MDT在老年患者急腹症围手术期应用价值  

MDT perioperative application value in elderly patients with acute abdomen

作　　者：汪启斌[1] 马芷琴[1] 黎朝良[1] 陈亮[1] 汪彪[1] 

机构地区：[1]湖北医药学院附属人民医院胃肠外科,442000

出　　处：《中国老年保健医学》2016年第3期3-5,共3页Chinese Journal of Geriatric Care

摘　　要：目的评价多学科协作诊治方案在老年患者急腹症围手术期中应用的价值。方法采用回顾性方法研究2013年7月~2014年7月就诊于我院的老年急腹症患者,分析老年组（年龄≥60岁）和非老年组（年龄〈60岁）之间MDT诊治方案在围手术期的临床疗效差异。结果①比较术前资料,入院至手术开始之间的术前准备时间,老年组明显比非老年组长,差异有统计学意义（P〈0.05）;老年组术前多种基础病构成比率明显高于非老年组（P〈0.05）;②术中各项指标的差异无统计学意义（P〉0.05）;③术后并发症,老年组发生率高于非老年组（P〈0.05）;而拔除胃管、尿管、各种引流管的时间两组之间的差异无统计学意义（P〉0.05）;术后进食时间、肛门排气排便时间、下床活动时间两组之间比较差异无统计学意义（P〉0.05）。结论虽然老年患者围手术期合并多种基础病,急诊救治风险大,术前实施MDT似乎延误急诊手术时间,但不影响治疗效果,而且提高了老年患者手术的安全性,所以在普通外科老年患者围手术期应用MDT是安全有效的,值得推广。Objectives To evaluate MDT plan in elderly patients with acute abdomen in perioperation of application security and difference. Methods A retrospective study of treatment in elderly patients with acute abdomen patients in our hospital from July 2013 to July 2014 ,To analyse the difference and clinical effect of MDT treatment during the perioperation between elderly group （ 〉t 60 years old） and non elderly group （ 〈 60years）. Results ①Compared with the preoperative data, on the preoperative preparation time of admission to the beginning of the operation, the elderly group were significantly longer than non elderly group, the difference was statistically significant （ P 〈 0. 05 ）. The elderly group had several based disease before operation, the occurring rate was signifi- cantly higher than that of non aged group （ P 〈 0.05 ）. ②The difference of the operation index was no statistical significance （ P 〉 0. 05 ）. ③The postoperative complications, elderly group was higher than that in the non aged group （ P 〈 0. 05 ）, and the time differ- ence of extraction tube,catheter,drainage tube between the two groups had no statistical significance （P 〉0. 05） ; The difference was no statistically significant （ P 〉 0. 05 ） about the time after the operation began to eat, anus exhaust and defecation time, out of bed ac- tivity time between two groups. Conclusions Although patients on admission has existed many kinds of diseases in the perioperation period, emergency care being very risky, preoperative implementation of MDT seems to delay emergency surgery time, but does not re- duce the effect of comprehensive treatment of elderly group patients, and improve the safety of surgery, so that is safe and effective in general surgery elderly patients with perioperative application of MDT.

关 键 词：多学科协作 老年患者 围手术期 手术并发症 急腹症 

分 类 号：R656.1[医药卫生—急诊医学]