刘继帅

[{"body":{"content":"你好，我是三级甲等医院神经内科中级医师，***，请问您有什么需要咨询的医学问题？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049595516},{"body":{"content":"你是患者本人吗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049606155},{"body":{"content":"是的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049612738},{"body":{"content":"这么年轻","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049626743},{"body":{"content":"不应该啊","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049629347},{"body":{"content":"是家里人","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049640119},{"body":{"content":"奥奥","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049683854},{"body":{"content":"咨询什么问题","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049689152},{"body":{"content":"家里老人轻微中风","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049706834},{"body":{"content":"医生，请您帮我开具处方或用药建议。","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049713486},{"body":{"content":"可以","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049725390},{"body":{"content":"开几盒","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049727803},{"body":{"content":"为了用药安全，请问你是否有药物过敏史，是否有肝肾功能异常，是否有慢性疾病","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049732198},{"body":{"content":"5","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049732283},{"body":{"content":"无","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049742701},{"body":{"content":"谢谢医生","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049861411},{"body":{"content":"回看沟通记录可见电子处方。点开电子处方，下方会有 预约药品，点击后会跳转京东，补充**等信息，支付后，京东药师审核后，会直接按照您预留**发货，无需再上传处方。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049869848},{"body":{"content":"不用客气，祝您早日康复","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049871882},{"body":{"content":"脑梗塞应这样\n1.应平衡饮食和营养，多吃蔬菜、水果和谷类食品，减少饱和脂肪酸和胆固醇的摄入；每天盐摄入量限制在6克以下。\n\n2、继续锻炼，持续锻炼可减少20%的复发风险，每天至少进行30分钟的适度体育活动，如步行、慢跑、**拳、骑自行车等，每周5次。\n\n3、定期体检和会诊，患者应定期检查血压、心电图、血糖**脂，并根据自己的检查结果咨询神经科医生，帮助解决所遇到的各种问题。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049876299},{"body":{"content":"你可以点开我的头像关注我，以后有问题随时可以咨询我， 或者去：京东_搜我的名字***，点击图文咨询直接咨询就行。这样就能找到我了，有什么用药问题或者购药问题都可以继续咨询我。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049879609},{"body":{"content":"希望我的建议能够帮助到您，非常感谢您的信任！请对话结束后对给予5星好评，您的好评是对我最好的肯定与鼓励，祝您生活愉快，再见！","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049881616}]

女31岁

2022.05.20

[{"body":{"content":"您好,感谢您的信任!!!","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050201269},{"body":{"content":"你好","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050220204},{"body":{"content":"买了胶水 修鞋 ******","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050240920},{"body":{"content":"味道很大 有点难受","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050254159},{"body":{"content":"去通风的地方呆几个小时 如果还难受就去医院","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050614415},{"body":{"content":"闻了 几分钟","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050619262},{"body":{"content":"现在好多了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050629119},{"body":{"content":"应该没事吧","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050638940},{"body":{"content":"那就行 主要是脱离那个环境 问题不大","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050652989},{"body":{"content":"好的 谢谢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051589657}]

男32岁

2022.05.20

[{"body":{"content":"请问您有什么需要咨询的医学问题？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652999828008},{"body":{"content":"你好，问问以前手淫后还有点睡意想休息","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652999850205},{"body":{"content":"现在手淫后就没有了，不怎么有睡意了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652999864778},{"body":{"content":"这个问题?","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652999905154},{"body":{"content":"对","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652999915068},{"body":{"content":"问问","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652999917300},{"body":{"content":"是不是有问题","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652999921480},{"body":{"content":"还是正常没事的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652999925392},{"body":{"content":"没有问题的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652999928181},{"body":{"content":"正常","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652999934940},{"body":{"content":"比较精神现在","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652999957576},{"body":{"content":"没事对吧","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652999959837},{"body":{"content":"兴奋缘故","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652999971724},{"body":{"content":"没事对吧","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652999978456},{"body":{"content":"没有关系的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652999980086},{"body":{"content":"我也还好啊","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652999991364},{"body":{"content":"嗯嗯","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652999999283},{"body":{"content":"不是很兴奋","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653000001619},{"body":{"content":"没有关系的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653000016063},{"body":{"content":"反正这样没事吧","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653000018701},{"body":{"content":"嗯","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653000027394},{"body":{"content":"我问问我晚上8点做的 晚上12点睡 6点起 睡6个小时不影响手淫后身体吧","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653000049108},{"body":{"content":"不影响","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653000070874},{"body":{"content":"睡6个小时够了吧","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653000106619},{"body":{"content":"嗯嗯","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653000156318},{"body":{"content":"好的感谢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653000181998},{"body":{"content":"别结束，让他24小时自动关闭","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653000189740},{"body":{"content":"后期有可能还有问题","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653000195169},{"body":{"content":"不客气","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653000195786}]

男20岁

2022.05.20

[{"body":{"content":"您好，我是妇产科医生王轩，非常高兴由我为您提供医疗咨询服务","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051384394},{"body":{"content":"我有阴道炎和宫颈炎，医生让我提高免疫力，给我开**********","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051543508},{"body":{"content":"是您的医生给您的用药建议对吗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051562252},{"body":{"content":"对","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051570112},{"body":{"content":"是*************栓 50万IU*3枚这个是吗？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051592845},{"body":{"content":"3盒是吗？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051627956},{"body":{"content":"嗯","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051647919},{"body":{"content":"您是需要帮您开一下是吗/","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051652686},{"body":{"content":"对，帮我开一下","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051682440},{"body":{"content":"请问您有药物过敏史，肝肾功能异常及其他高血压、糖尿病等慢性病史、或血栓、乳腺病史吗？是否孕期、哺乳期、备孕期？以便我给您建议","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051684986},{"body":{"content":"血压吃药正常，乳腺增生","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051761670},{"body":{"content":"您之前的检查是有发现有HPV的情况是吗？因为帮您开处方需要写上诊断，这个用药是治疗HPV的情况的，所以跟您核实一下","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051766139},{"body":{"content":"您稍等，后续关注一下处方的信息","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051828726},{"body":{"content":"您看一下","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051894109},{"body":{"content":"用药前请您仔细阅读药品说明书中禁忌，注意事项，如无禁忌可使用我为您开具的药品，如您在用药过程中出现不适，请您及时上线咨询或去医院就诊。注意按时复诊。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051897494}]

女51岁

2022.05.20

[{"body":{"content":"感谢您体验京东育婴师育儿咨询服务，如果您有儿童常备药、儿童生长发育、科学备孕相关问题的需要，京东平台为您准备了儿科、妇产科专家一对一服务及专属福利！","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050171838},{"body":{"content":"您好","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050174706},{"body":{"content":"新生儿用哪一款面霜","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050221189},{"body":{"content":"您看看","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050246620},{"body":{"content":"https://item.m.jd.com/*******/*******.html?gx=***********************************&ad_od=share&**********=**********&**********=********&************=***********&********=*******","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050252431},{"body":{"content":"您看看这款","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050258891},{"body":{"content":"请问您还有什么需要咨询的问题吗？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050378624},{"body":{"content":"对话结束后，麻烦您对我的服务做个评价，耽误您几秒钟，请点右上角的“表扬医生”按钮。拜托拜托??祝\t生活愉快，宝宝健康快乐成长！","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050381178}]

女

2022.05.20

[{"body":{"content":"以前去医院看过吗用药了吗效果怎么样？根据上述情况我可以给您一些用药建议。为用药安全，请问是否有肝肾功能损伤，请问是否有严重药物过敏史或者药物严重不良反应？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652964982681},{"body":{"content":"图片看下","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652964984851},{"body":{"content":"湿 疹是过 敏性皮疹，注意观察饮食，吃了什么加重就是过 敏就不要吃了，食物可以一个一个试，这是最精确的判断过 敏 原的办法，再就是查过 敏 原，查了过 敏 原并不能面面俱到，也是需要自己细心观察，再就是湿 疹忌讳洗，忌讳干燥，忌讳热，一直保持油腻状态看起来油光光的，湿 疹的外用药物一类是保持油腻的，一类就是***了，如果普通药物效果不好可以用***","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965142841},{"body":{"content":"用药了吗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965149101},{"body":{"content":"没有","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965158939},{"body":{"content":"家里有什么药物","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965184766},{"body":{"content":"家里没有储备药物","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965224867},{"body":{"content":"好的好的麻烦医生了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965593043},{"body":{"content":"好的好的，谢谢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965681153},{"body":{"content":"不客气祝宝贝健康，结束后记得给我个好评哦感谢您的支持","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965694388},{"body":{"content":"嗯嗯","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965719249},{"body":{"content":"❤️","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965734893}]

女5岁

2022.05.20

[{"body":{"content":"您好，我是京东儿科医生宁冬梅，非常高兴由我为您提供医疗咨询服务。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965058300},{"body":{"content":"宝宝是母乳喂养吗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965067614},{"body":{"content":"是的医生","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965073776},{"body":{"content":"一天大便几次？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965081290},{"body":{"content":"这种情况多久了","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965088010},{"body":{"content":"昨天开始的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965096379},{"body":{"content":"这两天平均四五次","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965104188},{"body":{"content":"中午看的时候是水样便","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965114124},{"body":{"content":"晚上给他换的时候发现看着比较严重","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965130955},{"body":{"content":"有可能是消化不良","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965140859},{"body":{"content":"晚上看着好像胃粘液**出来了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965169445},{"body":{"content":"那需要吃什么改善呢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965178527},{"body":{"content":"吃上***调理一下","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965255193},{"body":{"content":"好的谢谢您","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965274914},{"body":{"content":"不客气，祝宝宝健康快乐成长，有事联系，很高兴为您提供服务","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965330290},{"body":{"content":"非常感谢您的咨询，请在对话结束以后对我的服务做出评价，祝您生活愉快。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965335013}]

男4个月13天

2022.05.20

[{"body":{"content":"而且很痛","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652878654689},{"body":{"content":"您好,感谢您的信任!!!","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652878784166},{"body":{"content":"您好，非常高兴由我为您提供医疗咨询服务，请稍等，我正在详细阅读您的病情描述。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652878790736},{"body":{"content":"好","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652878831734},{"body":{"content":"您好！脸上红印，红血丝较多，形成敏感肌，痘痘为结节囊肿型","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652878897261},{"body":{"content":"平时常用洗面奶洗脸的频率如何？都使用哪些类型的洗面奶？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652878981247},{"body":{"content":"***","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652881169301},{"body":{"content":"晚上早上洗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652881195080},{"body":{"content":"您好,感谢您的信任!!!","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652881492821},{"body":{"content":"敏感肌建议您精简护肤，平时用温水洗脸即可。使用洗面奶。尽量避免使用清洁型或磨砂型，使用频率每周不超过两次为宜。每次洗脸之后需涂***。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652881539035},{"body":{"content":"同时平时注意防晒。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652881546353},{"body":{"content":"痘痘之所以反复发作跟体内激素水平高有关，会导致毛囊皮脂腺分泌旺盛，堵塞毛管，痤疮丙酸杆菌，细菌灰尘，等会定植毛囊引发炎症。痘痘有硬结是炎症比较深，深达真皮层。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652881614316},{"body":{"content":"您都用过哪些药物治疗？效果如何？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652881640524},{"body":{"content":"没有用其他药物","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652919276830},{"body":{"content":"根据您的情况，建议您：\n1、中药口服内调体质，增加皮肤修复能力；局部外用药膏改善炎症，减少痘印；\n2、配合使用药妆品和肌肤屏障修复剂；有助于皮肤修复，改善敏感肌，减少痘痘复发；\n3、日常精简护肤，用温水洗脸，尽量避免使用深度清洁型洗面奶及磨砂型洗面奶，选择比较温和的保湿产品，避免选用***类产品。使用洗面奶的频率，每周两次左右。要特别注意防晒、保湿。这些措施要贯彻在你治疗的全过程。\n4、另外一个是饮食注意少食辛辣油炸刺激之品。避免食用奶茶，奶酪，牛奶，奶油等奶制品以及巧克力冰淇淋等甜食甜品。这些都是造成痘痘反复不愈的原因。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652926585887},{"body":{"content":"什么中药呢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652934819750},{"body":{"content":"您好,感谢您的信任!!!","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652937215777},{"body":{"content":"需要根据您的舌开具中药方，中药免煎颗粒，开水冲服那种","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652937252364},{"body":{"content":"您发个舌苔图片看看","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652937260673}]

女31岁

2022.05.20

[{"body":{"content":"您好， 我是京东医生，非常高兴由我为您提供医疗咨询服务，请稍等，我正在详细阅读您的病情描述。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050744709},{"body":{"content":"可以游泳","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050767523},{"body":{"content":"套脖圈也没问题吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050779906},{"body":{"content":"网上说会损伤脊椎","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050792576},{"body":{"content":"一般不会的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050868148},{"body":{"content":"如果宝宝哭闹就不要游泳了","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050892208},{"body":{"content":"有没什么办法可以判断宝宝脖子有没问题，还是要去医院拍片的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051053716},{"body":{"content":"宝宝以前趴着能抬头吗？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051080863},{"body":{"content":"以前可以的 现在比较少","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051091888},{"body":{"content":"一般经常抬头的时期是几月开始的 以前偶尔会抬几次","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051124874},{"body":{"content":"一般1到3个月","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051276317},{"body":{"content":"如果以前会抬头，现在不能抬头了，建议你带宝宝去医院就医","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051323920},{"body":{"content":"好的，谢谢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051350450},{"body":{"content":"不客气","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051378229},{"body":{"content":"请问您是否还有其他医药问题需要咨询？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051383292},{"body":{"content":"暂时没有了，谢谢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051431808},{"body":{"content":"非常感谢您的信任！请对话结束后对我的服务作出评价，谢谢您！再见！","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051502024}]

女1个月11天

2022.05.20

[{"body":{"content":"您好，感谢信任，接到您的问题，我先根据您提供的情况仔细分析一下，然后给您答复。我这条内容您不用回复，请稍等几分钟，我会详细解答。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879268155},{"body":{"content":"他现在在做靶免治疗，这边医生说肿瘤控制的还可以，就是肝硬化有点严重。","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879324502},{"body":{"content":"你好，看结果，肝功能异常，与肝硬化，肝癌，以及肝癌靶免治疗都有关系，目前具体用的那几个药物？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879402729},{"body":{"content":"\n他现在吃 *******，*****，当***，*******","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879443546},{"body":{"content":"嗯，靶免治疗用的什么？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879536304},{"body":{"content":"而且靶免治疗多久了？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879664881},{"body":{"content":"用的*****联合*****","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879722424},{"body":{"content":"嗯，目前看肝功能指标，黄疸转氨酶都比较高，靶免治疗需要注意风险","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879795185},{"body":{"content":"21天一次用了5次","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879798590},{"body":{"content":"嗯嗯，因为靶免治疗也有肝损害风险","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879817120},{"body":{"content":"那您能给一个治疗建议，治疗方案吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879889341},{"body":{"content":"一般我们的患者靶免治疗期间如果肝功能指标持续升高，就要先暂停一次，加强***物治疗，等肝功能改善，尤其是胆红素水平最好降低到40以下再恢复","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879957265},{"body":{"content":"谢谢医生 那现在有没有用药建议。他吃的药需不需要换。","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652880150636},{"body":{"content":"如果乙肝病毒DNA阴性，*****就不用换，***物也可以先维持目前几个，观察一周左右复查肝功能看变化，再决定下一步方案","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652880220951},{"body":{"content":"那等一周后肝功能结果出来了我再联系你吧医生。他之前吃**，后来换的这个","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652880358250},{"body":{"content":"可以，方案是否有效，关键看复查结果","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652880385869},{"body":{"content":"那就先维持治疗，靶免停一停吧。","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652880445830},{"body":{"content":"对的，治疗安全第一，其次是效果","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652880477356},{"body":{"content":"他现在还会偶尔发烧","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652880587846},{"body":{"content":"如果没有明确细菌感染，发烧考虑肿瘤有关，可以对症治疗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652880636479},{"body":{"content":"这边医生考虑是腹水引起的腹膜炎","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652880672486},{"body":{"content":"那就要用***","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652880684305},{"body":{"content":"嗯 输着***，到时候看看效果吧。","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652880706907},{"body":{"content":"嗯嗯一般至少3-5天","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652880725506},{"body":{"content":"好 等结果出来我再联系您吧","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652881425055},{"body":{"content":"好的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652881434381}]

男54岁

2022.05.20