[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"$f65-g5LTUgHIk8dGZIHhGe2pKpxnfW0g-O4HGxk3yxcs":3,"$f3aWpREUm7-2lFuHZhNHAnqNqzlGgH6oieV6m2GqXQ28":8,"$fp54BRIFFTVBN_BAgRA2pDR6iMGGMXzORphAVaefwx4w":55,"$fjQg3QLHFV1pBjhFORBcUqKTw1geKhqz-kRJ8Yd_kQkQ":59},{"code":4,"msg":5,"message":6,"data":6,"success":7},401,"认证失败，无法访问系统资源",null,false,{"code":9,"msg":10,"message":6,"data":11,"success":54},200,"操作成功",{"id":12,"specialistId":13,"specialistAssistants":14,"profilePhoto":15,"specialistName":16,"hospital":17,"department":18,"postsTitle":19,"materialTotal":20,"videoTotal":21,"isConcern":7,"title":22,"coverVertical":23,"coverAcross":24,"content":25,"description":26,"views":27,"likes":21,"isThumbsUp":7,"isCollection":7,"collections":21,"createTime":28,"seoTitle":22,"seoKeywords":29,"seoDescription":30,"shelvesTime":31,"version":32,"menus":33,"menuId":35,"type":42,"quality":53,"commentCount":21,"isComment":42},69226,870213,[],"https://cdn.haohuanjiao.com/learnMaterial/ystApp//hk0nky0jW6hC6kA5kTPwGdSYQ068rXoE.png","俞宁娟","浙江大学医学院附属第二医院","肿瘤科","主治医师",34,0,"胆管癌的识别与应对","","https://ystcdn.venuertc.com/venue/AI/30f6d137-fdfe-4389-8b96-c33675c62f07.jpg","\u003Cdiv class=\"biliary-guide-container\">\n\n  \u003Ch1 id=\"material_title\" class=\"biliary-main-title\">\n    胆管癌的识别与应对\n  \u003C/h1>\n  \n  \u003Csection class=\"biliary-section\">\n    \u003Cdiv class=\"biliary-section-banner biliary-bg-light\">\n      \u003Cspan class=\"biliary-section-emoji\">💡\u003C/span>\n      \u003Cspan class=\"biliary-section-title\">01 你了解胆管癌吗？\u003C/span>\n    \u003C/div>\n    \u003Cdiv class=\"biliary-section-body\">\n      \u003Cp>\n        平时聊天时，或许很少有人提到“胆管癌”这个词。其实在体检或医院就诊中，这个名字偶尔会冒出来，让人有点担心。简单来说，胆管癌是指发生在胆管内的恶性肿瘤。胆管本身像一条安静的小径，负责把肝脏分泌的胆汁输送到肠道。它的位置不抢眼，可一旦出了问题，影响却不小。\n      \u003C/p>\n      \u003Cp>\n        近年来，胆管癌的发病率有一定上升趋势，尤其在50岁以后风险逐步升高。目前，全球每年有数十万人因此疾病受到困扰。据权威文献（Khan SA, Thomas HC, Davidson BR, Taylor-Robinson SD. Cholangiocarcinoma. Lancet. 2005）介绍，胆管癌根据发生部位分为肝内胆管癌与肝外胆管癌，两者在早期表现与治疗选择上有不少差别，但都属于较为隐蔽、起病缓慢的恶性肿瘤类型。\n      \u003C/p>\n      \u003Cdiv class=\"biliary-tips biliary-bg-hint\">\n        \u003Cspan class=\"biliary-tips-emoji\">🔎\u003C/span>\n        \u003Cspan>虽然胆管癌不常见，但它的隐蔽性让人不容易察觉。\u003C/span>\n      \u003C/div>\n    \u003C/div>\n  \u003C/section>\n  \n  \u003Csection class=\"biliary-section\">\n    \u003Cdiv class=\"biliary-section-banner biliary-bg-light\">\n      \u003Cspan class=\"biliary-section-emoji\">🚩\u003C/span>\n      \u003Cspan class=\"biliary-section-title\">02 警惕这些症状信号\u003C/span>\n    \u003C/div>\n    \u003Cdiv class=\"biliary-section-body\">\n      \u003Cp>\n        胆管癌刚起步时，好多症状往被忽略。有些人可能会有短暂的肚子不舒服，或者偶尔有点食欲差。大部分轻微不适甚至不会太在意。直到病情慢发展，才会出现一些更明显的警告信号。\n      \u003C/p>\n      \u003Cul class=\"biliary-list\">\n        \u003Cli>\n          \u003Cspan class=\"biliary-list-emoji\">🟡\u003C/span>\u003Cstrong>皮肤或眼白变黄：\u003C/strong>医生称为“黄疸”。这是因为胆汁无法顺利流到肠道，胆红素在身体里积累。\n        \u003C/li>\n        \u003Cli>\n          \u003Cspan class=\"biliary-list-emoji\">⚡\u003C/span>\u003Cstrong>腹部持续性隐痛：\u003C/strong>常出现在右上腹部的钝痛，时间长、间歇性加重。\n        \u003C/li>\n        \u003Cli>\n          \u003Cspan class=\"biliary-list-emoji\">🔻\u003C/span>\u003Cstrong>体重下降、乏力：\u003C/strong>没有刻意减肥，体重却悄地往下掉。\n        \u003C/li>\n        \u003Cli>\n          \u003Cspan class=\"biliary-list-emoji\">🦶\u003C/span>\u003Cstrong>皮肤瘙痒：\u003C/strong>胆汁滞留导致皮肤变得异常瘙痒，晚上或入睡前更明显。\n        \u003C/li>\n      \u003C/ul>\n      \u003Cdiv class=\"biliary-case biliary-bg-case\">\n        \u003Cspan class=\"biliary-case-emoji\">📋\u003C/span>\n        \u003Cspan>\n          \u003Cstrong>真实案例：\u003C/strong>63 岁女性，因黄疸和体重持续下降就诊。医生检查发现肝内转移，后确诊为胆管癌。这类例子说明，莫名其妙的黄疸和瘙痒别一拖再拖，尽早去医院排查。\n        \u003C/span>\n      \u003C/div>\n      \u003Cp>\n        当症状持续存在，尤其是黄疸、腹痛和无法解释的消瘦，最好别硬扛，应寻求专业帮助。\n      \u003C/p>\n    \u003C/div>\n  \u003C/section>\n\n  \u003Csection class=\"biliary-section\">\n    \u003Cdiv class=\"biliary-section-banner biliary-bg-light\">\n      \u003Cspan class=\"biliary-section-emoji\">🧬\u003C/span>\n      \u003Cspan class=\"biliary-section-title\">03 胆管癌的致病机理与高危因素\u003C/span>\n    \u003C/div>\n    \u003Cdiv class=\"biliary-section-body\">\n      \u003Cp>\n        为什么看似安分的胆管会出问题？实际上，这和日常许多习惯以及身体状态有关。\n      \u003C/p>\n      \u003Col class=\"biliary-orderlist\">\n        \u003Cli>\n          \u003Cspan class=\"biliary-list-emoji\">🥄\u003C/span>\u003Cstrong>慢性胆道炎症：\u003C/strong>比如长期胆管炎症反复，在胆管壁形成持续刺激（Endo I et al., Bile Duct Carcinoma and Pathogenesis, 2013）。患者常伴有胆结石史或反复感染。\n        \u003C/li>\n        \u003Cli>\n          \u003Cspan class=\"biliary-list-emoji\">🔩\u003C/span>\u003Cstrong>胆管结石及囊肿：\u003C/strong>胆汁长期流通不畅，就像河道常堵塞，慢可能滋生异常细胞。\n        \u003C/li>\n        \u003Cli>\n          \u003Cspan class=\"biliary-list-emoji\">⚙️\u003C/span>\u003Cstrong>肝硬化或慢性肝炎：\u003C/strong>乙肝、丙肝病人，尤其合并肝硬化时，胆管癌风险远高于常人。\n        \u003C/li>\n        \u003Cli>\n          \u003Cspan class=\"biliary-list-emoji\">👴\u003C/span>\u003Cstrong>年龄增长：\u003C/strong>50 岁以后发病率上涨，60～70 岁为高发段。\n        \u003C/li>\n        \u003Cli>\n          \u003Cspan class=\"biliary-list-emoji\">🧬\u003C/span>\u003Cstrong>部分遗传因素：\u003C/strong>家族中有此类肿瘤的成员，风险略有增加。\n        \u003C/li>\n      \u003C/ol>\n      \u003Cp>\n        数据表明，东南亚慢性肝吸虫流行地区胆管癌高发，而乙肝高发区也呈相关（Razumilava, N., & Gores, G. J., Cholangiocarcinoma, Lancet, 2014）。\n      \u003C/p>\n      \u003Cdiv class=\"biliary-info biliary-bg-hint\">\n        \u003Cspan class=\"biliary-list-emoji\">⚠️\u003C/span>\n        \u003Cspan>慢性胆道疾病和年龄增长是主要危险因素。\u003C/span>\n      \u003C/div>\n    \u003C/div>\n  \u003C/section>\n\n  \u003Csection class=\"biliary-section\">\n    \u003Cdiv class=\"biliary-section-banner biliary-bg-light\">\n      \u003Cspan class=\"biliary-section-emoji\">🔬\u003C/span>\n      \u003Cspan class=\"biliary-section-title\">04 胆管癌的诊断方法\u003C/span>\n    \u003C/div>\n    \u003Cdiv class=\"biliary-section-body\">\n      \u003Cp>\n        面对胆管癌，光靠症状推断不太靠谱。最关键的，是走进医院接受系统检查。一般流程会包括：\n      \u003C/p>\n      \u003Cul class=\"biliary-list\">\n        \u003Cli>\n          \u003Cspan class=\"biliary-list-emoji\">🖥️\u003C/span>\u003Cstrong>影像学检查：\u003C/strong>包括B超、CT、MRI。这些工具能发现肿瘤的具体位置和大小，对评估病情非常关键。\n        \u003C/li>\n        \u003Cli>\n          \u003Cspan class=\"biliary-list-emoji\">🧪\u003C/span>\u003Cstrong>血液肿瘤标志物检测：\u003C/strong>比方说CA199、CEA。如果发现这类指标异常升高，要格外小心。\n        \u003C/li>\n        \u003Cli>\n          \u003Cspan class=\"biliary-list-emoji\">🔍\u003C/span>\u003Cstrong>组织活检：\u003C/strong>通过细针穿刺等方式，直接获取肿瘤组织，做显微镜下的进一步确诊。\n        \u003C/li>\n      \u003C/ul>\n      \u003Cdiv class=\"biliary-check biliary-bg-hint\">\n        \u003Cspan class=\"biliary-list-emoji\">🔎\u003C/span>\n        \u003Cspan>早发现、早诊断，是提高治疗成功率的关键。不要等症状加重才就医。\u003C/span>\n      \u003C/div>\n      \u003Cp>\n        医学界普遍认为，胆管癌早期发现较难，因此建议一旦有可疑症状，及时就医检查（Bridgewater, J. et al., Guidelines for the diagnosis and management of intrahepatic cholangiocarcinoma, Gut, 2014）。\n      \u003C/p>\n    \u003C/div>\n  \u003C/section>\n\n  \u003Csection class=\"biliary-section\">\n    \u003Cdiv class=\"biliary-section-banner biliary-bg-light\">\n      \u003Cspan class=\"biliary-section-emoji\">💊\u003C/span>\n      \u003Cspan class=\"biliary-section-title\">05 治疗方式的选择\u003C/span>\n    \u003C/div>\n    \u003Cdiv class=\"biliary-section-body\">\n      \u003Cp>\n        胆管癌治疗不再单一，选择哪种方案，要看肿瘤大小、位置以及有无转移。总体说来，主要手段包括：\n      \u003C/p>\n      \u003Col class=\"biliary-orderlist\">\n        \u003Cli>\n          \u003Cstrong>外科手术切除\u003C/strong>——如果发现得早，且肿瘤尚未广泛扩散，外科医生会建议切除肿瘤连带部分胆管。手术是目前根治胆管癌的第一选择。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>化疗或放疗\u003C/strong>——有些病例不能开刀的时候，可以考虑药物“杀灭”异常细胞，或者用放射线控制病灶进展。例如白蛋白紫杉醇，这类药物能延缓肿瘤发展，减轻症状。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>支持及对症治疗\u003C/strong>——实际操作中，配合升白、补血等措施，帮助患者更好地应对化疗副反应，提高身体抵抗力。\n        \u003C/li>\n      \u003C/ol>\n      \u003Cp>\n        例如上述那位63岁的患者，正在使用系统性抗肿瘤药物合并辅助支持治疗。说明在确诊后，及时、系统、多学科的综合管理能明显改善生活质量。\n      \u003C/p>\n      \u003Cdiv class=\"biliary-key biliary-bg-hint\">\n        \u003Cspan class=\"biliary-list-emoji\">🥼\u003C/span>\n        \u003Cspan>个体化治疗方案要根据自身条件和医生建议来定。\u003C/span>\n      \u003C/div>\n    \u003C/div>\n  \u003C/section>\n\n  \u003Csection class=\"biliary-section\">\n    \u003Cdiv class=\"biliary-section-banner biliary-bg-light\">\n      \u003Cspan class=\"biliary-section-emoji\">🥦\u003C/span>\n      \u003Cspan class=\"biliary-section-title\">06 如何在日常生活中进行健康管理？\u003C/span>\n    \u003C/div>\n    \u003Cdiv class=\"biliary-section-body\">\n      \u003Cp>\n        胆管癌患者及高危人群，平日里最重要的是“善待”自己的身体。简单的做法可以帮助增强抵抗力，也为后续治疗打下好基础。\n      \u003C/p>\n      \u003Cul class=\"biliary-list\">\n        \u003Cli>\n          \u003Cstrong>坚持均衡饮食 🥗 ：\u003C/strong>\n          \u003Cspan class=\"biliary-keyword\">新鲜蔬菜\u003C/span>、\u003Cspan class=\"biliary-keyword\">水果\u003C/span>含丰富抗氧化物和纤维，有助于减缓胆道慢病进展。建议每天主餐都搭配不同的彩色蔬果。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>适当运动🏃‍♂️：\u003C/strong>\n          动一动有利于维持体重、改善代谢。可以根据自己体力选择散步、慢跑或轻度体操，每周不少于三次，每次约30分钟。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>好心情😄：\u003C/strong>\n          心理压力也是影响免疫力的因素之一。和家人朋友多沟通交流，减少孤独感，能够帮助身体应对疾病。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>定期复查：\u003C/strong>\n          治疗期间，要密切关注自身变化，如新发皮肤瘙痒、腹胀或排便异常及时联系医生。\n        \u003C/li>\n      \u003C/ul>\n      \u003Cdiv class=\"biliary-tips biliary-bg-hint\">\n        \u003Cspan class=\"biliary-tips-emoji\">🩺\u003C/span>\n        \u003Cspan>胆管癌患者，治疗期间和康复期都要和专业肿瘤科医生保持联系。有任何不适别憋着。\u003C/span>\n      \u003C/div>\n      \u003Cp>\n        文献提示，均衡膳食和中等强度锻炼对肝胆系统健康均有正向作用（World Cancer Research Fund/American Institute for Cancer Research, Diet, Nutrition, Physical Activity and Cancer: a Global Perspective, 2019）。\n      \u003C/p>\n    \u003C/div>\n  \u003C/section>\n\n  \u003Csection class=\"biliary-section\">\n    \u003Cdiv class=\"biliary-section-banner biliary-bg-light\">\n      \u003Cspan class=\"biliary-section-emoji\">🙌\u003C/span>\n      \u003Cspan class=\"biliary-section-title\">07 温和建议，积极面对\u003C/span>\n    \u003C/div>\n    \u003Cdiv class=\"biliary-section-body\">\n      \u003Cp>\n        说起来，胆管癌并不会“一下子打倒一个人”，但它确实提醒我们要关注身体发出的微小信号。从规律生活、科学饮食、合理锻炼到及早就医，这些一步步扎实的行动，是守护健康最实在的选择。每个人的状况不一样，如果遇到了不懂的问题，找专业医生面对面聊，会更有底气。\n      \u003C/p>\n      \u003Cp>\n        最后，养成良好生活习惯，才是最基本也是最有效的预防之道。胆管癌并不可怕，早知早治才安心。\n      \u003C/p>\n    \u003C/div>\n  \u003C/section>\n\n\n  \u003Csection class=\"biliary-section biliary-bg-refer\">\n    \u003Cdiv class=\"biliary-section-banner biliary-bg-light\">\n      \u003Cspan class=\"biliary-section-emoji\">📚\u003C/span>\n      \u003Cspan class=\"biliary-section-title\">参考文献\u003C/span>\n    \u003C/div>\n    \u003Cdiv class=\"biliary-section-body biliary-references\">\n      \u003Col>\n        \u003Cli>\n          Khan SA, Thomas HC, Davidson BR, Taylor-Robinson SD. (2005). Cholangiocarcinoma. \u003Ci>The Lancet\u003C/i>, 366(9493), 1303-1314.\n        \u003C/li>\n        \u003Cli>\n          Endo I, et al. (2013). Bile Duct Carcinoma and Pathogenesis. \u003Ci>Surgery Today\u003C/i>, 43(3), 267-274.\n        \u003C/li>\n        \u003Cli>\n          Razumilava N, Gores GJ. (2014). Cholangiocarcinoma. \u003Ci>The Lancet\u003C/i>, 383(9935), 2168-2179.\n        \u003C/li>\n        \u003Cli>\n          Bridgewater, J., Galle, P. R., Khan, S. A., Llovet, J. M., Park, J. W., Patel, T., ... & Valle, J. W. (2014). Guidelines for the diagnosis and management of intrahepatic cholangiocarcinoma. \u003Ci>Gut\u003C/i>, 63(11), 1657-1669.\n        \u003C/li>\n        \u003Cli>\n          World Cancer Research Fund/American Institute for Cancer Research. (2019). Diet, Nutrition, Physical Activity and Cancer: a Global Perspective. Available at: \u003Ca href=\"https://www.wcrf.org/\" target=\"_blank\">https://www.wcrf.org/\u003C/a>\n        \u003C/li>\n      \u003C/ol>\n    \u003C/div>\n  \u003C/section>\n\u003C/div>\n\n\u003Cstyle>\n.biliary-guide-container {\n  font-family: 'Segoe UI', 'PingFang SC', 'Hiragino Sans GB', 'Arial', sans-serif;\n  background-color: #faf9f6;\n  color: #373737;\n  padding: 32px 18px;\n  max-width: 760px;\n  margin: 0 auto;\n  border-radius: 10px;\n  box-shadow: 0 2px 8px 0 rgba(90,110,120,.07);\n}\n\n.biliary-main-title {\n  font-size: 2.2em;\n  font-weight: 600;\n  letter-spacing: .04em;\n  margin-top: 0;\n  margin-bottom: 32px;\n  text-align: center;\n  color: #065c4a;\n}\n\n.biliary-section {\n  margin-bottom: 42px;\n}\n\n.biliary-section-banner {\n  display: flex;\n  align-items: center;\n  padding: 18px 22px;\n  border-radius: 7px 7px 0 0;\n  border-bottom: 2px solid #e0ebe9;\n  font-size: 1.15em;\n}\n\n.biliary-section-emoji {\n  font-size: 1.45em;\n  margin-right: 10px;\n}\n\n.biliary-section-title {\n  font-weight: 500;\n  color: #167058;\n  letter-spacing: .02em;\n}\n\n.biliary-section-body {\n  background: #fff;\n  padding: 20px 22px 20px 26px;\n  border-radius: 0 0 8px 8px;\n  box-shadow: 0 4px 10px 0 rgba(6,92,74,0.03) inset;\n}\n\n.biliary-bg-light {\n  background: linear-gradient(90deg,#eaf7f3 85%, #f4fafd 100%);\n}\n\n.biliary-bg-hint {\n  background: #e3f2f7;\n  border-left: 5px solid #79d5c1;\n  margin: 18px 0 12px 0;\n  padding: 10px 18px;\n  border-radius: 6px;\n  font-size: 1.03em;\n  display: flex;\n  align-items: center;\n}\n\n.biliary-bg-case {\n  background: #fef8e3;\n  border-left: 5px solid #e8c46c;\n  margin: 20px 0 18px 0;\n  padding: 10px 15px;\n  border-radius: 6px;\n  font-size: 1.02em;\n  display: flex;\n  align-items: flex-start;\n}\n\n.biliary-bg-refer {\n  background: #f7faf7;\n  border-radius: 9px;\n}\n\n.biliary-list,\n.biliary-orderlist {\n  margin: 16px 0 20px 0;\n  padding:0 0 0 15px;\n}\n\n.biliary-list-emoji {\n  display: inline-block;\n  font-size:1.1em;\n  margin-right:6px;\n}\n\n.biliary-list li, .biliary-orderlist li {\n  margin: 0 0 12px 0;\n  line-height: 1.9em;\n}\n\n.biliary-case-emoji,\n.biliary-tips-emoji {\n  font-size: 1.15em;\n  margin-right:7px;\n  color: #e2a92b;\n}\n\n.biliary-tips {\n  margin-top: 10px;\n  margin-bottom: 10px;\n  font-weight: 400;\n}\n\n.biliary-key {\n  margin-top: 10px;\n  margin-bottom: 10px;\n  font-weight: 400;\n}\n\n.biliary-info {\n  margin: 15px 0;\n  font-weight: 400;\n}\n\n.biliary-keyword {\n  color: #31867d;\n  font-weight: 500;\n}\n\n.biliary-references {\n  font-size: 1em;\n  padding: 8px 0;\n  color: #374c49;\n}\n\n.biliary-references a {\n  color: #297378;\n  text-decoration: underline;\n}\n\n@media (max-width: 540px) {\n  .biliary-guide-container {\n    padding: 10px 3px;\n    margin-top: 0;\n  }\n  .biliary-main-title {\n    font-size: 1.2em;\n    margin-bottom: 16px;\n  }\n  .biliary-section-banner {\n    padding: 11px 12px;\n    font-size: 1em;\n  }\n  .biliary-section-body {\n    padding: 16px 7px 13px 11px;\n  }\n}\n\n\u003C/style>","\u003Cdiv class=\"biliary-guide-container\">\n\n  \u003Ch1 id=\"material_title\" class=\"biliary-main-title\">\n    胆管癌",540,"2025-10-31 00:10:32","胆管癌, 黄疸, 体重下降, 医疗检查, 胆道疾病, 治疗方式, 健康管理, 早期症状","了解胆管癌的症状、致病机理与治疗方案，及早识别，提高生活质量，适合中老年人关注健康的重要指南。","2025-11-13 20:01:06",2,[34],{"menuId":35,"menuName":36,"parentId":21,"orderNum":32,"path":37,"component":38,"isFrame":39,"isCache":40,"menuType":41,"visible":42,"status":21,"createDept":6,"remark":23,"createTime":43,"children":44,"columnImage":45,"columnLogo":46,"uncheckedLogo":6,"checkedLogo":6,"isHot":42,"isHome":21,"forceLogin":21,"color":47,"seoTitle":48,"seoKeywords":49,"seoDescription":50,"contentNum":6,"promotionalPoster":51,"menuFrame":7,"innerLink":7,"parentView":7,"routeName":52,"routerPath":37,"componentInfo":38},"1986713082609147906","健康科普","article","/article.html","1","0","T",1,"2025-11-07 16:31:25",[],"https://ystcdn.venuertc.com/venue/undefined/2026-01-24-18:08:49/d4291d16-ed1c-48dd-84c8-ec1f85980b75.png","https://ystcdn.venuertc.com/venue/undefined/2026-01-24-18:08:52/6fe64094-9416-442c-a66d-032fb292666a.png","#c8e6ca","健康科普助力健康中国2030:共享健康知识新理念","健康科普, 健康中国, 科普知识, 健康家庭, 性健康, 营养健康, 运动健康, 科普宣传","探索健康科普在健康中国行动中的重要角色,了解最新的健康科普创新大赛、动漫及短视频,传播健康知识,助力全民健康。","https://ystcdn.venuertc.com/venue/undefined/2026-01-24-18:08:56/bd33f471-6c54-4d1b-a364-b06973dbc144.png","Article","癌症肿瘤,重大疾病",true,{"code":9,"msg":10,"message":6,"data":56,"success":54},{"pageNo":42,"pageSize":57,"result":58,"totalSize":21},10,[],{"code":9,"msg":10,"message":6,"data":60,"success":54},{"authors":61,"appraiseDimensionScoresVos":62},[],[]]