急性后循环缺血性卒中静脉溶栓桥接血管内机械取栓术一例

2020-06-02 冯鹏程 康煜 程凌燕 中国现代神经疾病杂志 神经科病例撷英拾粹

患者男性,51岁。因头晕伴恶心、呕吐3小时,于2017年5月3日凌晨4∶00急诊入院。患者约于3小时前(2017年5月3日夜间1∶00)无明显诱因突发头晕伴恶心、呕吐,呕吐物为胃内容物,无&ldquo

患者男性,51岁。因头晕伴恶心、呕吐3小时,于2017年5月3日凌晨4∶00急诊入院。患者约于3小时前(2017年5月3日夜间1∶00)无明显诱因突发头晕伴恶心、呕吐,呕吐物为胃内容物,无“咖啡”样残渣,无意识障碍、构音障碍、复视、肢体无力、失语、大小便失禁等症状与体征,头部CT检查未见明显异常(图1a),以“头晕待查,后循环缺血性卒中”收入院。既往高血压病史10余年,血压最高达200/100mmHg(1mmHg=0.133kPa),长期规律服用氨氯地平5mg/d,血压控制良好;吸烟史近30年(20支/d);饮白酒史近30年(100mg/d)。其余既往史、个人史及家族史无特殊。入院后体格检查:体温36.6℃,脉搏86次/min,呼吸19次/min,血压150/80mmHg。心、肺、腹部检查无明显异常。神志清楚,对答切题,注意力、记忆力、定向力尚可,脑神经检查无明显异常;四肢肌力、肌张力正常;共济运动和感觉系统粗测正常,生理反射存在,病理反射未引出,脑膜刺激征阴性。美国国立卫生研究院卒中量表(NIHSS)评分为零,改良Rankin量表(mRS)评分1分。拟诊后循环缺血。采取抗血小板、调脂和清除氧自由基等对症支持治疗,分别予以氯吡格雷75mg/d和阿托伐他汀(立普妥)20mg/晚口服,以及依达拉奉30mg/次(2次/d)静脉滴注。入院后4小时(2017年5月3日上午8∶00)突发烦躁不安、失语伴左侧肢体无力。体格检查:血压200/120mmHg,神志清楚,烦躁不安,失语;双侧瞳孔等大、等圆,直径约3mm,对光反射迟钝,各向眼动充分,无复视和眼震,双眼向左侧凝视,右侧鼻唇沟浅,其余脑神经检查不合作;左上肢肌力0级、左下肢2级,右侧肢体肌力4级,四肢肌张力均正常;共济运动和感觉系统检查不合作;生理反射减退,右侧病理征阳性、左侧可疑阳性。NIHSS评分12分,mRS评分为4分。实验室检查:血常规白细胞计数23.18×109/L[(4-10)×109/L],中性粒细胞比例0.94(0.50-0.70);血清总胆固醇(TC)5.33mmol/L(2.33-5.17mmol/L),甘油三脂(TG)1.78mmol/L(0.50-1.70mmol/L),脂蛋白(a)[LP(a)]415.30mg/L(0-300mg/L),高敏心肌肌钙蛋白T(hs-cTnT)、肌红蛋白、肌酸激酶同工酶均于正常值范围,糖化血红蛋白(HbA1c)、凝血功能,以及甲型肝炎病毒抗体、丙型肝炎病毒抗体、戊型肝炎病毒抗体均于正常值范围。复查头部CT未发现颅内出血(图1b)。心电图无异常心电活动。临床诊断:急性脑干缺血性卒中。遂于入院当日上午8∶30以重组组织型纤溶酶原激活物(rt-PA)55mg行静脉溶栓,其中5.50mg于1分钟内静脉推注,其余49.50mg于1小时内经静脉泵入。溶栓治疗过程中血压维持在150/80mmHg,2小时后神志逐渐清楚,可正常言语交流;肢体肌力明显改善,左侧3级、右侧5-级;NIHSS评分5分,mRS评分3分。至中午12∶00意识障碍突然加重,昏睡状态,左侧肢体肌力0-2级;头部MRI检查显示脑干缺血性卒中(图2),颅内未见明显出血灶;MRA显示基底动脉闭塞(图3)。遂向患者家属通报病情,建议进一步行数字减影血管造影术(DSA)和血管内机械取栓术,并告知家属手术的可能风险,在患者家属知情同意的情况下于17∶00施行DSA检查。术中可见基底动脉尖端血栓形成,右椎动脉V4段闭塞,左椎动脉V4段重度狭窄,呈节段性(图4)。根据DSA所见,行桥接基底动脉和右椎动脉机械取栓术,以及左椎动脉支架植入术:患者平卧位,气管插管全身麻醉,于右侧腹股沟穿刺点置入8F导引导管,沿导引导管置入Rebar18微导管,反复手动推注对比剂确定血栓远端,沿微导管置入Solitaire FR支架(4mm×20mm,美国EV3公司),与血栓融合后,撤出部分微导管,释放Solitaire FR支架,回撤微导管和Solitaire FR支架,取出新鲜血栓,同法取出右椎动脉V4段少量新鲜血栓;置入微导丝,沿微导丝将微导管送至左椎动脉V4段狭窄段远端,沿微导管植入Solitaire FR支架,同法于左椎动脉V4狭窄段近端植入Apollo支架(3mm×8mm,上海微创?公司)。术后DSA显示,基底动脉血流通畅,右椎动脉V4段未再通,左椎动脉V4段植入2枚支架后血流通畅(图5)。术后即刻复查头部CT未见缺血性卒中复发和颅内出血,临床亦未见缺血-再灌注损伤或脑血管痉挛症状与体征。术后0.50小时予以替罗非班4ml/h持续静脉泵入24小时以预防支架内再狭窄,硝普钠1-5ml/h持续静脉泵入24小时用以控制血压于100-140/60-90mmHg,术后24小时予以阿司匹林100mg/d和氯吡格雷75mg/d口服行双联抗血小板、阿托伐他汀40mg/d口服调脂、依达拉奉30mg/次(2次/d)静脉滴注清除氧自由基、丁苯酞100ml/次(2次/d)静脉滴注保护神经细胞、促进侧支循环。患者共计住院14天,出院时一般状况良好,可离床短距离活动但行走不稳。出院后继续服用阿司匹林100mg/d、氯吡格雷75mg/d和阿托伐他汀20mg/d,同时辅以康复训练。出院后3个月电话随访,言语清晰,日常生活和活动尚可。


讨论

急性缺血性卒中是颅内动脉血管狭窄或闭塞引起的局部脑组织缺血、缺氧所导致的缺血性坏死,病残率和病死率较高,尤其是后循环缺血性卒中的病残率和病死率高达80%以上,严重影响患者生活质量,并加重家庭和社会医疗与经济负担。目前,对于发病时间在6小时以内的急性缺血性卒中患者,静脉溶栓是最有效的超早期救治方法。然而,由于静脉溶栓的颅内大血管再通率低(仅10%-30%)、“治疗时间窗”短(≤6小时)等限制性要求,使其在临床推广应用大大受限。对于此类处于“取栓时间窗”(前循环缺血性卒中发病≤8小时、后循环缺血性卒中发病≤24小时)但超过“溶栓时间窗”或静脉溶栓疗效欠佳的患者,可考虑施行血管内机械取栓术,而且经临床实践业已证实,凡处于这一适应证范围内的急性缺血性卒中患者治疗后多可取得较为理想的效果。基于此,有学者提出可采取静脉溶栓桥接血管内机械取栓术,以更有效地改善急性颅内动脉血管闭塞患者的预后。与动脉溶栓和静脉溶栓相比,血管内机械取栓术对闭塞大血管的重建更为有利,术中DSA实时监测血管再通及其程度,可减少溶栓药物的应用剂量、延长“治疗时间窗”、提高血管再通率。

本文患者为急性后循环缺血性卒中,采取静脉溶栓桥接血管内机械取栓术疗效显著,且术后未发生颅内出血、缺血性卒中复发、缺血-再灌注损伤、脑血管痉挛等严重不良反应。Gory等认为,静脉溶栓可以减少血管内机械取栓术后90天内病死率。多中心回顾性研究显示,静脉溶栓桥接血管内机械取栓术是一种安全、有效的血管再通方法,可以显著改善患者发病3个月后的神经功能,既适用于前循环亦适用于后循环缺血性卒中病例,且二者预后无明显差异。Smith采用血管内机械取栓术治疗111例急性缺血性卒中患者,30例术前应用rt-PA静脉溶栓,结果显示,与单纯血管内机械取栓术相比,静脉溶栓桥接血管内机械取栓术的血管再通率显著增加(P<0.05),而颅内出血率组间差异无统计学意义(P>0.05)。Cobb等报告1例63岁男性急性左颈内动脉和大脑中动脉闭塞(MCAO)病例,入院时NIHSS评分20分,急诊行静脉溶栓桥接血管内机械取栓术,术后NIHSS评分为零,MRI仅显示左侧纹状体少量缺血,手术当日服用氯吡格雷负荷剂量300mg,后予阿司匹林81mg/d和氯吡格雷75mg/d口服维持治疗,未发生出血等严重不良反应。根据Vendrell等的临床报告,采用rt-PA静脉溶栓治疗急性大脑中动脉闭塞后1小时,若患者临床症状改善不明显,桥接血管内机械取栓术可显著改善患者发病3个月后的临床症状,且较少发生症状性颅内出血等不良反应。大样本回顾性病例对照研究也得出相似结论,而且提出治疗越早、患者预后越佳的观点。近年来,国内也开展了一系列有关静脉溶栓桥接血管内机械取栓术治疗颅内大动脉血管闭塞的临床研究,证实静脉溶栓桥接Solitaire AB支架取栓可使闭塞的大动脉获得良好的再通,不仅显著改善神经功能,而且可通过精简桥接流程、缩短取栓时间等而使患者进一步获益,与本研究结果相一致。

综上所述,对于急性颅内大动脉闭塞患者,“溶栓时间窗”内首选静脉溶栓治疗,若效果欠佳应立即于DSA引导下行桥接血管内机械取栓术;超过“溶栓时间窗”但处于“取栓时间窗”可直接施行血管内机械取栓术;尤其是后循环急性缺血性卒中患者,应强调静脉溶栓桥接血管内机械取栓术的序贯治疗,越早治疗、预后越佳。

原始出处:

冯鹏程,康煜,程凌燕,杨娟,王晶,吴玉萍,柳丹,成熟,李翠华.急性后循环缺血性卒中静脉溶栓桥接血管内机械取栓术一例[J].中国现代神经疾病杂志,2019,19(10):775-779.

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=2033450, encodeId=3dc920334500d, content=<a href='/topic/show?id=800638008ea' target=_blank style='color:#2F92EE;'>#取栓术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38008, encryptionId=800638008ea, topicName=取栓术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc7a157, createdName=jinweidong, createdTime=Sun Oct 18 02:10:12 CST 2020, time=2020-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806393, encodeId=146d18063939b, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Fri Feb 26 18:10:12 CST 2021, time=2021-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1893303, encodeId=f3b4189330335, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Sat Nov 07 03:10:12 CST 2020, time=2020-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1698103, encodeId=aa16169810395, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Fri Nov 13 13:10:12 CST 2020, time=2020-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1924256, encodeId=7c261924256dc, content=<a href='/topic/show?id=dd88390827d' target=_blank style='color:#2F92EE;'>#后循环缺血性卒中#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39082, encryptionId=dd88390827d, topicName=后循环缺血性卒中)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=72bf2500198, createdName=小小小向日葵, createdTime=Wed Aug 19 09:10:12 CST 2020, time=2020-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1479083, encodeId=725814e9083da, content=<a href='/topic/show?id=b97f3800ee0' target=_blank style='color:#2F92EE;'>#取栓#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38007, encryptionId=b97f3800ee0, topicName=取栓)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=99077483919, createdName=1249862am74(暂无昵称), createdTime=Thu Jun 04 05:10:12 CST 2020, time=2020-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1578905, encodeId=447015e89057c, content=<a href='/topic/show?id=80286123908' target=_blank style='color:#2F92EE;'>#机械取栓#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61239, encryptionId=80286123908, topicName=机械取栓)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=de0216462203, createdName=ms2186806800017884, createdTime=Thu Jun 04 05:10:12 CST 2020, time=2020-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026647, encodeId=486c102664e4f, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Tue Jun 02 17:10:12 CST 2020, time=2020-06-02, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=2033450, encodeId=3dc920334500d, content=<a href='/topic/show?id=800638008ea' target=_blank style='color:#2F92EE;'>#取栓术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38008, encryptionId=800638008ea, topicName=取栓术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc7a157, createdName=jinweidong, createdTime=Sun Oct 18 02:10:12 CST 2020, time=2020-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806393, encodeId=146d18063939b, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Fri Feb 26 18:10:12 CST 2021, time=2021-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1893303, encodeId=f3b4189330335, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Sat Nov 07 03:10:12 CST 2020, time=2020-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1698103, encodeId=aa16169810395, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Fri Nov 13 13:10:12 CST 2020, time=2020-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1924256, encodeId=7c261924256dc, content=<a href='/topic/show?id=dd88390827d' target=_blank style='color:#2F92EE;'>#后循环缺血性卒中#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39082, encryptionId=dd88390827d, topicName=后循环缺血性卒中)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=72bf2500198, createdName=小小小向日葵, createdTime=Wed Aug 19 09:10:12 CST 2020, time=2020-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1479083, encodeId=725814e9083da, content=<a href='/topic/show?id=b97f3800ee0' target=_blank style='color:#2F92EE;'>#取栓#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38007, encryptionId=b97f3800ee0, topicName=取栓)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=99077483919, createdName=1249862am74(暂无昵称), createdTime=Thu Jun 04 05:10:12 CST 2020, time=2020-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1578905, encodeId=447015e89057c, content=<a href='/topic/show?id=80286123908' target=_blank style='color:#2F92EE;'>#机械取栓#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61239, encryptionId=80286123908, topicName=机械取栓)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=de0216462203, createdName=ms2186806800017884, createdTime=Thu Jun 04 05:10:12 CST 2020, time=2020-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026647, encodeId=486c102664e4f, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Tue Jun 02 17:10:12 CST 2020, time=2020-06-02, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=2033450, encodeId=3dc920334500d, content=<a href='/topic/show?id=800638008ea' target=_blank style='color:#2F92EE;'>#取栓术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38008, encryptionId=800638008ea, topicName=取栓术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc7a157, createdName=jinweidong, createdTime=Sun Oct 18 02:10:12 CST 2020, time=2020-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806393, encodeId=146d18063939b, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Fri Feb 26 18:10:12 CST 2021, time=2021-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1893303, encodeId=f3b4189330335, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Sat Nov 07 03:10:12 CST 2020, time=2020-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1698103, encodeId=aa16169810395, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Fri Nov 13 13:10:12 CST 2020, time=2020-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1924256, encodeId=7c261924256dc, content=<a href='/topic/show?id=dd88390827d' target=_blank style='color:#2F92EE;'>#后循环缺血性卒中#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39082, encryptionId=dd88390827d, topicName=后循环缺血性卒中)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=72bf2500198, createdName=小小小向日葵, createdTime=Wed Aug 19 09:10:12 CST 2020, time=2020-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1479083, encodeId=725814e9083da, content=<a href='/topic/show?id=b97f3800ee0' target=_blank style='color:#2F92EE;'>#取栓#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38007, encryptionId=b97f3800ee0, topicName=取栓)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=99077483919, createdName=1249862am74(暂无昵称), createdTime=Thu Jun 04 05:10:12 CST 2020, time=2020-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1578905, encodeId=447015e89057c, content=<a href='/topic/show?id=80286123908' target=_blank style='color:#2F92EE;'>#机械取栓#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61239, encryptionId=80286123908, topicName=机械取栓)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=de0216462203, createdName=ms2186806800017884, createdTime=Thu Jun 04 05:10:12 CST 2020, time=2020-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026647, encodeId=486c102664e4f, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Tue Jun 02 17:10:12 CST 2020, time=2020-06-02, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=2033450, encodeId=3dc920334500d, content=<a href='/topic/show?id=800638008ea' target=_blank style='color:#2F92EE;'>#取栓术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38008, encryptionId=800638008ea, topicName=取栓术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc7a157, createdName=jinweidong, createdTime=Sun Oct 18 02:10:12 CST 2020, time=2020-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806393, encodeId=146d18063939b, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Fri Feb 26 18:10:12 CST 2021, time=2021-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1893303, encodeId=f3b4189330335, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Sat Nov 07 03:10:12 CST 2020, time=2020-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1698103, encodeId=aa16169810395, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Fri Nov 13 13:10:12 CST 2020, time=2020-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1924256, encodeId=7c261924256dc, content=<a href='/topic/show?id=dd88390827d' target=_blank style='color:#2F92EE;'>#后循环缺血性卒中#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39082, encryptionId=dd88390827d, topicName=后循环缺血性卒中)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=72bf2500198, createdName=小小小向日葵, createdTime=Wed Aug 19 09:10:12 CST 2020, time=2020-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1479083, encodeId=725814e9083da, content=<a href='/topic/show?id=b97f3800ee0' target=_blank style='color:#2F92EE;'>#取栓#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38007, encryptionId=b97f3800ee0, topicName=取栓)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=99077483919, createdName=1249862am74(暂无昵称), createdTime=Thu Jun 04 05:10:12 CST 2020, time=2020-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1578905, encodeId=447015e89057c, content=<a href='/topic/show?id=80286123908' target=_blank style='color:#2F92EE;'>#机械取栓#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61239, encryptionId=80286123908, topicName=机械取栓)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=de0216462203, createdName=ms2186806800017884, createdTime=Thu Jun 04 05:10:12 CST 2020, time=2020-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026647, encodeId=486c102664e4f, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Tue Jun 02 17:10:12 CST 2020, time=2020-06-02, status=1, ipAttribution=)]
    2020-11-13 fusion
  5. [GetPortalCommentsPageByObjectIdResponse(id=2033450, encodeId=3dc920334500d, content=<a href='/topic/show?id=800638008ea' target=_blank style='color:#2F92EE;'>#取栓术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38008, encryptionId=800638008ea, topicName=取栓术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc7a157, createdName=jinweidong, createdTime=Sun Oct 18 02:10:12 CST 2020, time=2020-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806393, encodeId=146d18063939b, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Fri Feb 26 18:10:12 CST 2021, time=2021-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1893303, encodeId=f3b4189330335, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Sat Nov 07 03:10:12 CST 2020, time=2020-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1698103, encodeId=aa16169810395, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Fri Nov 13 13:10:12 CST 2020, time=2020-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1924256, encodeId=7c261924256dc, content=<a href='/topic/show?id=dd88390827d' target=_blank style='color:#2F92EE;'>#后循环缺血性卒中#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39082, encryptionId=dd88390827d, topicName=后循环缺血性卒中)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=72bf2500198, createdName=小小小向日葵, createdTime=Wed Aug 19 09:10:12 CST 2020, time=2020-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1479083, encodeId=725814e9083da, content=<a href='/topic/show?id=b97f3800ee0' target=_blank style='color:#2F92EE;'>#取栓#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38007, encryptionId=b97f3800ee0, topicName=取栓)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=99077483919, createdName=1249862am74(暂无昵称), createdTime=Thu Jun 04 05:10:12 CST 2020, time=2020-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1578905, encodeId=447015e89057c, content=<a href='/topic/show?id=80286123908' target=_blank style='color:#2F92EE;'>#机械取栓#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61239, encryptionId=80286123908, topicName=机械取栓)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=de0216462203, createdName=ms2186806800017884, createdTime=Thu Jun 04 05:10:12 CST 2020, time=2020-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026647, encodeId=486c102664e4f, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Tue Jun 02 17:10:12 CST 2020, time=2020-06-02, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=2033450, encodeId=3dc920334500d, content=<a href='/topic/show?id=800638008ea' target=_blank style='color:#2F92EE;'>#取栓术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38008, encryptionId=800638008ea, topicName=取栓术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc7a157, createdName=jinweidong, createdTime=Sun Oct 18 02:10:12 CST 2020, time=2020-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806393, encodeId=146d18063939b, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Fri Feb 26 18:10:12 CST 2021, time=2021-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1893303, encodeId=f3b4189330335, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Sat Nov 07 03:10:12 CST 2020, time=2020-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1698103, encodeId=aa16169810395, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Fri Nov 13 13:10:12 CST 2020, time=2020-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1924256, encodeId=7c261924256dc, content=<a href='/topic/show?id=dd88390827d' target=_blank style='color:#2F92EE;'>#后循环缺血性卒中#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39082, encryptionId=dd88390827d, topicName=后循环缺血性卒中)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=72bf2500198, createdName=小小小向日葵, createdTime=Wed Aug 19 09:10:12 CST 2020, time=2020-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1479083, encodeId=725814e9083da, content=<a href='/topic/show?id=b97f3800ee0' target=_blank style='color:#2F92EE;'>#取栓#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38007, encryptionId=b97f3800ee0, topicName=取栓)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=99077483919, createdName=1249862am74(暂无昵称), createdTime=Thu Jun 04 05:10:12 CST 2020, time=2020-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1578905, encodeId=447015e89057c, content=<a href='/topic/show?id=80286123908' target=_blank style='color:#2F92EE;'>#机械取栓#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61239, encryptionId=80286123908, topicName=机械取栓)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=de0216462203, createdName=ms2186806800017884, createdTime=Thu Jun 04 05:10:12 CST 2020, time=2020-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026647, encodeId=486c102664e4f, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Tue Jun 02 17:10:12 CST 2020, time=2020-06-02, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=2033450, encodeId=3dc920334500d, content=<a href='/topic/show?id=800638008ea' target=_blank style='color:#2F92EE;'>#取栓术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38008, encryptionId=800638008ea, topicName=取栓术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc7a157, createdName=jinweidong, createdTime=Sun Oct 18 02:10:12 CST 2020, time=2020-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806393, encodeId=146d18063939b, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Fri Feb 26 18:10:12 CST 2021, time=2021-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1893303, encodeId=f3b4189330335, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Sat Nov 07 03:10:12 CST 2020, time=2020-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1698103, encodeId=aa16169810395, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Fri Nov 13 13:10:12 CST 2020, time=2020-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1924256, encodeId=7c261924256dc, content=<a href='/topic/show?id=dd88390827d' target=_blank style='color:#2F92EE;'>#后循环缺血性卒中#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39082, encryptionId=dd88390827d, topicName=后循环缺血性卒中)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=72bf2500198, createdName=小小小向日葵, createdTime=Wed Aug 19 09:10:12 CST 2020, time=2020-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1479083, encodeId=725814e9083da, content=<a href='/topic/show?id=b97f3800ee0' target=_blank style='color:#2F92EE;'>#取栓#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38007, encryptionId=b97f3800ee0, topicName=取栓)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=99077483919, createdName=1249862am74(暂无昵称), createdTime=Thu Jun 04 05:10:12 CST 2020, time=2020-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1578905, encodeId=447015e89057c, content=<a href='/topic/show?id=80286123908' target=_blank style='color:#2F92EE;'>#机械取栓#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61239, encryptionId=80286123908, topicName=机械取栓)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=de0216462203, createdName=ms2186806800017884, createdTime=Thu Jun 04 05:10:12 CST 2020, time=2020-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026647, encodeId=486c102664e4f, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Tue Jun 02 17:10:12 CST 2020, time=2020-06-02, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=2033450, encodeId=3dc920334500d, content=<a href='/topic/show?id=800638008ea' target=_blank style='color:#2F92EE;'>#取栓术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38008, encryptionId=800638008ea, topicName=取栓术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc7a157, createdName=jinweidong, createdTime=Sun Oct 18 02:10:12 CST 2020, time=2020-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806393, encodeId=146d18063939b, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Fri Feb 26 18:10:12 CST 2021, time=2021-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1893303, encodeId=f3b4189330335, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Sat Nov 07 03:10:12 CST 2020, time=2020-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1698103, encodeId=aa16169810395, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Fri Nov 13 13:10:12 CST 2020, time=2020-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1924256, encodeId=7c261924256dc, content=<a href='/topic/show?id=dd88390827d' target=_blank style='color:#2F92EE;'>#后循环缺血性卒中#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39082, encryptionId=dd88390827d, topicName=后循环缺血性卒中)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=72bf2500198, createdName=小小小向日葵, createdTime=Wed Aug 19 09:10:12 CST 2020, time=2020-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1479083, encodeId=725814e9083da, content=<a href='/topic/show?id=b97f3800ee0' target=_blank style='color:#2F92EE;'>#取栓#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38007, encryptionId=b97f3800ee0, topicName=取栓)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=99077483919, createdName=1249862am74(暂无昵称), createdTime=Thu Jun 04 05:10:12 CST 2020, time=2020-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1578905, encodeId=447015e89057c, content=<a href='/topic/show?id=80286123908' target=_blank style='color:#2F92EE;'>#机械取栓#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61239, encryptionId=80286123908, topicName=机械取栓)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=de0216462203, createdName=ms2186806800017884, createdTime=Thu Jun 04 05:10:12 CST 2020, time=2020-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026647, encodeId=486c102664e4f, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Tue Jun 02 17:10:12 CST 2020, time=2020-06-02, status=1, ipAttribution=)]
    2020-06-02 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0

相关资讯

NEJM:达比加群在未确定栓塞性卒中病史的患者中的预防作用

对于来源不确定的栓塞性卒中患者,我们进行了达比加群每天150 mg或110 mg每天两次与阿司匹林100 mg每日一次剂量的多中心,随机,双盲试验。主要结果是卒中复发。主要安全结果是大出血。

Stroke:步行速度与卒中发病率之间的关系

在这项以人群为基础的队列研究中,64岁以上的参与者步行速度慢与较高的卒中风险有关。在初级保健或公共卫生临床咨询中增加自我报告步行速度这一指标可能是一个有用的卒中风险筛查工具。

JACC:房隔瘤和分流大小对卵圆孔未闭患者卒中复发的影响

在卵圆孔未闭(PFO)的患者中,大分流或房间隔动脉瘤(ASA)的存在被认为是卒中复发的高危因素。本研究的目的旨在评估PFO的大小和ASA对卒中复发的影响。

高血压女士尿酸高,要警惕糖尿病!中国卒中一级预防研究全新分析

5月3日,针对中国卒中一级预防研究(CSPPT)的一项最新回顾性分析提示,血尿酸水平升高的高血压女士未来患糖尿病的风险显著增加,但男士中未发现此现象。

Circulation:各类房颤筛查方法的综合对比

卒中(中风)是一个日益严重的全球性健康问题。房颤(AF)是卒中的一个主要风险因素,随着新的监测技术的开发,当下越来越重视对AF的筛查。本研究旨在评估一个大规模筛查策略的表现,评估与确诊相关的人群特征。

ACC: 疫情期间,心梗和卒中患者要及时就医!欧美心脏学会呼吁

目前,受新冠病毒疫情影响,全球很多国家到医院就诊的心肌梗死或中风的病人数量大幅下降。