。然而，这些方法是侵入性的，其成功率有限，安全性让人担忧。止血钳软凝在内镜黏膜下剥离术中可治疗出血。最近，日本香川大学医学院的Hideki Kobara教授等首次应用内镜下止血钳治疗活动性宫颈出血。 一名51岁的宫颈癌患者在经历4个月的放化疗(每周紫

宫颈癌是最常见的妇科恶性肿瘤。目前，放化疗已成为世界各国治疗子宫颈癌的主要方法。而宫颈癌放化疗后出现的宫颈出血通常需要手术或动脉栓塞进行治疗。然而，这些方法是侵入性的，其成功率有限，安全性让人担忧。止血钳软凝在内镜黏膜下剥离术中可治疗出血。最近，日本香川大学医学院的Hideki Kobara教授等首次应用内镜下止血钳治疗活动性宫颈出血。

一名51岁的宫颈癌患者在经历4个月的放化疗(每周紫杉醇60 mg/m2，其次是卡铂5 mg/mL·min)后出现阴道出血(血红蛋白6.4 g/dL;正常11-15 g/dL)。阴道检查在溃疡中的出血部位发现大量的血凝块。因此，医生考虑内镜治疗，并获得了患者的知情同意书。首先，在患者保持清醒的情况下，内窥镜(GIF-Q260J，奥林巴斯，东京，日本)伸入阴道。操作者使用抓钳(FG-47l-1;奥林巴斯)移除血凝块。之后，使用内窥镜前端的透明帽和水射流功能成功暴露在宫颈口附近搏动的动脉血管(图1A，B)。该视频可在该网址(www.giejournal.org) 查询到。

图1. A，内窥镜显示宫颈口附近溃疡的出血部位。B，内窥镜显示通过使用透明帽(黄色箭头)和水射流功能检测动脉血管(蓝色箭头)。C，内窥镜显示使用止血钳在内镜直视下连续5次处理破裂血管(每次2秒)后成功止血。D，内窥镜显示使用止血钳完全混凝的部位。E，内窥镜显示暴露的血管在治疗后2天消失。 F，阴道检查显示粘膜在治疗后25天愈合。

化疗导致溃疡出现慢性纤维化，这使操作过程中组织抓取变得更加困难。因此，作者认为止血钳可能最适合用于止血。手术医生可以应用止血钳(coagrasper, FD-411QR;奥林巴斯)的凝血模式进行操作。最终，患者在5次连续的凝血试验(图1C)后，完全止血(图1D)。内镜检查显示暴露的血管在治疗后2天消失(图1E)。阴道检查可见粘膜在治疗后25天愈合(图1F)。这些发现表明内镜下止血钳可应用于妇科。

原始出处：

Kobara H1, Mori H1, Rafiq K2, Fujihara S1, Nishiyama N1, Morishita A1, Goda Y1, Kanenishi K3, Hata T3, Masaki T1.Application of endoscopic hemostatic forceps for uterine cervical bleeding.Gastrointest Endosc. 2015 Jan;81(1):234-5. doi: 10.1016/j.gie.2014.04.023. Epub 2014 Jun 2.

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 (8)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=2071563, encodeId=18ae20e156315, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Sun Sep 06 08:45:00 CST 2015, time=2015-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1710774, encodeId=fda01e10774bb, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Sat Dec 12 10:45:00 CST 2015, time=2015-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1943388, encodeId=27f619433880a, content=<a href='/topic/show?id=fa761e2916a' target=_blank style='color:#2F92EE;'>#Test#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17291, encryptionId=fa761e2916a, topicName=Test)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aea0290, createdName=lqvr, createdTime=Tue Nov 10 12:45:00 CST 2015, time=2015-11-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050431, encodeId=45e7205043130, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Sat Jan 17 20:45:00 CST 2015, time=2015-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2056393, encodeId=0ad2205639398, content=<a href='/topic/show?id=b38a63184f9' target=_blank style='color:#2F92EE;'>#止血钳#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63184, encryptionId=b38a63184f9, topicName=止血钳)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=19c567, createdName=habb, createdTime=Thu Feb 05 07:45:00 CST 2015, time=2015-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1261870, encodeId=20a112618e0e1, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Sun Jan 18 05:45:00 CST 2015, time=2015-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1263021, encodeId=3d85126302192, content=<a href='/topic/show?id=ebb5631e076' target=_blank style='color:#2F92EE;'>#止血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63170, encryptionId=ebb5631e076, topicName=止血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6f7770, createdName=jeanqiuqiu, createdTime=Sun Jan 18 05:45:00 CST 2015, time=2015-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407939, encodeId=b609140e939e7, content=<a href='/topic/show?id=92194628826' target=_blank style='color:#2F92EE;'>#宫颈#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46288, encryptionId=92194628826, topicName=宫颈)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11102737131, createdName=一闲, createdTime=Sun Jan 18 05:45:00 CST 2015, time=2015-01-18, status=1, ipAttribution=)]
    2015-09-06 许安

    #GAS#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=2071563, encodeId=18ae20e156315, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Sun Sep 06 08:45:00 CST 2015, time=2015-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1710774, encodeId=fda01e10774bb, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Sat Dec 12 10:45:00 CST 2015, time=2015-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1943388, encodeId=27f619433880a, content=<a href='/topic/show?id=fa761e2916a' target=_blank style='color:#2F92EE;'>#Test#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17291, encryptionId=fa761e2916a, topicName=Test)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aea0290, createdName=lqvr, createdTime=Tue Nov 10 12:45:00 CST 2015, time=2015-11-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050431, encodeId=45e7205043130, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Sat Jan 17 20:45:00 CST 2015, time=2015-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2056393, encodeId=0ad2205639398, content=<a href='/topic/show?id=b38a63184f9' target=_blank style='color:#2F92EE;'>#止血钳#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63184, encryptionId=b38a63184f9, topicName=止血钳)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=19c567, createdName=habb, createdTime=Thu Feb 05 07:45:00 CST 2015, time=2015-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1261870, encodeId=20a112618e0e1, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Sun Jan 18 05:45:00 CST 2015, time=2015-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1263021, encodeId=3d85126302192, content=<a href='/topic/show?id=ebb5631e076' target=_blank style='color:#2F92EE;'>#止血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63170, encryptionId=ebb5631e076, topicName=止血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6f7770, createdName=jeanqiuqiu, createdTime=Sun Jan 18 05:45:00 CST 2015, time=2015-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407939, encodeId=b609140e939e7, content=<a href='/topic/show?id=92194628826' target=_blank style='color:#2F92EE;'>#宫颈#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46288, encryptionId=92194628826, topicName=宫颈)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11102737131, createdName=一闲, createdTime=Sun Jan 18 05:45:00 CST 2015, time=2015-01-18, status=1, ipAttribution=)]
    2015-12-12 ms24272190615788285182

    #AST#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=2071563, encodeId=18ae20e156315, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Sun Sep 06 08:45:00 CST 2015, time=2015-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1710774, encodeId=fda01e10774bb, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Sat Dec 12 10:45:00 CST 2015, time=2015-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1943388, encodeId=27f619433880a, content=<a href='/topic/show?id=fa761e2916a' target=_blank style='color:#2F92EE;'>#Test#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17291, encryptionId=fa761e2916a, topicName=Test)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aea0290, createdName=lqvr, createdTime=Tue Nov 10 12:45:00 CST 2015, time=2015-11-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050431, encodeId=45e7205043130, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Sat Jan 17 20:45:00 CST 2015, time=2015-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2056393, encodeId=0ad2205639398, content=<a href='/topic/show?id=b38a63184f9' target=_blank style='color:#2F92EE;'>#止血钳#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63184, encryptionId=b38a63184f9, topicName=止血钳)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=19c567, createdName=habb, createdTime=Thu Feb 05 07:45:00 CST 2015, time=2015-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1261870, encodeId=20a112618e0e1, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Sun Jan 18 05:45:00 CST 2015, time=2015-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1263021, encodeId=3d85126302192, content=<a href='/topic/show?id=ebb5631e076' target=_blank style='color:#2F92EE;'>#止血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63170, encryptionId=ebb5631e076, topicName=止血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6f7770, createdName=jeanqiuqiu, createdTime=Sun Jan 18 05:45:00 CST 2015, time=2015-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407939, encodeId=b609140e939e7, content=<a href='/topic/show?id=92194628826' target=_blank style='color:#2F92EE;'>#宫颈#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46288, encryptionId=92194628826, topicName=宫颈)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11102737131, createdName=一闲, createdTime=Sun Jan 18 05:45:00 CST 2015, time=2015-01-18, status=1, ipAttribution=)]
    2015-11-10 lqvr

    #Test#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=2071563, encodeId=18ae20e156315, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Sun Sep 06 08:45:00 CST 2015, time=2015-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1710774, encodeId=fda01e10774bb, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Sat Dec 12 10:45:00 CST 2015, time=2015-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1943388, encodeId=27f619433880a, content=<a href='/topic/show?id=fa761e2916a' target=_blank style='color:#2F92EE;'>#Test#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17291, encryptionId=fa761e2916a, topicName=Test)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aea0290, createdName=lqvr, createdTime=Tue Nov 10 12:45:00 CST 2015, time=2015-11-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050431, encodeId=45e7205043130, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Sat Jan 17 20:45:00 CST 2015, time=2015-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2056393, encodeId=0ad2205639398, content=<a href='/topic/show?id=b38a63184f9' target=_blank style='color:#2F92EE;'>#止血钳#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63184, encryptionId=b38a63184f9, topicName=止血钳)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=19c567, createdName=habb, createdTime=Thu Feb 05 07:45:00 CST 2015, time=2015-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1261870, encodeId=20a112618e0e1, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Sun Jan 18 05:45:00 CST 2015, time=2015-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1263021, encodeId=3d85126302192, content=<a href='/topic/show?id=ebb5631e076' target=_blank style='color:#2F92EE;'>#止血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63170, encryptionId=ebb5631e076, topicName=止血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6f7770, createdName=jeanqiuqiu, createdTime=Sun Jan 18 05:45:00 CST 2015, time=2015-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407939, encodeId=b609140e939e7, content=<a href='/topic/show?id=92194628826' target=_blank style='color:#2F92EE;'>#宫颈#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46288, encryptionId=92194628826, topicName=宫颈)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11102737131, createdName=一闲, createdTime=Sun Jan 18 05:45:00 CST 2015, time=2015-01-18, status=1, ipAttribution=)]
    2015-01-17 xiangyuzhou971

    #EST#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2071563, encodeId=18ae20e156315, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Sun Sep 06 08:45:00 CST 2015, time=2015-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1710774, encodeId=fda01e10774bb, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Sat Dec 12 10:45:00 CST 2015, time=2015-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1943388, encodeId=27f619433880a, content=<a href='/topic/show?id=fa761e2916a' target=_blank style='color:#2F92EE;'>#Test#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17291, encryptionId=fa761e2916a, topicName=Test)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aea0290, createdName=lqvr, createdTime=Tue Nov 10 12:45:00 CST 2015, time=2015-11-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050431, encodeId=45e7205043130, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Sat Jan 17 20:45:00 CST 2015, time=2015-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2056393, encodeId=0ad2205639398, content=<a href='/topic/show?id=b38a63184f9' target=_blank style='color:#2F92EE;'>#止血钳#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63184, encryptionId=b38a63184f9, topicName=止血钳)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=19c567, createdName=habb, createdTime=Thu Feb 05 07:45:00 CST 2015, time=2015-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1261870, encodeId=20a112618e0e1, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Sun Jan 18 05:45:00 CST 2015, time=2015-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1263021, encodeId=3d85126302192, content=<a href='/topic/show?id=ebb5631e076' target=_blank style='color:#2F92EE;'>#止血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63170, encryptionId=ebb5631e076, topicName=止血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6f7770, createdName=jeanqiuqiu, createdTime=Sun Jan 18 05:45:00 CST 2015, time=2015-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407939, encodeId=b609140e939e7, content=<a href='/topic/show?id=92194628826' target=_blank style='color:#2F92EE;'>#宫颈#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46288, encryptionId=92194628826, topicName=宫颈)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11102737131, createdName=一闲, createdTime=Sun Jan 18 05:45:00 CST 2015, time=2015-01-18, status=1, ipAttribution=)]
    2015-02-05 habb

    #止血钳#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2071563, encodeId=18ae20e156315, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Sun Sep 06 08:45:00 CST 2015, time=2015-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1710774, encodeId=fda01e10774bb, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Sat Dec 12 10:45:00 CST 2015, time=2015-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1943388, encodeId=27f619433880a, content=<a href='/topic/show?id=fa761e2916a' target=_blank style='color:#2F92EE;'>#Test#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17291, encryptionId=fa761e2916a, topicName=Test)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aea0290, createdName=lqvr, createdTime=Tue Nov 10 12:45:00 CST 2015, time=2015-11-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050431, encodeId=45e7205043130, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Sat Jan 17 20:45:00 CST 2015, time=2015-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2056393, encodeId=0ad2205639398, content=<a href='/topic/show?id=b38a63184f9' target=_blank style='color:#2F92EE;'>#止血钳#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63184, encryptionId=b38a63184f9, topicName=止血钳)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=19c567, createdName=habb, createdTime=Thu Feb 05 07:45:00 CST 2015, time=2015-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1261870, encodeId=20a112618e0e1, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Sun Jan 18 05:45:00 CST 2015, time=2015-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1263021, encodeId=3d85126302192, content=<a href='/topic/show?id=ebb5631e076' target=_blank style='color:#2F92EE;'>#止血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63170, encryptionId=ebb5631e076, topicName=止血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6f7770, createdName=jeanqiuqiu, createdTime=Sun Jan 18 05:45:00 CST 2015, time=2015-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407939, encodeId=b609140e939e7, content=<a href='/topic/show?id=92194628826' target=_blank style='color:#2F92EE;'>#宫颈#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46288, encryptionId=92194628826, topicName=宫颈)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11102737131, createdName=一闲, createdTime=Sun Jan 18 05:45:00 CST 2015, time=2015-01-18, status=1, ipAttribution=)]
    2015-01-18 jiafufeng@yaho

    #内镜#

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=2071563, encodeId=18ae20e156315, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Sun Sep 06 08:45:00 CST 2015, time=2015-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1710774, encodeId=fda01e10774bb, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Sat Dec 12 10:45:00 CST 2015, time=2015-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1943388, encodeId=27f619433880a, content=<a href='/topic/show?id=fa761e2916a' target=_blank style='color:#2F92EE;'>#Test#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17291, encryptionId=fa761e2916a, topicName=Test)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aea0290, createdName=lqvr, createdTime=Tue Nov 10 12:45:00 CST 2015, time=2015-11-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050431, encodeId=45e7205043130, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Sat Jan 17 20:45:00 CST 2015, time=2015-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2056393, encodeId=0ad2205639398, content=<a href='/topic/show?id=b38a63184f9' target=_blank style='color:#2F92EE;'>#止血钳#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63184, encryptionId=b38a63184f9, topicName=止血钳)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=19c567, createdName=habb, createdTime=Thu Feb 05 07:45:00 CST 2015, time=2015-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1261870, encodeId=20a112618e0e1, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Sun Jan 18 05:45:00 CST 2015, time=2015-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1263021, encodeId=3d85126302192, content=<a href='/topic/show?id=ebb5631e076' target=_blank style='color:#2F92EE;'>#止血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63170, encryptionId=ebb5631e076, topicName=止血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6f7770, createdName=jeanqiuqiu, createdTime=Sun Jan 18 05:45:00 CST 2015, time=2015-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407939, encodeId=b609140e939e7, content=<a href='/topic/show?id=92194628826' target=_blank style='color:#2F92EE;'>#宫颈#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46288, encryptionId=92194628826, topicName=宫颈)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11102737131, createdName=一闲, createdTime=Sun Jan 18 05:45:00 CST 2015, time=2015-01-18, status=1, ipAttribution=)]
    2015-01-18 jeanqiuqiu

    #止血#

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=2071563, encodeId=18ae20e156315, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Sun Sep 06 08:45:00 CST 2015, time=2015-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1710774, encodeId=fda01e10774bb, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Sat Dec 12 10:45:00 CST 2015, time=2015-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1943388, encodeId=27f619433880a, content=<a href='/topic/show?id=fa761e2916a' target=_blank style='color:#2F92EE;'>#Test#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17291, encryptionId=fa761e2916a, topicName=Test)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aea0290, createdName=lqvr, createdTime=Tue Nov 10 12:45:00 CST 2015, time=2015-11-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050431, encodeId=45e7205043130, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Sat Jan 17 20:45:00 CST 2015, time=2015-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2056393, encodeId=0ad2205639398, content=<a href='/topic/show?id=b38a63184f9' target=_blank style='color:#2F92EE;'>#止血钳#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63184, encryptionId=b38a63184f9, topicName=止血钳)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=19c567, createdName=habb, createdTime=Thu Feb 05 07:45:00 CST 2015, time=2015-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1261870, encodeId=20a112618e0e1, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Sun Jan 18 05:45:00 CST 2015, time=2015-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1263021, encodeId=3d85126302192, content=<a href='/topic/show?id=ebb5631e076' target=_blank style='color:#2F92EE;'>#止血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63170, encryptionId=ebb5631e076, topicName=止血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6f7770, createdName=jeanqiuqiu, createdTime=Sun Jan 18 05:45:00 CST 2015, time=2015-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407939, encodeId=b609140e939e7, content=<a href='/topic/show?id=92194628826' target=_blank style='color:#2F92EE;'>#宫颈#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46288, encryptionId=92194628826, topicName=宫颈)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11102737131, createdName=一闲, createdTime=Sun Jan 18 05:45:00 CST 2015, time=2015-01-18, status=1, ipAttribution=)]
    2015-01-18 一闲

    #宫颈#

    0