多学科协作在腹腔术后动力性肠梗阻治疗中的价值研究  

Significance of multidisciplinary collaboration in treatment of dynamic intestinal obstruction after abdominal operation

作　　者：许建多[1] 刘云星[1] 郑志刚[1] 韩志勤 孙建彬 XU Jianduo;LIU Yunxing;ZHENG Zhigang(The First Hospital of Shijiazhuang City,Hebei,Shijiazhuang 050011,China)

机构地区：[1]河北省石家庄市第一医院,050011 [2]中国人民解放军联勤保障部队第980医院

出　　处：《河北医药》2020年第12期1821-1824,共4页Hebei Medical Journal

基　　金：石家庄市科学技术研究与发展计划项目(编号:171201643)。

摘　　要：目的探讨多学科协作(MDT)腹腔术后并发动力性肠梗阻治疗中的价值。方法选择2015年1月至2018年1月腹腔术后并发动力性肠梗阻患者200例,随机分为试验组和对照组,每组100例。对照组采用传统治疗模式治疗,试验组采用多学科协作模式治疗,2组均随访8周。监测患者肠道功能恢复情况,酶联免疫吸附法测定2组患者干预后血清炎性因子水平、白细胞水平。结果试验组肠道功能改善情况优于对照组,差异有统计学意义(P<0.05);试验组患者、血清中炎性因子白介素-2(IL-2)、白介素-6(IL-6)、高敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞恢复速度快于对照组,差异有统计学意义(P<0.05)。应用Logistic回归分析,结果显示年龄、营养、护理和治疗情况是腹腔术后肠道功能恢复的重要因素(P值分别为0.004、0.000、0.032、0.025)。结论多学科协作新模式在腹腔术后动力性肠梗阻方面具有明显的临床优势,能明显改善患者的生活质量,加快各项指标的恢复速度。Objective To investigate the significance of multidisciplinary collaboration(MDT)in treatment of dynamic intestinal obstruction after abdominal operation.Methods A total of 200 patients with dynamic intestinal obstruction after abdominal cavity surgery in our hospital from January 2015 to January 2018 were randomly divided into experimental group and control group,with 100 patients in each group.The patients in control group were treated by traditional treatment mode,however,the patients in experimental group were treated by multidisciplinary cooperative treatment mode,with the patients being followed up for 8 weeks.After intervention,the patient’s intestinal function recovery was monitored,and the serum levels of inflammatory factors and leukocyte were detected by enzyme-linked immunosorbent assay(ELISA).Results The recovery rate of intestinal function in experimental group was significantly better than that in control group(P<0.05).The recovery time of intestinal function in experimental group and the recovery speed of serum levels of IL-2,IL-6,hs-CRP,TNF-αand leukocytes in experimental group were significantly faster than those in control group(P<0.05).Conclusion The new model of multidisciplinary collaboration has obvious clinical advantages in treatment of dynamic intestinal obstruction after abdominal surgery,which can significantly improve the life quality of patients and accelerate the recovery of various indexes.

关 键 词：肠梗阻 肠道感染 多学科协作 治疗模式 精准治疗 路径 并发症 

分 类 号：R574.2[医药卫生—消化系统]