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创伤性髋关节前脱位合并膝关节脱位1例

2019-03-21 易林洪 郑欣 赵凤朝 实用骨科杂志

患者女性,69岁,因“骑车摔倒致右髋膝部疼痛活动受限7h”于2017年2月入院,查体:各项基本生命体征平稳,全身无皮肤破损,右髋关节外展外旋畸形,右下肢无感觉异常,足背动脉可触及搏动,骨盆分离挤压试验阴性

临床资料

患者女性,69岁,因“骑车摔倒致右髋膝部疼痛活动受限7h”于2017年2月入院,查体:各项基本生命体征平稳,全身无皮肤破损,右髋关节外展外旋畸形,右下肢无感觉异常,足背动脉可触及搏动,骨盆分离挤压试验阴性,右髋部深压痛阳性,右腹股沟韧带中点附近扪及股骨头,右膝关节肿胀畸形。急诊摄X线片示右髋关节前脱位+右膝关节后外旋转脱位,髋关节外展外旋畸形(见图1~2)。初步诊断为右髋关节前脱位(Levin综合分型Ⅱ型)+右膝关节后外旋转脱位。急诊入手术室全麻下行闭合复位。患者仰卧位,助手固定骨盆,术者向外侧推举大腿近端,同时另一助手纵向牵引内收、内旋患肢,闻及股骨头纳入髋臼弹响声,畸形消失,术中C型臂透视证实髋膝关节复位,位置良好,双下肢等长。复位后行右跟骨牵引术。术后行右髋关节三维CT,证实右侧髂嵴、右侧髋臼下缘骨折(见图3);行右膝关节MRI见右膝关节内外侧半月板后角、前交叉韧带及外侧副韧带损伤(见图4)。术后跟骨持续牵引,牵引重量4kg,利伐沙班抗凝治疗。术后第7日出院。出院后患者于家中持续跟骨牵引、制动,利伐沙班抗凝,术后1个月至门诊拔除斯氏针,术后半年患者可完成日常基本动作,行走无髋膝关节疼痛,右髋Harris评分75分,右膝美国特种外科医院膝关节评分72分。术后9个月复查,髋关节正位X线片示右侧髋关节在位,未见明显股骨头缺血性坏死(见图5),右膝关节正侧位X线片未见明显异常(见图6)。



讨论

创伤性髋关节脱位由高能创伤导致,常见于交通事故伤。髋关节后脱位合并膝关节脱位国内外均有报道,髋关节前脱位合并膝关节脱位国外曾报道1例,报道中患者诊断为髋关节前脱位+膝关节后脱位,未存在髋臼骨折,术后3个月MRI示膝关节后交叉韧带、外侧副韧带及半月板损伤,髌骨软化。此类疾病常伴有髋臼骨折,当股骨强力急骤外展、外旋时,大粗隆与髋臼上缘顶撞,以此为支点形成杠杆作用,迫使股骨头穿破关节囊,由髂股韧带与耻骨韧带之间的薄弱区穿出,脱位过程中股骨头与髋臼强烈撞击可造成髋臼骨折。本例术前急诊X线片未见明显骨折块,术后CT示右侧髂嵴、右侧髋臼下缘骨折,但骨折块较小,无明显移位,予以跟骨牵引、制动,保守观察。对于髋膝关节同时脱位,复位后为防止髋膝关节再脱位行跟骨牵引治疗。若单纯行膝关节支具固定无法保证髋关节稳定性,遂行跟骨牵引使髋膝关节同时稳定。髋关节脱位常见远期并发症为股骨头坏死,在创伤性髋关节脱位中发病率为26%,但少见于前脱位。

据另一报道,髋关节创伤脱位6h内复位患者,股骨头缺血坏死率为5%,6h后复位患者股骨头缺血性坏死率高达50%,因此强调早期诊断和治疗髋关节脱位。本例患者伤后8h复位,术后9个月髋关节X线片未见股骨头坏死征像,但仍存在创伤后关节炎及股骨头缺血性坏死可能。患者随访时因经济条件限制,拒绝行MRI检查明确股骨头坏死情况,为本报道不足之一,远期疗效尚待进一步观察。膝关节脱位也常是高能创伤导致,常伴有2~3条韧带断裂同时伴有大量膝关节周围软组织损伤。患者摔倒时膝关节着地,小腿外旋,同时由于股骨的强力向下作用力导致膝关节后外旋脱位。膝关节脱位中血管损伤发生率在0~40%。神经损伤发生率为16%~43%,腓总神经损伤占大多数。此例患者膝关节脱位后纵向牵引复位满意,复位后MRI示膝关节前交叉韧带及外侧副韧带损伤,内外侧半月板损伤,髌骨、股骨远端及胫骨近端局限性骨挫伤,其它韧带完整。术后足背动脉搏动好,且右下肢无明显皮肤感觉减退。由于患者年龄较大,对膝关节功能要求不高,且术后患者功能基本能满足日常生活需要,因经济原因后期未对韧带及半月板损伤进行进一步处理。

髋部骨折术后未行抗凝治疗下肢深静脉血栓发生率高达50%,利伐沙班可预防骨折相关术后下肢深静脉血栓。本例术后采用利伐沙班抗凝治疗1个月,随访未见出血及血栓相关并发症。髋关节前脱位合并同侧膝关节脱位极为罕见,急诊复位髋膝关节十分重要,此类病例术后可行跟骨牵引、制动,下肢深静脉血栓高危患者可行抗凝治疗,原则上脱位关节相关韧带损伤需行二期手术对韧带进行修复,髋臼骨折则根据骨折类型及骨折块大小行进一步治疗。

原始出处:

易林洪,郑欣,赵凤朝,郭开今 *. 创伤性髋关节前脱位合并膝关节脱位1例报告[J]. 实用骨科杂志, 2019, 25(2): 186-188.

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    创伤性髋关节前脱位的治疗。

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18:25:29 CST 2020, time=2020-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378749, encodeId=73fc3e8749a9, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Jan 31 18:08:01 CST 2020, time=2020-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378321, encodeId=72d53e8321d4, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sun Jan 19 18:40:44 CST 2020, time=2020-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=377897, encodeId=118b3e789758, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Jan 07 18:17:37 CST 2020, time=2020-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=377458, encodeId=b3ab3e7458b0, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Thu Dec 26 18:56:36 CST 2019, time=2019-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=376835, encodeId=a29c3e68352a, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Dec 11 19:17:36 CST 2019, time=2019-12-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2025491, encodeId=89fc202549181, content=<a href='/topic/show?id=66f93204223' target=_blank style='color:#2F92EE;'>#创伤性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32042, encryptionId=66f93204223, topicName=创伤性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=325a197, createdName=amyloid, createdTime=Wed Dec 18 13:28:00 CST 2019, time=2019-12-18, status=1, ipAttribution=)]
    2020-02-25 jyzxjiangqin

    创伤性髋关节前脱位的治疗。

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=380245, encodeId=dbce3802455f, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Mon Mar 09 18:02:05 CST 2020, time=2020-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2003526, encodeId=b19e2003526fa, content=<a href='/topic/show?id=95f53013946' target=_blank style='color:#2F92EE;'>#关节脱位#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30139, encryptionId=95f53013946, topicName=关节脱位)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4cce318, createdName=wleon8895, createdTime=Mon May 27 04:28:00 CST 2019, time=2019-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=379660, encodeId=1cf23e9660b5, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Feb 25 17:48:15 CST 2020, time=2020-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=379196, encodeId=7f4b3e919647, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Thu Feb 13 18:25:29 CST 2020, time=2020-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378749, encodeId=73fc3e8749a9, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Jan 31 18:08:01 CST 2020, time=2020-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378321, encodeId=72d53e8321d4, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sun Jan 19 18:40:44 CST 2020, time=2020-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=377897, encodeId=118b3e789758, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Jan 07 18:17:37 CST 2020, time=2020-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=377458, encodeId=b3ab3e7458b0, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Thu Dec 26 18:56:36 CST 2019, time=2019-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=376835, encodeId=a29c3e68352a, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Dec 11 19:17:36 CST 2019, time=2019-12-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2025491, encodeId=89fc202549181, content=<a href='/topic/show?id=66f93204223' target=_blank style='color:#2F92EE;'>#创伤性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32042, encryptionId=66f93204223, topicName=创伤性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=325a197, createdName=amyloid, createdTime=Wed Dec 18 13:28:00 CST 2019, time=2019-12-18, status=1, ipAttribution=)]
    2020-02-13 jyzxjiangqin

    创伤性髋关节前脱位的治疗。

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=380245, encodeId=dbce3802455f, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Mon Mar 09 18:02:05 CST 2020, time=2020-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2003526, encodeId=b19e2003526fa, content=<a href='/topic/show?id=95f53013946' target=_blank style='color:#2F92EE;'>#关节脱位#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30139, encryptionId=95f53013946, topicName=关节脱位)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4cce318, createdName=wleon8895, createdTime=Mon May 27 04:28:00 CST 2019, time=2019-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=379660, encodeId=1cf23e9660b5, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Feb 25 17:48:15 CST 2020, time=2020-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=379196, encodeId=7f4b3e919647, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Thu Feb 13 18:25:29 CST 2020, time=2020-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378749, encodeId=73fc3e8749a9, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Jan 31 18:08:01 CST 2020, time=2020-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378321, encodeId=72d53e8321d4, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sun Jan 19 18:40:44 CST 2020, time=2020-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=377897, encodeId=118b3e789758, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Jan 07 18:17:37 CST 2020, time=2020-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=377458, encodeId=b3ab3e7458b0, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Thu Dec 26 18:56:36 CST 2019, time=2019-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=376835, encodeId=a29c3e68352a, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Dec 11 19:17:36 CST 2019, time=2019-12-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2025491, encodeId=89fc202549181, content=<a href='/topic/show?id=66f93204223' target=_blank style='color:#2F92EE;'>#创伤性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32042, encryptionId=66f93204223, topicName=创伤性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=325a197, createdName=amyloid, createdTime=Wed Dec 18 13:28:00 CST 2019, time=2019-12-18, status=1, ipAttribution=)]
    2020-01-31 jyzxjiangqin

    创伤性髋关节前脱位的治疗。

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=380245, encodeId=dbce3802455f, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Mon Mar 09 18:02:05 CST 2020, time=2020-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2003526, encodeId=b19e2003526fa, content=<a href='/topic/show?id=95f53013946' target=_blank style='color:#2F92EE;'>#关节脱位#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30139, encryptionId=95f53013946, topicName=关节脱位)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4cce318, createdName=wleon8895, createdTime=Mon May 27 04:28:00 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18:25:29 CST 2020, time=2020-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378749, encodeId=73fc3e8749a9, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Jan 31 18:08:01 CST 2020, time=2020-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378321, encodeId=72d53e8321d4, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sun Jan 19 18:40:44 CST 2020, time=2020-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=377897, encodeId=118b3e789758, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Jan 07 18:17:37 CST 2020, time=2020-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=377458, encodeId=b3ab3e7458b0, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Thu Dec 26 18:56:36 CST 2019, time=2019-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=376835, encodeId=a29c3e68352a, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Dec 11 19:17:36 CST 2019, time=2019-12-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2025491, encodeId=89fc202549181, content=<a href='/topic/show?id=66f93204223' target=_blank style='color:#2F92EE;'>#创伤性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32042, encryptionId=66f93204223, topicName=创伤性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=325a197, createdName=amyloid, createdTime=Wed Dec 18 13:28:00 CST 2019, time=2019-12-18, status=1, ipAttribution=)]
    2020-01-19 jyzxjiangqin

    创伤性髋关节前脱位的治疗。

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=380245, encodeId=dbce3802455f, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Mon Mar 09 18:02:05 CST 2020, time=2020-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2003526, encodeId=b19e2003526fa, content=<a href='/topic/show?id=95f53013946' target=_blank style='color:#2F92EE;'>#关节脱位#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30139, encryptionId=95f53013946, topicName=关节脱位)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4cce318, createdName=wleon8895, createdTime=Mon May 27 04:28:00 CST 2019, time=2019-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=379660, encodeId=1cf23e9660b5, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Feb 25 17:48:15 CST 2020, time=2020-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=379196, encodeId=7f4b3e919647, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Thu Feb 13 18:25:29 CST 2020, time=2020-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378749, encodeId=73fc3e8749a9, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Jan 31 18:08:01 CST 2020, time=2020-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378321, encodeId=72d53e8321d4, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sun Jan 19 18:40:44 CST 2020, time=2020-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=377897, encodeId=118b3e789758, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Jan 07 18:17:37 CST 2020, time=2020-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=377458, encodeId=b3ab3e7458b0, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Thu Dec 26 18:56:36 CST 2019, time=2019-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=376835, encodeId=a29c3e68352a, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Dec 11 19:17:36 CST 2019, time=2019-12-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2025491, encodeId=89fc202549181, content=<a href='/topic/show?id=66f93204223' target=_blank style='color:#2F92EE;'>#创伤性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32042, encryptionId=66f93204223, topicName=创伤性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=325a197, createdName=amyloid, createdTime=Wed Dec 18 13:28:00 CST 2019, time=2019-12-18, status=1, ipAttribution=)]
    2020-01-07 jyzxjiangqin

    创伤性髋关节前脱位的治疗。

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=380245, encodeId=dbce3802455f, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Mon Mar 09 18:02:05 CST 2020, time=2020-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2003526, encodeId=b19e2003526fa, content=<a href='/topic/show?id=95f53013946' target=_blank style='color:#2F92EE;'>#关节脱位#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30139, encryptionId=95f53013946, topicName=关节脱位)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4cce318, createdName=wleon8895, createdTime=Mon May 27 04:28:00 CST 2019, time=2019-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=379660, encodeId=1cf23e9660b5, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Feb 25 17:48:15 CST 2020, time=2020-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=379196, encodeId=7f4b3e919647, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Thu Feb 13 18:25:29 CST 2020, time=2020-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378749, encodeId=73fc3e8749a9, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Jan 31 18:08:01 CST 2020, time=2020-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378321, encodeId=72d53e8321d4, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sun Jan 19 18:40:44 CST 2020, time=2020-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=377897, encodeId=118b3e789758, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Jan 07 18:17:37 CST 2020, time=2020-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=377458, encodeId=b3ab3e7458b0, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Thu Dec 26 18:56:36 CST 2019, time=2019-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=376835, encodeId=a29c3e68352a, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Dec 11 19:17:36 CST 2019, time=2019-12-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2025491, encodeId=89fc202549181, content=<a href='/topic/show?id=66f93204223' target=_blank style='color:#2F92EE;'>#创伤性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32042, encryptionId=66f93204223, topicName=创伤性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=325a197, createdName=amyloid, createdTime=Wed Dec 18 13:28:00 CST 2019, time=2019-12-18, status=1, ipAttribution=)]
    2019-12-26 jyzxjiangqin

    创伤性髋关节前脱位的治疗。

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=380245, encodeId=dbce3802455f, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Mon Mar 09 18:02:05 CST 2020, time=2020-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2003526, encodeId=b19e2003526fa, content=<a href='/topic/show?id=95f53013946' target=_blank style='color:#2F92EE;'>#关节脱位#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30139, encryptionId=95f53013946, topicName=关节脱位)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4cce318, createdName=wleon8895, createdTime=Mon May 27 04:28:00 CST 2019, time=2019-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=379660, encodeId=1cf23e9660b5, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Feb 25 17:48:15 CST 2020, time=2020-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=379196, encodeId=7f4b3e919647, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Thu Feb 13 18:25:29 CST 2020, time=2020-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378749, encodeId=73fc3e8749a9, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Jan 31 18:08:01 CST 2020, time=2020-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378321, encodeId=72d53e8321d4, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sun Jan 19 18:40:44 CST 2020, time=2020-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=377897, encodeId=118b3e789758, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Jan 07 18:17:37 CST 2020, time=2020-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=377458, encodeId=b3ab3e7458b0, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Thu Dec 26 18:56:36 CST 2019, time=2019-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=376835, encodeId=a29c3e68352a, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Dec 11 19:17:36 CST 2019, time=2019-12-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2025491, encodeId=89fc202549181, content=<a href='/topic/show?id=66f93204223' target=_blank style='color:#2F92EE;'>#创伤性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32042, encryptionId=66f93204223, topicName=创伤性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=325a197, createdName=amyloid, createdTime=Wed Dec 18 13:28:00 CST 2019, time=2019-12-18, status=1, ipAttribution=)]
    2019-12-11 jyzxjiangqin

    创伤性髋关节前脱位的治疗。

    0

  10. 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18:25:29 CST 2020, time=2020-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378749, encodeId=73fc3e8749a9, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Jan 31 18:08:01 CST 2020, time=2020-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378321, encodeId=72d53e8321d4, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sun Jan 19 18:40:44 CST 2020, time=2020-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=377897, encodeId=118b3e789758, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Jan 07 18:17:37 CST 2020, time=2020-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=377458, encodeId=b3ab3e7458b0, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Thu Dec 26 18:56:36 CST 2019, time=2019-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=376835, encodeId=a29c3e68352a, content=创伤性髋关节前脱位的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Dec 11 19:17:36 CST 2019, time=2019-12-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2025491, encodeId=89fc202549181, content=<a href='/topic/show?id=66f93204223' target=_blank style='color:#2F92EE;'>#创伤性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32042, encryptionId=66f93204223, topicName=创伤性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=325a197, createdName=amyloid, createdTime=Wed Dec 18 13:28:00 CST 2019, time=2019-12-18, status=1, ipAttribution=)]
    2019-12-18 amyloid

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