多学科协作模式对创伤性截肢患者预后的影响  

Effect of multidisciplinary team model on prognosis of patients with traumatic amputation

作　　者：黄叶柳 林涧 王哲敏 张洪波 Huang Yeliu;Lin Jian;Wang Zhemin;Zhang Hongbo(Department of Orthopedics,Chongming Branch of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 202150,China;Department of Nursing,Chongming Branch of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 202150,China)

机构地区：[1]上海交通大学医学院附属新华医院崇明分院骨科,202150 [2]上海交通大学医学院附属新华医院崇明分院护理部,202150

出　　处：《中华创伤杂志》2020年第6期550-554,共5页Chinese Journal of Trauma

摘　　要：目的探讨多学科协作(MDT)模式对创伤性截肢患者预后的影响。方法采用回顾性病例对照研究分析2014年7月—2019年6月上海交通大学医学院附属新华医院崇明分院收治的54例创伤性截肢患者临床资料,其中男41例,女13例;年龄39~72岁,平均52.7岁。29例予MDT模式干预(观察组),25例予常规责任制整体护理(对照组)。比较两组在入院当天、术后2,4,8周的焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分和改良Barthel指数评分。结果入院当天两组SAS评分、SDS评分和改良Barthel指数评分差异无统计学意义(P>0.05);术后第2,4,8周,观察组SAS评分分别为(52.5±7.6)分、(48.3±7.1)分、(41.3±6.1)分,均低于对照组的(58.0±12.0)分、(54.4±10.7)分、(50.4±9.3)分(P<0.05)。观察组SDS评分分别为(52.6±8.8)分、(47.9±7.6)分、(43.8±5.7)分,均低于对照组的(58.4±12.4)分、(53.2±10.9)分、(49.5±8.7)分(P<0.05)。观察组改良Barthel指数评分分别为(57.2±8.9)分、(80.7±7.7)分、(94.7±3.9)分,均高于对照组的(50.4±11.4)分、(70.9±9.5)分、(85.6±6.8)分(P<0.05)。结论对于创伤性截肢患者,MDT模式有利于减轻患者的焦虑、抑郁状态,提高生活质量,值得临床推广。Objective To explore the effect of multidisciplinary team(MDT)model on prognosis of patients with traumatic amputation.Methods A retrospective case-control study was conducted to analyze the clinical data of 54 patients with traumatic amputation admitted to Chongming Branch of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from July 2014 to June 2019.There were 41 males and 13 females,aged 39-72 years with an average age of 52.7 years.A total of 29 patients treated using MDT model intervention were served as observation group,and 25 patients treated using routine responsibility system holistic nursing as control group.The self rating anxiety scale(SAS)score,self rating depression scale(SDS)score and improved Barthel index were compared between the two groups on the day of admission and at 2 weeks,4 weeks and 8 weeks after operation.Results There was no significant difference in SAS,SDS and improved Barthel index between the two groups on the day of admission(P>0.05).At 2 weeks,4 weeks and 8 weeks after operation,the SAS score in observation group was respectively(52.5±7.6)points,(48.3±7.1)points and(41.3±6.1)points,lower than those in control group[(58.0±12.0)points,(54.4±10.7)points and(50.4±9.3)points];the SDS scores in observation group was respectively(52.6±8.8)points,(47.9±7.6)points,(43.8±5.7)points,lower than those in control group[(58.4±12.4)points,(53.2±10.9)points,(49.5±8.7)points];the Barthel index score in observation group was respectively(57.2±8.9)points,(80.7±7.7)points,(94.7±3.9)points,higher than those in control group[(50.4±11.4)points,(70.9±9.5)points,(85.6±6.8)points](all P<0.05).Conclusion For patients with traumatic amputation,MDT model is conducive to reducing anxiety and depression of patients,can improve the quality of life,and is worthy of clinical application.

关 键 词：截肢 创伤性 焦虑 抑郁 生活质量 多学科协作模式 

分 类 号：R473.6[医药卫生—护理学]