肝胆胰疾病MDT单中心开展七年经验  

Multi-disciplinary team model for hepato-pancreato-biliary diseases:7-year experience from a single center

作　　者：张斌豪[1] 李开艳[1] 邱红[1] 李震[1] 朱小华[1] 况东[1] 吴亮[1] 陈倩[1] 胡学梅[1] 程恒辉[1] 倪明[1] 邹思娟 胡萍[1] 李勇[1] 丁则阳[1] 陈琳[1] 覃华[1] 刘梅[1] 张万广[1] 陈孝平[1] 张必翔[1] Zhang Binhao;Li Kaiyan;Qiu Hong;Li Zhen;Zhu Xiaohua;Kuang Dong;Wu Liang;Chen Qian;Hu Xuemei;Cheng Henghui;Ni Ming;Zou Sijuan;Hu Ping;Li Yong;Ding Zeyang;Chen Lin;Qin Hua;Liu Mei;Zhang Wanguang;Chen Xiaoping;Zhang Bixiang(Hepatic Surgery Center,Tongji Hospital,Tongji Medical College,Huazhong University of Science&Technology,MDT of Hepato-pancreato-biliary Diseases of Tongji Hospital,Tongji Medical College,Huazhong University of Science&Technology,Hubei Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院肝脏外科中心华中科技大学同济医学院附属同济医院肝胆胰疾病MDT团队,湖北武汉430030

出　　处：《腹部外科》2021年第4期285-290,共6页Journal of Abdominal Surgery

基　　金：国家自然科学基金(81502524);华中科技大学教学研究项目(2019131)。

摘　　要：目的探讨肝胆胰疾病多学科团队(multi-disciplinary team, MDT)单中心开展的7年总体情况和效果,为国内同行提供参考。方法收集华中科技大学同济医学院附属同济医院肝胆胰疾病MDT病例的基本信息。对MDT工作开展的总体情况,包括病人的地域分布、疾病归类、专家到场情况、讨论结果以及落实情况等进行统计分析。结果成功开展188期,讨论病例数共689例次,按病种分类,肝脏原发疾病占31.2%,肝转移瘤占27.6%,胆道疾病占19.2%,胰腺疾病占16.3%,腹膜后肿瘤占5.8%;按疾病的性质分类,良性疾病占19.0%,恶性肿瘤占81.0%。专家到场参加MDT讨论的平均出场率为92.3%,首席专家及执行组长出场率为83.2%。单例讨论时间由最初的(26.4±11.7) min降至目前的(12.2±4.5) min。讨论结果的落实率为76.5%,反馈率为35.7%。结论稳定的组织框架和长效工作机制是保证MDT高效持续开展的重点。MDT开展过程中,讨论结果的落实以及病人持续性的反馈是工作的难点。Objective To explore the overall 7-year status and outcome of multi-disciplinary team(MDT)for hepato-pancreato-biliary diseases from a single center to provide references for domestic peers.Methods Basic information of MDT cases was collected.The overall status of MDT,including geographical distribution of patients,disease classification,participation of experts,discussion results and implementation,was statistically analyzed.Results A total of 188 MDT sessions involving 689 cases were successfully organized.There were liver diseases(31.2%),liver metastases(27.6%),biliary tract diseases(19.2%),pancreatic diseases(16.3%)and retroperitoneal tumors(5.8%).Among them,benign diseases accounted for 19.0%and malignant tumors 81.0%.The average MDT discussion participating rate of experts was 92.3%and that of chief experts and executive leaders 83.2%.The average discussion time for a single case declined from(26.4±11.7)min at the beginning to current(12.2±4.5)min.The implementation rate of discussion results was 76.5%.And the feedback rate was 35.7%.Conclusion Stable and well-organized framework and long-term working mechanism are vital for ensuring an efficient and sustainable MDT discussion.And the implementation of discussion results and continuous feedback from patients remain bottlenecks in the application of MDT.

关 键 词：肝胆胰疾病 多学科团队(MDT) 重点 难点 

分 类 号：R604[医药卫生—外科学]