刘继帅

[{"body":{"content":"一周前在网上跟您咨询过，您让我先吃点***和*** 然后查一下肝功能。说我这个确实是肝掌。","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652878076516},{"body":{"content":"然后我去附近医院查了一个急诊肝功，我看着数据也挺正常的。不知道为啥会有肝掌。","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652878102413},{"body":{"content":"肝功能化验是没事的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652878624047},{"body":{"content":"这次肝功能化验没事，但是上次是异常的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652878737725},{"body":{"content":"既往长期的肝功能异常，会造成肝掌","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652878805720},{"body":{"content":"那我这个肝现在需要怎么处理一下吗？这个肝掌是不是以前肝功能非常不好才会这样？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879085616},{"body":{"content":"现在已经恢复正常了。继续减肥，到BMI正常范围，长期保持就行了。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879138485},{"body":{"content":"肝掌跟既往的肝脏损伤有关系","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879154232},{"body":{"content":"明白了，那请问这个肝掌可以恢复吗？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879223263},{"body":{"content":"还有我那个乙肝五项报告上写的抗体阳性剩下的都是阴性是啥意思？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879250105},{"body":{"content":"肝功能持续正常后，肝掌会恢复的，就算不恢复，也不会有什么影响，反正得定期检测肝功能，肝功能没事，就没事","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879720373},{"body":{"content":"你的乙肝报告在哪儿呢","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879781969},{"body":{"content":"那个报告我看不了电子版的，也不方便去医院。但是我给检验科的人打电话，他给我念的，说除了抗体是阳性剩下都是阴性。","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879880876},{"body":{"content":"是的大夫，我打算每半年查一次。","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879914703},{"body":{"content":"乙肝五项查的是两个抗原和三个抗体，如果你三个抗体都是阳性，就提示既往曾经感染过乙肝病毒，机体已经把病毒清除后的结果","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652880646824},{"body":{"content":"如果情况稳定，体重下降满意，没有反弹，半年查一次应该没问题","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652880671922},{"body":{"content":"好的大夫，那您说我还用吃那两个药吗？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652880869497},{"body":{"content":"手里有就吃完，还需要巩固一下","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652880911303},{"body":{"content":"好的，谢谢您，我没问题了。","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652880941660},{"body":{"content":"不客气！","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652880954583}]

男26岁

2022.05.20

[{"body":{"content":"你好，很高兴为你解答，我是皮肤科唐医生，有没有图片我看一下详细情况呢？局部有什么感觉呢？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965183670},{"body":{"content":"大腿外侧是这样的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965505129},{"body":{"content":"好长时间了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965510679},{"body":{"content":"感觉最近再**扩散","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965521190},{"body":{"content":"这叫皮肤膨胀纹也叫生长纹，比如生长发育，体重变化，身高变化等都可以导致皮肤纤维断裂，这个不影响健康不传染，**的可以减轻和淡化。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965524328},{"body":{"content":"好","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965574373},{"body":{"content":"嗯","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965582016},{"body":{"content":"谢谢医生","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965585513},{"body":{"content":"不客气的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965593152}]

女17岁

2022.05.20

[{"body":{"content":"你好，现在是一个什么情况。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965739199},{"body":{"content":"做的什么治疗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965744708},{"body":{"content":"你好","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965746858},{"body":{"content":"医生","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965749671},{"body":{"content":"影像所见:垂体上下径为0.7cm，上缘膨隆，垂体信号欠均匀，于垂体左侧部隐约见一小结节状T1WI低信号影，大小约为0.2cmx0.2cm，\t垂体柄居中，动态增强扫描示正常垂体明显均\t匀强化，垂体内病灶呈低信号，并见逐渐及度强化现象。鞍底骨质未见异常，鞍旁及鞍上**结构未见异常。","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965760367},{"body":{"content":"这个你看一下","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965766710},{"body":{"content":"有什么不舒服没有","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965783320},{"body":{"content":"泌乳素高","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965803036},{"body":{"content":"月经紊乱","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965827635},{"body":{"content":"那考虑还是跟这个垂体有关系","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965830609},{"body":{"content":"是的 就是看报告结果 医生你觉得严重么","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965896054},{"body":{"content":"我有点害怕","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965906315},{"body":{"content":"不严重","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965925272},{"body":{"content":"垂体瘤是常见的良性肿瘤","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965940287},{"body":{"content":"是吃药治疗么还是如何","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965954897},{"body":{"content":"可以完全治愈的么","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965968697},{"body":{"content":"好的，那就放心许多","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965978405},{"body":{"content":"可以先吃药看看","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965979908},{"body":{"content":"不行再考虑手术","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965990565},{"body":{"content":"好的，一般是吃什么药的呢?","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966017295},{"body":{"content":"如果这种做手术 风险应该不会很大的吧","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966054039},{"body":{"content":"手术微创，风险不大","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966118253},{"body":{"content":"吃药，吃***","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966128551},{"body":{"content":"好的 医生 这种去医院挂号的话，是挂神经外科还是内分泌科好","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966261683},{"body":{"content":"内分泌","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966372526},{"body":{"content":"好的，谢谢医生","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966419031}]

女22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":1653007325552},{"body":{"content":"肾结石什么问题?","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653007337165},{"body":{"content":"肾结石0.7","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653007375241},{"body":{"content":"可以服药**试试看","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653007410506}]

男32岁

2022.05.20

[{"body":{"content":"您好，你能再详细的说一下现有的症状吗？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652878768015},{"body":{"content":"有没有发烧，局部炎症？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652878786767},{"body":{"content":"没有","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879903522},{"body":{"content":"打了三天点滴，有一点消退了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879937101},{"body":{"content":"有没有查血常规呢","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652880041173},{"body":{"content":"没有查。就做了比超，打了**，现在又有点消退了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652882693354},{"body":{"content":"那您可以继续坚持治疗，另外还是建议您查个血常规，看看是不是炎症引起淋巴结肿大","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652882763536}]

男34岁

2022.05.20

[{"body":{"content":"你好","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653045617169},{"body":{"content":"抑郁症的症状：情绪低落，兴趣减退，精力下降，自卑，自杀，反应迟钝，不爱吃饭，不睡觉或者睡眠多！ 这些症状有几点？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653045621455}]

女14岁

2022.05.20

[{"body":{"content":"帮忙开个处方","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652878661387},{"body":{"content":"您好，我是马医生，非常高兴由我为您提供医疗咨询服务。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652878663188},{"body":{"content":"请问您有什么需要咨询的医学问题？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652878664652},{"body":{"content":"你是本人咨询吗？以往有过线下就诊经历吗？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652878665977},{"body":{"content":"您好，请问您之前在线下医院就诊过吗？目前的药物是您本人在服用吗？具体的诊断是什么？有带有患者名字的诊断记录/病历/处方单/检查单等就诊资料吗？请发给我看一下，谢谢！","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652878671786},{"body":{"content":"是的，精神分裂，","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652878713706},{"body":{"content":"因为精神科药品的特殊性，平台咨询不能代替线下就诊，所以我们只能给要过线下就诊经历诊断明确的病情稳定的开具处方。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652878726455},{"body":{"content":"不可开方情况：\n１.　用药指导不可以\n２.　门诊缴费凭证不可以\n３.　互联网平台处方凭证不可以\n 4. 取药单不可以\n 5. 发票单不可以\n 6. 非精神心理科提供的凭证不可以！（神经内科规范处方除外）\n以上均缺乏专业认证！！！！！！！\n\n可开方情况（满足一种即可)：\n特别说明：以下可开方情况的专业认证与本次问诊的患者姓名、诊断、药品名称三者必须全部一致，否则不可开方！！！！！！！\n\n１．门诊病历（可无盖章，必须有医生签名）\n２.　住院病历（必须有医院公章）\n３.　出院小结（纸质手写必须有医院公章，电子版可无公章）\n４.　诊断证明（必须有医院公章）\n５.　处方单（必须有医生签名）\n 6· 线下实体医院自有互联网医院处方单（必须有医生签名）","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879085715}]

女37岁

2022.05.20

[{"body":{"content":"您好，京东大药房药师工号0081，很高兴为您服务！","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051236153},{"body":{"content":"你干活的时候一直要用眼，所以眼睛干涩疼，还有点儿红，该用什么***呢？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051257512},{"body":{"content":"为了您的用药安全，方便药师指导用药，请问患者的性别和年龄？特殊情况请提前告知，如：（糖尿病、肝肾等其他病史、备孕期、孕期、哺乳期、是否有过敏史）","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051282432},{"body":{"content":"性别女，年龄50。没有其他病史。","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051458997},{"body":{"content":"好的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051463229},{"body":{"content":"该用什么***啊，医生？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051652429},{"body":{"content":"这个药物看下","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051662985},{"body":{"content":"功能主治】 用于缓解眼睛疲劳、结膜充血以及眼睛发痒等症状。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051894673},{"body":{"content":"【用法用量】 滴眼，一次1～2滴，一日3～4次。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653052020068},{"body":{"content":".打开后应在4周内用完，逾期请勿使用","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653052080547},{"body":{"content":"为了您的用药安全，请您在用药前仔细阅读说明书注意事项、禁忌等内容，严格按照说明书或药师指导的用法用量使用，若用药3-4天无效果或病情加重，请及时咨询医生师或立即线下就医。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653052092811},{"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":1653052098010},{"body":{"content":"没有没有，谢谢，谢谢。","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653052155151},{"body":{"content":"很高兴为您服务，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":1653052188223}]

女

2022.05.20

[{"body":{"content":"您好，京东大药房药师工号0493，很高兴为您服务！","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051044928},{"body":{"content":"什么部位有这种情况呢？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051049461},{"body":{"content":"额头上","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051066774},{"body":{"content":"稍等，我看一下","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051074368},{"body":{"content":"最初是外伤引起的吗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051092791},{"body":{"content":"为了您的用药安全，特殊情况请提前告知，如：（糖尿病、肝肾等其他慢性病史、是否有过敏史），如果没有则回复“无”","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051134400},{"body":{"content":"小时候摔跤磕到的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051135783},{"body":{"content":"好的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051139399},{"body":{"content":"请问针对您的症状，最近是否使用过药物治疗?","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051152894},{"body":{"content":"没有","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051165871},{"body":{"content":"好的，稍等帮您推荐一下药物","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051174343},{"body":{"content":"您可以参考一下这个产品，对您说的情况比较合适","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051240844},{"body":{"content":"***，一天两次，外用看看的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051252801},{"body":{"content":"建议您平时少吃油腻、刺激性食物，近期不吃鱼虾蟹等发物，不要挤压患处，以免继发感染，","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051291611},{"body":{"content":"为了您的用药安全，请您在用药前仔细阅读说明书注意事项、禁忌等内容，严格按照说明书或药师指导的用法用量使用，若用药无效果或病情加重，请及时咨询医生师或立即线下就医。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051297447},{"body":{"content":"要用多久才会有效果呢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051373191},{"body":{"content":"一般一个月是一个疗程的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051394504},{"body":{"content":"可以先用一个疗程，看一下改善的情况","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051403430},{"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":1653051481183},{"body":{"content":"希望我的建议能够帮助到您，非常感谢您的信任！请对话结束后对我的服务作出评价，祝您生活愉快，再见！","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051482788}]

女

2022.05.20

[{"body":{"content":"您好,感谢您的信任!!!","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965468505},{"body":{"content":"有什么咨询的吗？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965478411},{"body":{"content":"可以麻烦医生看一下这个病理结果吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965516714},{"body":{"content":"是恶性的吗 原发性的吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965531653},{"body":{"content":"可能","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965595472},{"body":{"content":"可能性较大","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965633477},{"body":{"content":"您可以简单解释一下这个检查结果吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965644223},{"body":{"content":"是直肠息肉吗？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965649684},{"body":{"content":"异性增生就提示恶性肿瘤","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965698858},{"body":{"content":"病理活检已经比较明确考虑恶性肿瘤了，建议进一步做免疫组化等，具体看你主治医生的意见较好，他比较了解具体情况","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965756329},{"body":{"content":"看到明显的肿物","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965794243},{"body":{"content":"那高级别上级内瘤是代表什么","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965799805},{"body":{"content":"提示恶性程度可能没那么高","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966022000},{"body":{"content":"就是可能是恶性的 但是要进行进一步的检查确认","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966092014},{"body":{"content":"那这样的情况容易转移吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966130964},{"body":{"content":"只能看个人情况咯","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966172955},{"body":{"content":"医生会帮你评估的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966187979},{"body":{"content":"好的 谢谢医生","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966201795},{"body":{"content":"不用","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966213005}]

女49岁

2022.05.20