刘继帅

[{"body":{"content":"您好。","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652878499020},{"body":{"content":"请说一下具体病史，如发病时间和部位，症状，有无诱因，家族史，既往史，医院化验结果，诊断， 治疗方案，效果如何？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652878849286},{"body":{"content":"后背，腋下","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652878865859},{"body":{"content":"化验单刚才发的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652878879511},{"body":{"content":"两大块儿，手上之前走过烧伤，感觉开始有小点点的白。","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652878948430},{"body":{"content":"后背腋下照片发给我看看","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879003392},{"body":{"content":"好的马上拍","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879058500},{"body":{"content":"后背","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879094766},{"body":{"content":"您看是***吗？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879129486},{"body":{"content":"腋下跟这个类似，然后就是手上很早年烧伤过，看着像是开始有小白点","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879251520},{"body":{"content":"有没有预防再在别处长的药或打针之类的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652880142114},{"body":{"content":"是***！","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652882524411},{"body":{"content":"预防发展就是用**","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652882553166},{"body":{"content":"吃药片或打针都行","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652882574311},{"body":{"content":"能直接给开药？还是要到医院？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652884765850},{"body":{"content":"您推荐吃药还是打针好？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652884795330},{"body":{"content":"**哪能瞎开啊","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652884929788},{"body":{"content":"必须去医院面诊","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652884943531},{"body":{"content":"如果开点外用药膏还可以","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652884963618},{"body":{"content":"吃药麻烦但是可以精确控制**的剂量，打针方便（一月一针）但不能精确控制剂量","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652885046821},{"body":{"content":"打扰下，打针一般需要几针，一个月到一次医院是吗？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652968746320},{"body":{"content":"一两针就好了，一个月到一次医院","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653002754293}]

女48岁

2022.05.20

[{"body":{"content":"您好，我是主治医师马跃青，很高兴由我为您提供咨询服务。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050875397},{"body":{"content":"你好","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050906667},{"body":{"content":"您好","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050914236},{"body":{"content":"5个月的婴儿吃啥样的**","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050920988},{"body":{"content":"五个月的话 只能吃400单位那款","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050922266},{"body":{"content":"请问是否有药物过敏史？肝肾功能是否正常？是否有其他疾病？近期在使用哪些其他药物？以便给您建议","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050923934},{"body":{"content":"没有","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050930107},{"body":{"content":"只有这种可以吃的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050936526},{"body":{"content":"每天一粒的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050939153},{"body":{"content":"对于婴儿是安全的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050944284},{"body":{"content":"好的谢谢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050944651},{"body":{"content":"好的 不客气的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050947654},{"body":{"content":"6个月后需要换吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050977756},{"body":{"content":"不需要","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050986429},{"body":{"content":"这款可以全年龄补充","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050990748},{"body":{"content":"谢谢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050991115},{"body":{"content":"日常建议摄入量也是400的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050997231},{"body":{"content":"谢谢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051003483},{"body":{"content":"不客气","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051004865},{"body":{"content":"使用商品前请您仔细阅读商品说明书，尤其重点关注禁忌及注意事项，如没有任何禁忌，可使用该商品，如您在使用过程中出现任何不适或疑问，请您及时上线咨询或去医院就诊。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051117880},{"body":{"content":"希望我的建议能够帮助到您，非常感谢您的信任。后续如果您还有疑问，随时上线咨询，可以打开京东APP，点击“我的”，再点击“问医生”，在搜索栏中搜索 我的名字 即可找到我。祝您平安健康","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051122250}]

女

2022.05.20

[{"body":{"content":"您好","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965090839},{"body":{"content":"好","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965095161},{"body":{"content":"这十天左右每天体重都在长","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965109541},{"body":{"content":"一天0.2斤","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965141269},{"body":{"content":"0.3","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965147404},{"body":{"content":"是不是要来月经之前","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965159377},{"body":{"content":"会这样","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965162795},{"body":{"content":"有没有慢性病","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965188604},{"body":{"content":"就是这次月经走之后体重一直往上升","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965201841},{"body":{"content":"没有","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965206174},{"body":{"content":"这怎么回事","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965385971},{"body":{"content":"这个不好说","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965406757},{"body":{"content":"您身高体重是多少","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965417496},{"body":{"content":"最近有没有运动","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965430818},{"body":{"content":"164","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965441827},{"body":{"content":"56.8","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965447566},{"body":{"content":"您这个体重很好的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965460616},{"body":{"content":"不用担心","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965464913},{"body":{"content":"这个月没来月经之前体重是五十五点","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965483952},{"body":{"content":"三斤以内波动是正常的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965515531},{"body":{"content":"然后自从月经结束每天都在增加","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965522747},{"body":{"content":"有没有用药物","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965522874},{"body":{"content":"没有","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965540104},{"body":{"content":"适当运动一下","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965549494},{"body":{"content":"就是用了一个涂抹的药膏","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965550464},{"body":{"content":"什么**","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965556337},{"body":{"content":"就是腿上有个红点然后用的药","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965571799},{"body":{"content":"也不知道什么名字","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965601134},{"body":{"content":"也不知道这几天是排卵期期的事","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965690742},{"body":{"content":"排卵期应该不会增加体重","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965782714},{"body":{"content":"适当运动一下","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965845908},{"body":{"content":"适当控制一下饮食","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965854784},{"body":{"content":"再看看","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965858483},{"body":{"content":"药物也有可能","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965862955},{"body":{"content":"我都是一直在减肥期间","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966001499},{"body":{"content":"所以说才奇怪","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966008433},{"body":{"content":"为什么天天涨","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966013554},{"body":{"content":"您体重偏瘦","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966044275},{"body":{"content":"不要追求过于瘦","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966056156},{"body":{"content":"太瘦也不好","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966063592},{"body":{"content":"一般早上称体重都是在55点起吧但是这十天左右每天都是56.3左右","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966229049},{"body":{"content":"然后就一直不掉称","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966245589},{"body":{"content":"三斤以内是正常的波动","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966353051},{"body":{"content":"观察就行了","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966358374},{"body":{"content":"不用担心","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966361742}]

女19岁

2022.05.20

[{"body":{"content":"这种情况考虑耵聍","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965181744},{"body":{"content":"没有不适症状的话，不用担心的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965194189},{"body":{"content":"耵聍腺分泌物脱水氧化形成的。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965298433},{"body":{"content":"不用担心","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965302362},{"body":{"content":"是这样的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965303335},{"body":{"content":"好的，谢谢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965312330},{"body":{"content":"不客气！希望我的建议可以帮助到您！非常感谢您的信任！请对话结束后对我的服务做出评价！祝您早日康复！谢谢！","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965317998}]

女17岁

2022.05.20

[{"body":{"content":"图片我看到了，你要问什么具体问题？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051006480},{"body":{"content":"您好","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051008996},{"body":{"content":"请讲具体问题。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051014897},{"body":{"content":"就是毛周角化症","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051023167},{"body":{"content":"胳膊这","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051025790},{"body":{"content":"然后之前去医院开的*****","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051050427},{"body":{"content":"抹了几个月一开始掉皮","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051057819},{"body":{"content":"现在就是起皮有颗粒感偶尔痒","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051070536},{"body":{"content":"没有什么改善","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051079556},{"body":{"content":"感觉有的地方扩散了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051090740},{"body":{"content":"这个病是慢性病，就得坚持用药，没有太快的。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051093212},{"body":{"content":"生活中可以口服****药店都有卖的，另外洗澡不要用力搓也不要太频繁。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051113590},{"body":{"content":"我看有推荐我*****","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051129543},{"body":{"content":"这个有效果吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051136851},{"body":{"content":"我也抹了一段时间","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051164133},{"body":{"content":"****就可以，就不错。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051199238},{"body":{"content":"那***呢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051214906},{"body":{"content":"这个用着感觉起皮泛红","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051223182},{"body":{"content":"抹起来赖不拉几的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051241653},{"body":{"content":"***可以，能滋养皮肤，没毛病。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051321484},{"body":{"content":"那您感觉我是涂**好一点还是**","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051345026},{"body":{"content":"一一种用一天。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051362969},{"body":{"content":"那我平时还需要擦油什么的吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051376538},{"body":{"content":"什么也不需要了，有这两种足够了。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051388540},{"body":{"content":"我看京东是***里面有**的这个可以吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051398600},{"body":{"content":"百分之10含量","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051405882},{"body":{"content":"这个的话涂的话频率是每天早晚吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051422753},{"body":{"content":"几次都行，随心，这个药没什么特殊说道。次数越多好的越快，有时间就涂。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051499292},{"body":{"content":"就是***吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051516797},{"body":{"content":"还是*****","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051524998},{"body":{"content":"***","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051573312},{"body":{"content":"好的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051579154},{"body":{"content":"好的，再见，祝早日康复。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051586761}]

男21岁

2022.05.20

[{"body":{"content":"尊敬的PLUS会员，您好，我是京东中医科医生，非常高兴由我为您提供医疗咨询服务","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050087531},{"body":{"content":"您好","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050098350},{"body":{"content":"抗体阳性，提示幽门螺旋杆菌感染","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050103688},{"body":{"content":"幽门螺杆菌感染的症状主要是反酸、烧心以及胃痛、口臭。幽门螺杆菌感染能够引起慢性胃炎。主要临床表现有：上腹部不适、隐痛，有时发生嗳气、反酸、恶心、呕吐的症状，病程较为缓慢，但是容易反复发作。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050111063},{"body":{"content":"我母亲幽门螺杆菌","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050111958},{"body":{"content":"恩恩","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050117356},{"body":{"content":"之前药物治疗过吗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050123871},{"body":{"content":"目前治疗是四联治疗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050366397},{"body":{"content":"疗程为2周","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050369845},{"body":{"content":"这些症状目前还没有","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050578532},{"body":{"content":"到检查显示幽门螺杆菌超","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050595386},{"body":{"content":"医生，请您帮我开具处方或用药建议。","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050607365},{"body":{"content":"请问您有药物过敏史，肝肾功能异常及其他慢性病史吗？以便我给您用药建议","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050614170},{"body":{"content":"没有","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050732835},{"body":{"content":"有中度脂肪肝，无其他病症","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050769374},{"body":{"content":"稍等，为您开方","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050843572},{"body":{"content":"*****，一次500mg，一日2次，饭后服用；******，一次1000mg，一日2次，饭后服用； ********，一次20mg，一日2次，饭前服用；*******，一次0.6g，一日2次，饭前服用","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051240919},{"body":{"content":"幽门螺旋杆菌感染 注意事项：\r①注意休息，保持良好情绪，规律作息。\r②三餐定时，饮食清淡易消化，进食要细嚼慢咽，避免过饱，忌烟酒、适当饮水，避免食用生冷、辛辣、油腻的食物。保持口腔健康（勤漱口、刷牙）。\r③幽门螺旋杆菌主要经过消化道传播（主要是共用餐具进餐），建议和您长期一起共用餐具的人进行碳13或碳14呼气试验检查，以便同时治疗，治疗时建议分餐，并做好餐具消毒。\r④幽门螺旋杆菌治疗疗程为2周，建议您治疗疗程结束后停药1月后复查碳13或碳14呼气试验。服药过程中可能会出现黑便（大部分是药物所致），若无症状加重情况，比如：乏力、头晕、胃痛等，建议您观察；反之，建议线上问诊或医院就诊。⑤ 如有不适，及时线上问诊或线下医院就诊。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051251488},{"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，比如：皮疹、皮肤瘙痒、发热等不适，请您及时停药并线上咨询或去医院就诊。不适随诊","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051380153},{"body":{"content":"您好，请问还有**问题需要咨询吗？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051383024}]

男60岁

2022.05.20

[{"body":{"content":"您好，我是主治医师侯卓成，很高兴由我为您提供咨询服务。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050162270},{"body":{"content":"您好,感谢您的信任!!!","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050165123},{"body":{"content":"可以的，避光","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050230450}]

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":1653049698659},{"body":{"content":"您好，可以的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049703911},{"body":{"content":"好的，谢谢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049729820},{"body":{"content":"不客气的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049756789},{"body":{"content":"你好，两岁半大约喝多少","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049764502},{"body":{"content":"一天两次一次10克就可","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049786356},{"body":{"content":"如果不上火了","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049790441},{"body":{"content":"一次5--10克","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049797880},{"body":{"content":"好的，谢谢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049874857},{"body":{"content":"不客气的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049900587}]

女

2022.05.20

[{"body":{"content":"您好，我是京东互联网医院医生，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。\n什么情况？是否有其他疾病？\n近期有没有什么用药史，\n或药物过敏史？\n请说","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050384421},{"body":{"content":"摸下什么感觉","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050404051},{"body":{"content":"皮肤下面有一粒","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050433657},{"body":{"content":"腱鞘囊肿？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050531141}]

男3岁

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