协和缓和医疗在行动|肿瘤医生怎么样理解缓和医疗
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">赵林</span></strong></span></p><img src="https://mmbiz.qpic.cn/mmbiz_jpg/DDHzxVR6iagibTl9ao0I1cD4KNtYqicxWlt04ibuwcASgiaVUH8g7YMnF4icpGjmdA8Ds2aAGYWY4JjSedr0UnHt7BeA/640?wx_fmt=jpeg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;">
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">北京协和医院肿瘤内科副<span style="color: black;">专家</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">北京肿瘤预防<span style="color: black;">科研</span>会消化肿瘤专</p>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">北京肿瘤病理<span style="color: black;">精细</span>诊断<span style="color: black;">科研</span>会副</p>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">赵林教授：肿瘤<span style="color: black;">大夫</span>是<span style="color: black;">怎样</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">理解缓和医疗的</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">肿瘤是当下威胁生命健康最严峻的问题，而缓和医疗是肿瘤治疗中非常<span style="color: black;">要紧</span>的一部分。肿瘤病人的痛苦<span style="color: black;">不仅</span>来<span style="color: black;">自己</span>体，还<span style="color: black;">包含</span>心理、社会、精神方面的痛苦。这种痛苦波及的<span style="color: black;">不仅</span>是<span style="color: black;">病人</span>，还有家属。在<span style="color: black;">全部</span>治疗过程中，<span style="color: black;">没</span>论是<span style="color: black;">大夫</span>、护士、<span style="color: black;">病人</span>还是家属，都面临着<span style="color: black;">非常多</span>困境。<span style="color: black;">因此</span>从多个方面来减轻病人及家属的痛苦，<span style="color: black;">才可</span>真正达到<span style="color: black;">帮忙</span>病人的目的。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">肿瘤治疗和缓和医疗是一个什么样的关系，它们是对立关系吗？一个病人<span style="color: black;">是否</span>接受抗肿瘤治疗了<span style="color: black;">便是</span>肿瘤治疗？不接受抗肿瘤治疗时<span style="color: black;">便是</span>缓和医疗？它们之间是对立还是融合？抗肿瘤治疗和缓和医疗<span style="color: black;">怎样</span>来融合呢？</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">抗肿瘤治疗是以治愈为目的的治疗，缓和医疗更<span style="color: black;">大都是</span>以缓解症状为主的治疗。缓和医疗<span style="color: black;">实质</span>上<span style="color: black;">便是</span><span style="color: black;">怎样</span><span style="color: black;">加强</span>面临危及生命的<span style="color: black;">疾患</span>的<span style="color: black;">病人</span>及其家人的生活质量。缓和医疗<span style="color: black;">经过</span><span style="color: black;">初期</span>识别和<span style="color: black;">评定</span>，尽早<span style="color: black;">干涉</span>，<span style="color: black;">重点</span>目的是预防和减轻痛苦。在病人肿瘤<span style="color: black;">初期</span>，治疗<span style="color: black;">重点</span>是以治愈为目的，而随着病情<span style="color: black;">发展</span>和治疗手段的<span style="color: black;">逐步</span>减少，以缓解症状为主的治疗比例是<span style="color: black;">逐步</span><span style="color: black;">增加</span>的。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">实质</span>上，从一<span style="color: black;">起始</span>，抗肿瘤治疗和缓和医疗<span style="color: black;">便是</span>互相融合的关系，应该把抗肿瘤治疗和缓和医疗并行对待。<span style="color: black;">必须</span>更好的团队合作，<span style="color: black;">才可</span>够真正实现既能缓解病人身体的痛苦，<span style="color: black;">亦</span>能尽力<span style="color: black;">处理</span>病人心灵等方面的痛苦。临床工作中，门诊时间很短，<span style="color: black;">大夫</span>所能做的非常有限。缓和医疗团队的<span style="color: black;">初期</span>介入<span style="color: black;">能够</span>给<span style="color: black;">病人</span>和家属<span style="color: black;">更加多</span>、更细致的<span style="color: black;">指点</span>来<span style="color: black;">帮助</span>疏导痛苦。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">临床中遇到有的病人<span style="color: black;">尤其</span><span style="color: black;">剧烈</span><span style="color: black;">巴望</span>做手术或化疗，这些治疗<span style="color: black;">办法</span>对病人而言都不是治疗<span style="color: black;">目的</span>、而仅是治疗的手段。<span style="color: black;">咱们</span>的<span style="color: black;">目的</span>是<span style="color: black;">经过</span><span style="color: black;">各样</span><span style="color: black;">办法</span>来延长<span style="color: black;">病人</span>的<span style="color: black;">存活</span>预期、改善生活质量。在这方面，抗肿瘤治疗和<span style="color: black;">安定</span>缓和医疗的目的都是<span style="color: black;">同样</span>的，抗肿瘤治疗在延长<span style="color: black;">存活</span>方面可能有侧重，而缓和医疗对改善病人生活质量的权重方面则会<span style="color: black;">更加多</span>一点。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">缓和医疗很大一个特点是最大程度缓解<span style="color: black;">疾患</span>所带来的<span style="color: black;">伴同</span>症状，这和抗肿瘤治疗的目的是一致的。缓和医疗的服务对象，客观上讲是针对更广大的人群，除病人外还<span style="color: black;">包含</span>病人家属及其<span style="color: black;">伴侣</span>。而抗肿瘤治疗只针对病人，但病人患病以后，他<span style="color: black;">自己</span>及<span style="color: black;">整家</span>都面临困境。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">如今<span style="color: black;">大众</span>都提倡多学科团队合作，缓和医疗<span style="color: black;">亦</span>扩大了团队成员，<span style="color: black;">包含</span>医护人员、志愿者以及宗教人士等，肿瘤治疗团队和缓和医疗团队的携手合作和互相融合<span style="color: black;">能够</span>更大程度、更好地改善病人生活质量。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">2010年，<span style="color: black;">报告</span>了一项针对晚期非小细胞肺癌<span style="color: black;">病人</span>的<span style="color: black;">科研</span>，实验组接受<span style="color: black;">初期</span>标准抗肿瘤治疗加缓和照护，对照组只接受抗肿瘤治疗。<span style="color: black;">科研</span>结果<span style="color: black;">表示</span>，实验组比对照组接受了更少的晚期治愈性治疗<span style="color: black;">办法</span>，但中位<span style="color: black;">存活</span>时间却比对照组更长，生活质量和心情改善更加<span style="color: black;">显著</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">因此</span>肿瘤科<span style="color: black;">大夫</span>制定的治疗<span style="color: black;">办法</span>要<span style="color: black;">按照</span>病人的<span style="color: black;">详细</span>病情，把握好尺度。当病人有治愈的机会时，<span style="color: black;">必定</span>要重拳出击给病人争取更好的治愈，但<span style="color: black;">倘若</span>病人<span style="color: black;">已然</span>到了身心<span style="color: black;">没</span>法耐受抗肿瘤治疗时，就<span style="color: black;">不该</span>该再做<span style="color: black;">没</span>谓的、<span style="color: black;">乃至</span><span style="color: black;">增多</span><span style="color: black;">病人</span>痛苦的治疗<span style="color: black;">办法</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">《柳叶刀》曾<span style="color: black;">发布</span>一篇高分医学<span style="color: black;">文案</span>，提出抗肿瘤治疗和缓和医疗应该<span style="color: black;">初期</span>整合，进行以病人为中心的护理，减少<span style="color: black;">没</span>效化疗的<span style="color: black;">运用</span>，<span style="color: black;">这般</span><span style="color: black;">能够</span>更好的<span style="color: black;">加强</span><span style="color: black;">存活</span>率，<span style="color: black;">掌控</span>症状，减少焦虑和抑郁等心灵痛苦，改善生活质量，<span style="color: black;">加强</span><span style="color: black;">全部</span>家庭的满意度。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">《美国临床肿瘤学会临床实践指南》提出将<span style="color: black;">安定</span>缓和治疗纳入标准的抗肿瘤治疗，并<span style="color: black;">意见</span>住院及门诊晚期癌症病人，应在病程<span style="color: black;">初期</span>就接受<span style="color: black;">安定</span>缓和治疗服务。最理想的<span style="color: black;">状况</span>是为病人<span style="color: black;">供给</span>真正的跨学科团队的<span style="color: black;">安定</span>缓和治疗服务，<span style="color: black;">亦</span><span style="color: black;">便是</span>说<span style="color: black;">安定</span>缓和治疗和抗肿瘤治疗团队密切合作，将<span style="color: black;">初期</span>或晚期癌症病人及其家人<span style="color: black;">伴侣</span>都纳入到服务对象中，以更好地改善病人生活质量。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">现实中，抗肿瘤治疗和<span style="color: black;">安定</span>缓和<span style="color: black;">初期</span>融合还存在<span style="color: black;">非常多</span>问题，不仅是医护人员，病人和家属<span style="color: black;">亦</span>都<span style="color: black;">必须</span>学习和教育。<span style="color: black;">必须</span>大力推动以减少误解，<span style="color: black;">安定</span>缓和医疗并不<span style="color: black;">表率</span>放弃治疗。团队之间<span style="color: black;">必须</span>更好的沟通合作，<span style="color: black;">才可</span>给病人更加准确的综合<span style="color: black;">指点</span>，而不会两个团队各给一个<span style="color: black;">意见</span>，让病人及家属<span style="color: black;">没</span>所适从、更加茫然。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">在中国，肿瘤治疗中存在一个现实问题<span style="color: black;">便是</span>病人经常不<span style="color: black;">晓得</span>病情。<span style="color: black;">针对</span><span style="color: black;">疾患</span><span style="color: black;">通知</span>和治疗，应当征求病人的意愿，什么时候进行抗肿瘤治疗，什么时候以缓解症状为主，这个过程中<span style="color: black;">认识</span><span style="color: black;">病人</span>的意愿非常<span style="color: black;">要紧</span>，<span style="color: black;">这般</span><span style="color: black;">才可</span>让医护人员对<span style="color: black;">初期</span>融合治疗的尺度进行<span style="color: black;">恰当</span>把握。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">美国卡特总统在高龄时曾<span style="color: black;">病患</span>晚期恶性黑色素瘤，但经过免疫治疗，达到了治愈，<span style="color: black;">针对</span>这类病人，到底什么时候<span style="color: black;">必须</span>进行抗肿瘤治疗，什么时候以减轻痛苦的治疗为主，<span style="color: black;">必须</span>团队深度合作，<span style="color: black;">必须</span>对肿瘤治疗有非常深刻的理解，否则有可能过度治疗或过早放弃治疗。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">怎么样</span><span style="color: black;">才可</span>给<span style="color: black;">病人</span>和家属一个全方位、更好的治疗和照顾，<span style="color: black;">必须</span><span style="color: black;">咱们</span>认真思考<span style="color: black;">怎样</span>在临床中花<span style="color: black;">更加多</span>的时间和精力去践行肿瘤治疗和缓和医疗的融合。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">在缓和医疗和抗肿瘤治疗过程中，<span style="color: black;">必须</span>团队<span style="color: black;">一起</span>合作来把握治疗的尺度。<span style="color: black;">日前</span>肿瘤内科，就有一个非常好的缓和医疗团队，有<span style="color: black;">大夫</span>、护士、社工、志愿者、宗教人员。经过<span style="color: black;">大众</span>的<span style="color: black;">一起</span><span style="color: black;">奋斗</span>，经过十几年脚踏实地<span style="color: black;">保持</span>做这个工作，不仅缓解了病人的痛苦，<span style="color: black;">亦</span><span style="color: black;">帮忙</span>了病人的家庭，虽然非常<span style="color: black;">不易</span>，<span style="color: black;">然则</span>非常值得<span style="color: black;">保持</span>和推广。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">肿瘤科在面对恶性<span style="color: black;">疾患</span>时，很容易<span style="color: black;">显现</span>纠纷，但我<span style="color: black;">能够</span>自豪的说面对这么困难的<span style="color: black;">状况</span>，协和医院肿瘤内科的纠纷是非常少的，<span style="color: black;">这儿</span>面缓和医疗团队起到了非常<span style="color: black;">要紧</span>的<span style="color: black;">功效</span>，<span style="color: black;">她们</span>做了<span style="color: black;">海量</span>的工作，举行<span style="color: black;">定时</span>活动和<span style="color: black;">陪同</span>，改善了病人痛苦的<span style="color: black;">同期</span><span style="color: black;">亦</span>得到了病人和家属的良好回馈。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">在肿瘤内科，缓和医疗在发挥越来越多的<span style="color: black;">功效</span>，肿瘤内科医护人员缓和理念越来越<span style="color: black;">广泛</span>，<span style="color: black;">非常多</span>的<span style="color: black;">大夫</span>都参加了<span style="color: black;">科研</span>生缓和医疗<span style="color: black;">教育</span>，<span style="color: black;">教育</span>相长，对缓和医疗理念<span style="color: black;">亦</span>在<span style="color: black;">持续</span>加强。<span style="color: black;">此刻</span>的医护联合门诊，<span style="color: black;">更加是</span>迈出了非常<span style="color: black;">要紧</span>的一步，<span style="color: black;">咱们</span>不仅要<span style="color: black;">供给</span>最好的医疗，<span style="color: black;">亦</span>要<span style="color: black;">供给</span>最温暖的医疗，在缓和医疗团队<span style="color: black;">一起</span><span style="color: black;">奋斗</span>下，协和肿瘤内科病房里的病人虽然面临<span style="color: black;">非常多</span>痛苦，但<span style="color: black;">咱们</span>还是<span style="color: black;">能够</span>听到<span style="color: black;">她们</span>的欢笑，看到心愿墙上<span style="color: black;">她们</span>张贴的美好愿望。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">病例1：对缓和医疗的误解</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">一位老年女士，<span style="color: black;">病患</span>晚期恶性肿瘤，存在腹膜转移，<span style="color: black;">通常</span><span style="color: black;">状况</span>比较弱，预后<span style="color: black;">欠好</span>。<span style="color: black;">思虑</span>到病人整体<span style="color: black;">情况</span>，<span style="color: black;">疾患</span>和心灵的痛苦，肿瘤内科邀请缓和医疗团队积极介入。当缓和医疗团队介入时，家属来找我，问<span style="color: black;">是否</span>放弃治疗了？我当时非常惊讶，<span style="color: black;">无</span>想到家属会提出<span style="color: black;">这般</span>的问题。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">这<span style="color: black;">不仅</span>是家属的困惑，可能<span style="color: black;">亦</span>是<span style="color: black;">非常多</span>肿瘤科医护人员的困惑，应该什么时候介入缓和医疗？开展了缓和医疗，<span style="color: black;">便是</span>放弃了抗肿瘤治疗吗？这是一个很大的误解，缓和医疗和抗肿瘤治疗应该是互相融合的关系。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">病例2：肿瘤治疗与缓和医疗合作，为病人<span style="color: black;">供给</span>良好照护</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">一位40岁病人，大腿<span style="color: black;">显现</span>一巨大肿瘤，恶性度高，生长快，治疗<span style="color: black;">办法</span>相对比较有限。入院时<span style="color: black;">已然</span><span style="color: black;">发掘</span>远处转移，是一位晚期病人。他非常痛苦，<span style="color: black;">不可</span>行走，肿瘤很大，<span style="color: black;">病痛</span><span style="color: black;">已然</span>达到<span style="color: black;">不可</span>接受的程度，<span style="color: black;">心情</span>低落，在家属反复劝说下才来医院就诊，对治疗不报<span style="color: black;">期盼</span>。母亲不<span style="color: black;">晓得</span>儿子<span style="color: black;">患病</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">根据</span>传统抗肿瘤治疗模式，<span style="color: black;">便是</span>给<span style="color: black;">病人</span>分期并进行抗肿瘤化疗。但面对<span style="color: black;">这般</span>一位<span style="color: black;">病人</span>，还存在<span style="color: black;">非常多</span>艰难的问题，<span style="color: black;">例如</span>病人的痛苦绝望，<span style="color: black;">大夫</span>面对<span style="color: black;">这般</span>的病人时所产生的痛苦和<span style="color: black;">没</span>助。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">在这个病例中，肿瘤内科缓和医疗团队的<span style="color: black;">大夫</span>和护士跟病人和家属进行了充分的病情沟通，给予病人充分的止痛，<span style="color: black;">帮忙</span>家属排班，告诉<span style="color: black;">她们</span><span style="color: black;">怎样</span>向病人母亲<span style="color: black;">通知</span>病情，<span style="color: black;">怎样</span><span style="color: black;">安抚</span>病人的心灵、疏导心理。经<span style="color: black;">太多</span>科会诊，<span style="color: black;">同期</span>加强专业护理，<span style="color: black;">短期</span>内取得了非常好的效果。病人<span style="color: black;">病痛</span>好转，家属有条不紊进行<span style="color: black;">帮忙</span>和<span style="color: black;">陪同</span>，医护之间<span style="color: black;">创立</span>了良好的信任关系。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">半年后，病人病情<span style="color: black;">发展</span>，按常规<span style="color: black;">咱们</span>只能告诉病人家属，没什么办法了，回家吧！而在缓和医疗融入后，<span style="color: black;">大夫</span>、护士跟病人<span style="color: black;">一块</span>来沟通他的愿望：他<span style="color: black;">期盼</span>回去和母亲度过最后的时间，<span style="color: black;">期盼</span>在家中去世，<span style="color: black;">咱们</span>尊重他的<span style="color: black;">选取</span>，并给出新的止痛<span style="color: black;">方法</span>，<span style="color: black;">帮助</span>联系当地缓和医疗人员<span style="color: black;">帮忙</span>和随访跟踪。最后病人平静<span style="color: black;">逝去</span>，病人和他的家人都得到了<span style="color: black;">她们</span>所期望的过程。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">病例3：根据病人个体<span style="color: black;">状况</span>，</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">决定缓和治疗介入的</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">最佳<span style="color: black;">机会</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"> 32岁男性病人, 确诊生殖细胞肿瘤，入院时<span style="color: black;">显现</span>上腔静脉梗阻。上腔静脉梗阻是肿瘤治疗中的重症和急症，该<span style="color: black;">怎样</span>制定治疗计划？这<span style="color: black;">必须</span>对肿瘤治疗有非常深刻的把握。这个<span style="color: black;">疾患</span>对化疗<span style="color: black;">敏锐</span>，尽早积极化疗会达到非常好的效果，给病人争取治愈的机会。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">另一位上腔静脉梗阻病人是一位<span style="color: black;">青年</span>的肺腺癌<span style="color: black;">病人</span>，在<span style="color: black;">运用</span>靶向<span style="color: black;">药品</span>后病情继续<span style="color: black;">发展</span>，<span style="color: black;">显现</span>上腔静脉梗阻。金属支架<span style="color: black;">移植</span>后<span style="color: black;">1星期</span>症状<span style="color: black;">连续</span>存在，手术<span style="color: black;">不仅</span>加重了卧床，<span style="color: black;">况且</span>精神状态非常差。<span style="color: black;">此时</span>候<span style="color: black;">怎样</span>来制定治疗计划？到底做化疗、放疗，还是以支持治疗为主？结合病人的<span style="color: black;">详细</span><span style="color: black;">状况</span>，<span style="color: black;">思虑</span>到他属于治疗耐药，<span style="color: black;">通常</span><span style="color: black;">状况</span><span style="color: black;">已然</span>非常虚弱，<span style="color: black;">倘若</span>继续化疗、放疗，不仅<span style="color: black;">不可</span>带来治疗获益，反而会加重他的痛苦。于是和病人及家属充分沟通后，进行了以缓解症状为<span style="color: black;">重点</span>目的的治疗。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"> 文字整理：单素兰</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"> 编辑：单素兰 祝家莹</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"> 审核：郑莹 赵林</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"> 版式：王熙</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">往期<span style="color: black;">文案</span><span style="color: black;">举荐</span></strong></p>
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祝福你、祝你幸福、早日实现等。 交流如星光璀璨，点亮思想夜空。 “板凳”（第三个回帖的人）
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