术前多学科集中式病例讨论模式在脑质瘤手术患者中的应用  

Application of Preoperative Multidisciplinary Centralized Case Discussion Mode in Patients for Brain Tumor Surgery

作　　者：代广晶 杨光[1] DAI Guang-jing;YANG Guang(Dept.of Neurosurgery,the 1st Affiliated Hospital of Harbin Medical University,Haerbin Heilongjiang 150001,China)

机构地区：[1]哈尔滨医科大学附属第一医院神经外科,黑龙江哈尔滨150001

出　　处：《昆明医科大学学报》2020年第9期149-153,共5页Journal of Kunming Medical University

基　　金：国家自然科学基金资助项目(81572482)。

摘　　要：目的探究术前多学科集中式病例讨论模式的构建对脑胶质瘤手术患者基础应激指标及躁动情况的影响。方法选取哈尔滨医科大学附属第一医院自2016年5月至2019年5月收治的脑胶质瘤患者88例,采取随机数字表法进行分组,每组各44例,对照组给予常规的术前干预,观察组在对照组基础上构建并实施术前多学科集中式病例讨论模式下的干预,对比2组患者围术期基础应激指标反映、视觉模拟评分法(visual analogue scale/score,VAS)、Ricker镇静-躁动评分(Ricker sedation-agitation scale,SAS)、巴氏指数(bathel index,BI)。结果2组T2、T2时间点与T0时间点相比CRP及IL-6水平降低,观察组T1、T2时间点CRP及IL-6水平明显低于对照组T1、T2时间点CRP及IL-6水平,组间差异具有统计学意义(P<0.05)。观察组与对照组相比术后SAS评分较低,VAS评分较低,组间差异具有统计学意义(P<0.05)。两组干预后与干预前相比BI评分均更高,观察组干预后与对照组干预后相比BI评分升高更加显著,组间差异具有统计学意义(P<0.05)。结论术前多学科集中式病例讨论模式干预的构建及应用能够保证脑胶质瘤手术患者基础应激指标维持在更加平稳的水平,减少躁动及疼痛,对术后日常生活能力也产生了促进升高的作用。Objective To explore and analyze the influence of preoperative multidisciplinary centralized case discussion mode on the basic stress indicators and agitation in patients for glioma surgery.Method Eighty-eight patients with glioma admitted to The First Affiliated Hospital of Harbin Medical University from May 2016 to May 2019 were enrolled in a randomized digital table.Each group received 44 patients.The control group received routine preoperative intervention.On the basis of the control group,the intervention under the preoperative multidisciplinary centralized case discussion mode was constructed and compared.The perioperative basic stress index,visual analog scale(VAS),Ricker sedation-agitation scale(SAS)and Bachelor index(BI)were compared between the two groups.Results The levels of CRP and IL-6 in the T2 and T2 time points were lower than those in the T0 time points.The levels of CRP and IL-6 in the observation group at T1 and T2 were significantly lower than those in the T1 and T2 time points of the control group.The difference between the groups was statistically significant(P<0.05).Compared with the control group,the SAS score was lower in the observation group and the VAS score was lower. The difference between the groups was statistically significant(P < 0.05). After the intervention, the BI scores were higher than those before the intervention. The scores of the BI scores in the observation group were significantly higher than those in the control group. The difference between the two groups was statistically significant(P < 0.05). Conclusion The construction and application of multi-disciplinary centralized case discussion mode intervention can ensure that the basic stress index of patients for glioma surgery is maintained at a more stable level,reduce agitation and pain, and promote the improvement of daily living ability after the surgery.

关 键 词：术前 多学科 集中式病例讨论 脑胶质瘤 应激指标 躁动 日常生活能力 

分 类 号：R6121[医药卫生—外科学]