刘继帅

[{"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52岁

2022.05.20

[{"body":{"content":"家长好，我没有理解家长的问诊描述意思","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049681174},{"body":{"content":"那地方红了 应该还没有烂","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049695679},{"body":{"content":"涂什么能好呢 ","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049711184},{"body":{"content":"太红了 可能是水或者尿没有及时擦干","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049727850},{"body":{"content":"这个是局部潮湿引起的类似湿疹，涂点***或者紫草膏","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049738483},{"body":{"content":"在哪可以买到呢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050080246},{"body":{"content":"药店都有吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050085168},{"body":{"content":"是的，基本药物","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050192012},{"body":{"content":"好的，谢谢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050925692}]

男4个月28天

2022.05.20

[{"body":{"content":"您好，我是副主任医师石俊英，很高兴由我为您提供咨询服务。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049691820},{"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":1653049697003},{"body":{"content":"可以喝","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049720715},{"body":{"content":"宝宝一岁是喝这个吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049728566},{"body":{"content":"是的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049735764},{"body":{"content":"之前是喝的这个","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049758198},{"body":{"content":"嗯","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049772579},{"body":{"content":"才刚喝一罐","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049781368},{"body":{"content":"是要换吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049787968},{"body":{"content":"嗯，宝宝有乳糖不耐受吗？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049797101},{"body":{"content":"其实不需要换，接着喝这个就行","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049823681},{"body":{"content":"是","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049835856},{"body":{"content":"好的?","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049889314}]

女

2022.05.20

[{"body":{"content":"现在因疫情图片不在手里","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652878871979},{"body":{"content":"想开几盒补铁药","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652878932274},{"body":{"content":"家长您好","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879235885},{"body":{"content":"你好","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879244058},{"body":{"content":"医生，请您帮我开具处方或用药建议。","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879250650},{"body":{"content":"非常高兴由我为您提供医疗咨询服务","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879256807},{"body":{"content":"好的，您需要开几盒？怎么服用的？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879272924},{"body":{"content":"想开5盒，每天2次","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879304506},{"body":{"content":"好的，稍等","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879330671},{"body":{"content":"谢谢！","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879336879},{"body":{"content":"家长您好！处方已开","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879472577},{"body":{"content":"你****能开30袋一盒的吗？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879740765},{"body":{"content":"这样买还便宜?","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879859520},{"body":{"content":"你好！可以不用处方了！","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652880143141},{"body":{"content":"家长您好","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652913116491}]

女4岁

2022.05.20

[{"body":{"content":"你好","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051785890},{"body":{"content":"你好","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051788711},{"body":{"content":"肛周囊肿","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051794736},{"body":{"content":"确诊了吗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051814466},{"body":{"content":"没","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051820904},{"body":{"content":"方便的话发个图看看，以便区别其他疾病","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051830384},{"body":{"content":"疼吗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051861349},{"body":{"content":"红肿疼痛难忍","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051887807},{"body":{"content":"像肛周脓肿了","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051894209},{"body":{"content":"是的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051899003},{"body":{"content":"去医院做手术吧","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051902184},{"body":{"content":"肛周脓肿一经确诊，应尽快行脓肿切开引流术，以免感染进一步扩散。根据脓肿的深浅和具体的位置，其采用的麻醉方式和手术操作步骤有所区别","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051905326},{"body":{"content":"别耽误了","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051911861},{"body":{"content":"去公立医院","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051917524},{"body":{"content":"基本里面已经化脓了摸起来就很软","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051931464},{"body":{"content":"但有部分是比较硬的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051946409},{"body":{"content":"炎症浸润了","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051966648},{"body":{"content":"就是那个样的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653052003353},{"body":{"content":"嗯 这个直接做引流手术就可以了吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653052008393},{"body":{"content":"你哪里的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653052009919},{"body":{"content":"**的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653052015965},{"body":{"content":"和手术医生交流","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653052041461},{"body":{"content":"好 之前全是硬块 最近是摸了些*****然后就变成这样了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653052076838},{"body":{"content":"只能手术别的办法都是骗人的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653052085197},{"body":{"content":"好吧","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653052116657},{"body":{"content":"感谢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653052120011}]

男17岁

2022.05.20

[{"body":{"content":"您好，我是住院医师曹众辰，很高兴由我为您提供咨询服务。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050132124},{"body":{"content":"我正在查看以上商品，请稍等。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050137337},{"body":{"content":"不含蔗糖，但是含有其他糖分","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050189079},{"body":{"content":"有血糖高的人可以吃吗？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050236318},{"body":{"content":"血糖控制的怎么样？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050268808},{"body":{"content":"可以，不高","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050296976},{"body":{"content":"可以少吃点，算作主食","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050385224},{"body":{"content":"好的，谢谢你！","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050407166},{"body":{"content":"不客气的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050464192}]

女

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":1653050037218},{"body":{"content":"这个表不适合女性，有什么问题可以直接咨询","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050212394}]

女

2022.05.20

[{"body":{"content":"您好，京东大药房药师工号0082号，很高兴为您服务！","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050485229},{"body":{"content":"医生，您好","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050499277},{"body":{"content":"在的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050513887},{"body":{"content":"您现在主要是什么症状呢？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050519863},{"body":{"content":"怀孕初期除了***还要补充什么****吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050534162},{"body":{"content":"没有什么症状","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050543046},{"body":{"content":"吃的哪种**呢","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050550784},{"body":{"content":"就是*****","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050591957},{"body":{"content":"嗯嗯","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050615926},{"body":{"content":"有无药物过敏史呢","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050618351},{"body":{"content":"没有","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050633065},{"body":{"content":"请您稍等，我马上为您查询一下","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050645232},{"body":{"content":"我听说还要补充维生素D是吗？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050654205},{"body":{"content":"可以用***代替***服用哈","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050698303},{"body":{"content":"可以服用***补充备孕期和孕期补充**和***的\n\n【用法用量】\n口服。一次 1 片，一日 1 次，与早餐同时服用；如存在晨起恶心现象，可在中午或者晚上服用。\n\n请您查看药品说明书中的注意事项，本品不推荐儿童使用。使用后如果症状没有改善或出现症状加重的情况，建议尽快线下就医。用药期间因为含铁, 本药可改变粪便的颜色使之变黑, 这无临床意义。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050786922},{"body":{"content":"平时多吃水果蔬菜加强营养","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050798084},{"body":{"content":"您好，您看还有其他药理问题需要咨询药师吗？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050929077},{"body":{"content":"很高兴为您服务，请对我本次的服务做出评价，感谢您对京东大药房的支持，祝您生活愉快，谢谢！\n\n\n\n很高兴为您服务，请对我本次的服务做出评价，感谢您对京东大药房的支持，祝您生活愉快，谢谢！","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051834539}]

女

2022.05.20

[{"body":{"content":"感谢您体验京东育婴师育儿咨询服务，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":1653049640000},{"body":{"content":"您好","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049641748},{"body":{"content":"您好，您发链接的这款就是了，真三段适合两岁宝宝。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049671521}]

女

2022.05.20

[{"body":{"content":"有没有照片呢","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965164369},{"body":{"content":"发现这种情况多久了？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965397189},{"body":{"content":"两年多了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965867559},{"body":{"content":"医生，在不在？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965993098},{"body":{"content":"在的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966204539},{"body":{"content":"这看起来像疱疹感染","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966223699}]

男50岁

2022.05.20