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临床必备!8 类心血管急救药物用法全面汇总

2021-12-26 中国医学论坛报今日循环 中国医学论坛报今日循环

心血管急症具有发病急、病情复杂、危重等特点,在临床中,心血管急症的救治药物的应用起着关键性作用。

血管急症具有发病急、病情复杂、危重等特点,在临床中,心血管急症的救治药物的应用起着关键性作用。
因此,熟练掌握心血管急救药物的使用至关重要,是临床医生抢救患者成功的制胜法宝。8 类心血管急救药物用法一览,一起来看看吧~
 
肾上腺素(副肾)
作用及用途:
为肾上腺受体兴奋剂,兴奋心脏,使血管收缩、血压升高,又可使支气管平滑肌弛缓并减少支气管黏膜及充血,用于心脏骤停,过敏性休克,支气管哮喘
抢救过敏性休克
 
皮下注射或肌注0.5~1 mg,也可用0.1~0.5 mg缓慢静注(以0.9%氯化钠注射液稀释到10 ml)。如疗效不好,可改用4~8 mg静滴(溶于5%葡萄糖液500~1000 ml)。
 
抢救心脏骤停
 
可用0.5~1 mg立即静注,可每隔3~5 min重复应用数次。必要时以0.25~0.5 mg心内注射,同时作心脏按摩、人工呼吸和纠正酸中毒。
对非心脏骤停者(如感染性休克和有症状的窦性心动过缓)
 
肾上腺素也可作为升压药和正性频率药使用,但此时肾上腺素并非首选药,用量一般为0.1~2 μg/kg/min,配置方法以公斤体重×0.3配制成50 ml微量泵,以1 ml/h速度泵入相当于0.1 μg/ kg/min,用量范围为1~20 ml/h。如60 kg患者,配置方法为18 mg(18支)+0.9%NS 32 ml配制成50 ml微量泵,1 ml/h=0.1 μg/kg/min。
用量范围:
1~20 ml/h=0.1~2 μg/kg/min。静脉泵入时严格监测患者的血流动力学,逐步调整剂量至达到所需的血流动力学状态。
异丙肾上腺素
适应证:
主要用于治疗严重窦性心动过缓、窦房传导阻滞、窦性停搏和完全性房室传导阻滞。心源性休克,感染性休克,支气管哮喘急性发作;QT间期延长综合征伴扭转型室性心动过速,当本品治疗无效时则使用起搏器
用法与用量:
静滴
 
以1~2 mg溶于5%葡萄糖液500 ml缓慢滴注,根据心律、心率酌情调整滴速,滴速每分钟0.02~0.1 μg/kg
 
静脉泵入安全可控
 
(kg)×0.03配置,1 ml/h为0.01 μg/ kg/min。
去甲肾上腺素
作用及用途:
具有肾上腺素α受体强烈激动作用,引起血管极度收缩,血压升高,冠状动脉血流增加;同时也激动β受体,使心肌收缩加强,心排血量增加,静注用于各种原因引起的休克
用法与用量:
小剂量每分钟0.4 μg/kg时,β受体激动为主;用较大剂量时,以a受体激动为主。
一般采用静脉滴注,需注意外渗易发生局部组织坏死
静脉给药后起效迅速,停止滴注后作用时效维持1~2 min。小剂量开始使用,以0.02~0.1 μg/kg/min速度滴注,按需要调节滴速,按体重(kg)乘以0.03或0.3的总去甲肾上腺素剂量配于50 ml液体中,以1 ml/h的速度滴注,其给药量即为0.01 μg/ kg/min或0.1 μg/ kg/min。
多巴胺注射液
为多巴胺受体激动药。具有兴奋肾上腺素α、β受体的作用,但对β2受体作用较弱;同时也作用于肾脏和肠系膜血管、冠状动脉的多巴胺受体。
为较理想的抗休克药物,适用于中毒性休克、心源性休克、出血性休克、中枢性休克等各种类型休克,心脏停搏时升压等,尤其适用于伴有肾功能不全、心排出量降低、周围血管阻力增加而已补足血容量的休克患者
小剂量
 
小剂量静脉滴注(每分钟1~5 μg/kg或每分钟200 μg)时,多为β作用,心排出量增加、肾血流量增加(肾动脉和肾小球血管扩张)、尿量增加,临床上可见到明显的升血压效果,而心率增加不明显。
 
中等剂量
 
中等剂量静脉滴注(每分钟5~20 μg/kg或每分钟0.3~1 mg)时由于α受体兴奋的缘故,虽然血压仍可升高,但由于外周血管收缩及肾血管的收缩作用,使心脏后负荷明显增加,心率亦可增快(多巴胺的正性频率作用出现)或减慢(升压反射所致),尿量反而减少(肾脏的有效滤过率下降)。
大剂量
 
大剂量(每分钟1.5~3 mg)时,由于其较强的α作用,组织灌注并不好,此时应加用扩血管药物,如硝普钠等扩血管药,减轻心脏的前后负荷,改善组织的灌注状态。
一般情况下,如果多巴胺的用量已经达到或超过20 μg/kg/min时,应及时加用第二种正性肌力药如多巴酚丁胺、肾上腺素、异丙肾上腺素等
配制和应用方法:
用微量输液泵进行输注,体重(kg)×3为多巴胺的总剂量,用NS或GS 稀释至50 ml后,用微量推注泵给药,1 ml/h即为1 μg/kg/min。
利多卡因
作用:
适用于心肌梗死、洋地黄中毒、锑剂中毒、外科手术等所致的室性期前收缩、室性心动过速和心室颤动
用法与用量:
静脉注射1~1.5 mg/kg,一般用50~100 mg作首次负荷量静注2~3 min,必要时每5 min后重复静脉注射1~2次,但1小时之内的总量不得超过300 mg。一般治疗量2~4 mg/min, 维持量1  mg/min。
静脉滴注配法
 
利多卡因500 mg+5%GS 500 ml,ivgtt。
  • 50 kg患者:50 ml/h=1 mg/kg/h;
  • 60 kg患者:60 ml/h=1 mg/ kg/h;
  • 70 kg患者:70 ml/h=1 mg/ kg/h。
微量泵给药
 
0.9%NS 25 ml+利多卡因500 mg配制成50 ml微量泵。
  • 50 kg患者:5 ml/h=1 mg/ kg/h;
  • 60 kg患者:6 ml/h=1 mg/ kg/h;
  • 70 kg患者:7 ml/h=1 mg/ kg/h。
胺碘酮
作用:
是多通道阻滞剂,可表现出Ⅰ~Ⅳ类所有抗心律失常药物的药理作用。有广泛的抗心律失常作用。
主要适应症:阵发性室上速,特别是伴预激综合征患者;快速房颤、房扑心室率控制;室性心动过速、室颤。
首选适应症:威胁生命的室速、室颤;心肌梗死后心律失常;心律失常伴心功能不全;房颤、房扑的转律和窦律维持。
室颤或无脉室速的抢救
 
在心肺复苏中,如2~3次电除颤和血管加压药物无效时,立即用胺碘酮300 mg静脉注射,以5%葡萄糖稀释,快速推注,然后再次除颤。
如仍无效可于10~15 min后重复追加胺碘酮150 mg
静脉滴注维持量,在初始6 h以内以1 mg/min速度给药;随后18 h以0.5 mg/min速度给药,第一个24 h内用药总量(包括静脉首次注射、追加用量及维持用药)一般控制在2.0~2.2g以内;第二个24 h及以后的维持量根据心律失常发作情况酌情减量。
 
持续性室速
 
对于血流动力学稳定的持续性单形、多形性室速和未明确诊断的宽QRS心动过速,首剂静脉用药150 mg,用5%葡萄糖稀释后推注10 min,首剂用药10~15min后如仍不见转复可重复追加静脉150 mg再负荷,用法同前。
若使用了胺碘酮数次负荷后室速未能很快转复,应考虑电复律。此种持续室速有反复发作的可能,一般需要静脉维持用药,方法同前述室颤或无脉性室速。
用法与用量:
首剂:常规150 mg+5%GS  20 ml,静推10 min给予负荷量,继而1 mg/min泵入,6h后可减至0.5 mg/min。
配法:450 mg+5%GS 36 ml至45 ml泵入,6 ml/h=1 mg/min,6 h后减至半量3 ml/h=0.5 mg/min,或600 mg+5%GS 38 ml至50 ml泵入,5 ml/h=1 mg/min,6 h后减至半量2.5 ml/h=0.5 mg/min。
硝酸甘油
适应证:
用于冠心病心绞痛的治疗及预防,也可用于降低血压或治疗充血性心力衰竭。
用法用量:
用5%葡萄糖注射液或氯化钠注射液稀释后静脉滴注,5%GS 250 ml+硝酸甘油10 mg,开始剂量为5 μg/min,根据血压调速。
最好用输液泵恒速输入,5%GS 44 ml+硝酸甘油30 mg配成50 ml微量泵,1 ml/h=10 μg/min,用量为10~200 μg/min,应根据个体的血压、心率和其他血流动力学参数来调整用量。
硝普钠
作用于动、静脉的速效短时强扩张剂,给药后即刻达峰,停药后仅维持1~10 min。适用用高血压急症,尤其适用于合并肺水肿的急性左心衰,难治性心衰伴高血压危象等情况
用法与用量:
1~3 μg/ kg/min,从0.5 μg/ kg/min起始,每隔5~10 min增加0.5~1 μg,极量为10 μg/kg/min,直到达到满意的血流动力学效果。
配制方法:
50 mg+5%GS 45 ml配成50 ml微量泵,避光应用。
  • 50 kg患者:1.5 ml/h=0.5 μg/ kg/min;
  • 60 kg患者:1.8 ml/h=0.5 μg/ kg/min;
  • 70 kg患者:2.1 ml/h=0.5 μg/ kg/min,一般应用不要超过72小时。

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    2022-02-10 江雨波

    太实用了,赶紧收藏

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    2021-12-31 ms8000000342134097

    学习

    0

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    2021-12-31 华医-Dr.Yang

    学习

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1192072, encodeId=5aed11920e23a, content=太实用了,赶紧收藏, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLyfjHfjulibFC6SnjRd1O97dAia2v8QM04SgDgh1DDfRsDaYfCQCa4NibVnACFKoZUznP3vP1D1y08g/0, createdBy=3f702230638, createdName=江雨波, createdTime=Thu Feb 10 22:23:11 CST 2022, time=2022-02-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1179353, encodeId=014511e9353d4, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ad45575182, createdName=ms8000000342134097, createdTime=Fri Dec 31 16:11:57 CST 2021, time=2021-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1179068, encodeId=628711e906814, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211212/939025d50927467da89cd41f64d7471f/ce06e2f49bc3467590d5cbb218ea8e75.jpg, createdBy=fd796398131, createdName=华医-Dr.Yang, createdTime=Fri Dec 31 08:15:50 CST 2021, time=2021-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1085781, encodeId=7c621085e81aa, content=不错👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=db002807211, createdName=jiaoxuechu2255, createdTime=Thu Dec 30 11:42:21 CST 2021, time=2021-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1085394, encodeId=f77c1085394b9, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c0885585216, createdName=时期, createdTime=Wed Dec 29 11:21:47 CST 2021, time=2021-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1085103, encodeId=becc10851037c, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=38c55503168, createdName=slli, createdTime=Tue Dec 28 15:32:54 CST 2021, time=2021-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385324, encodeId=5f5f138532440, content=<a href='/topic/show?id=477851e987a' target=_blank style='color:#2F92EE;'>#心血管急救#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51798, encryptionId=477851e987a, topicName=心血管急救)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f08498, createdName=wenzhiren, createdTime=Tue Dec 28 12:53:23 CST 2021, time=2021-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1084992, encodeId=6113108499275, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fcdb6159738, createdName=ms6000000487809205, createdTime=Tue Dec 28 07:49:44 CST 2021, time=2021-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1084949, encodeId=3ac010849496c, content=棒啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c7515581774, createdName=小余97, createdTime=Tue Dec 28 00:10:12 CST 2021, time=2021-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1084907, encodeId=9066108490e2e, content=受益匪浅!, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f6045422367, createdName=ms5000000350028237, createdTime=Mon Dec 27 22:28:51 CST 2021, time=2021-12-27, status=1, ipAttribution=)]
    2021-12-30 jiaoxuechu2255

    不错👍

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1192072, encodeId=5aed11920e23a, content=太实用了,赶紧收藏, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLyfjHfjulibFC6SnjRd1O97dAia2v8QM04SgDgh1DDfRsDaYfCQCa4NibVnACFKoZUznP3vP1D1y08g/0, createdBy=3f702230638, createdName=江雨波, createdTime=Thu Feb 10 22:23:11 CST 2022, time=2022-02-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1179353, encodeId=014511e9353d4, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ad45575182, createdName=ms8000000342134097, createdTime=Fri Dec 31 16:11:57 CST 2021, time=2021-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1179068, encodeId=628711e906814, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211212/939025d50927467da89cd41f64d7471f/ce06e2f49bc3467590d5cbb218ea8e75.jpg, createdBy=fd796398131, createdName=华医-Dr.Yang, createdTime=Fri Dec 31 08:15:50 CST 2021, time=2021-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1085781, encodeId=7c621085e81aa, content=不错👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=db002807211, createdName=jiaoxuechu2255, createdTime=Thu Dec 30 11:42:21 CST 2021, time=2021-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1085394, encodeId=f77c1085394b9, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c0885585216, createdName=时期, createdTime=Wed Dec 29 11:21:47 CST 2021, time=2021-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1085103, encodeId=becc10851037c, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=38c55503168, createdName=slli, createdTime=Tue Dec 28 15:32:54 CST 2021, time=2021-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385324, encodeId=5f5f138532440, content=<a href='/topic/show?id=477851e987a' target=_blank style='color:#2F92EE;'>#心血管急救#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51798, encryptionId=477851e987a, topicName=心血管急救)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f08498, createdName=wenzhiren, createdTime=Tue Dec 28 12:53:23 CST 2021, time=2021-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1084992, encodeId=6113108499275, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fcdb6159738, createdName=ms6000000487809205, createdTime=Tue Dec 28 07:49:44 CST 2021, time=2021-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1084949, encodeId=3ac010849496c, content=棒啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c7515581774, createdName=小余97, createdTime=Tue Dec 28 00:10:12 CST 2021, time=2021-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1084907, encodeId=9066108490e2e, content=受益匪浅!, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f6045422367, createdName=ms5000000350028237, createdTime=Mon Dec 27 22:28:51 CST 2021, time=2021-12-27, status=1, ipAttribution=)]
    2021-12-29 时期

    学习

    0

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    2021-12-28 slli

    0

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  8. [GetPortalCommentsPageByObjectIdResponse(id=1192072, encodeId=5aed11920e23a, content=太实用了,赶紧收藏, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLyfjHfjulibFC6SnjRd1O97dAia2v8QM04SgDgh1DDfRsDaYfCQCa4NibVnACFKoZUznP3vP1D1y08g/0, createdBy=3f702230638, createdName=江雨波, createdTime=Thu Feb 10 22:23:11 CST 2022, time=2022-02-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1179353, encodeId=014511e9353d4, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ad45575182, createdName=ms8000000342134097, createdTime=Fri Dec 31 16:11:57 CST 2021, time=2021-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1179068, encodeId=628711e906814, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211212/939025d50927467da89cd41f64d7471f/ce06e2f49bc3467590d5cbb218ea8e75.jpg, createdBy=fd796398131, createdName=华医-Dr.Yang, createdTime=Fri Dec 31 08:15:50 CST 2021, time=2021-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1085781, encodeId=7c621085e81aa, content=不错👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=db002807211, createdName=jiaoxuechu2255, createdTime=Thu Dec 30 11:42:21 CST 2021, time=2021-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1085394, encodeId=f77c1085394b9, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c0885585216, createdName=时期, createdTime=Wed Dec 29 11:21:47 CST 2021, time=2021-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1085103, encodeId=becc10851037c, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=38c55503168, createdName=slli, createdTime=Tue Dec 28 15:32:54 CST 2021, time=2021-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385324, encodeId=5f5f138532440, content=<a href='/topic/show?id=477851e987a' target=_blank style='color:#2F92EE;'>#心血管急救#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51798, encryptionId=477851e987a, topicName=心血管急救)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f08498, createdName=wenzhiren, createdTime=Tue Dec 28 12:53:23 CST 2021, time=2021-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1084992, encodeId=6113108499275, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fcdb6159738, createdName=ms6000000487809205, createdTime=Tue Dec 28 07:49:44 CST 2021, time=2021-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1084949, encodeId=3ac010849496c, content=棒啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c7515581774, createdName=小余97, createdTime=Tue Dec 28 00:10:12 CST 2021, time=2021-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1084907, encodeId=9066108490e2e, content=受益匪浅!, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f6045422367, createdName=ms5000000350028237, createdTime=Mon Dec 27 22:28:51 CST 2021, time=2021-12-27, status=1, ipAttribution=)]
    2021-12-28 ms6000000487809205

    学习了

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1192072, encodeId=5aed11920e23a, content=太实用了,赶紧收藏, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLyfjHfjulibFC6SnjRd1O97dAia2v8QM04SgDgh1DDfRsDaYfCQCa4NibVnACFKoZUznP3vP1D1y08g/0, createdBy=3f702230638, createdName=江雨波, createdTime=Thu Feb 10 22:23:11 CST 2022, time=2022-02-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1179353, encodeId=014511e9353d4, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ad45575182, createdName=ms8000000342134097, createdTime=Fri Dec 31 16:11:57 CST 2021, time=2021-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1179068, encodeId=628711e906814, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211212/939025d50927467da89cd41f64d7471f/ce06e2f49bc3467590d5cbb218ea8e75.jpg, createdBy=fd796398131, createdName=华医-Dr.Yang, createdTime=Fri Dec 31 08:15:50 CST 2021, time=2021-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1085781, encodeId=7c621085e81aa, content=不错👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=db002807211, createdName=jiaoxuechu2255, createdTime=Thu Dec 30 11:42:21 CST 2021, time=2021-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1085394, encodeId=f77c1085394b9, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c0885585216, createdName=时期, createdTime=Wed Dec 29 11:21:47 CST 2021, time=2021-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1085103, encodeId=becc10851037c, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=38c55503168, createdName=slli, createdTime=Tue Dec 28 15:32:54 CST 2021, time=2021-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385324, encodeId=5f5f138532440, content=<a href='/topic/show?id=477851e987a' target=_blank style='color:#2F92EE;'>#心血管急救#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51798, encryptionId=477851e987a, topicName=心血管急救)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f08498, createdName=wenzhiren, createdTime=Tue Dec 28 12:53:23 CST 2021, time=2021-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1084992, encodeId=6113108499275, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fcdb6159738, createdName=ms6000000487809205, createdTime=Tue Dec 28 07:49:44 CST 2021, time=2021-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1084949, encodeId=3ac010849496c, content=棒啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c7515581774, createdName=小余97, createdTime=Tue Dec 28 00:10:12 CST 2021, time=2021-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1084907, encodeId=9066108490e2e, content=受益匪浅!, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f6045422367, createdName=ms5000000350028237, createdTime=Mon Dec 27 22:28:51 CST 2021, time=2021-12-27, status=1, ipAttribution=)]
    2021-12-28 小余97

    棒啊

    0

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    2021-12-27 ms5000000350028237

    受益匪浅!

    0

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