多学科协作模式在高龄胆道结石患者围术期全程管理中的应用  

Application of multidisciplinary collaboration mode in perioperative whole-course management of elderly patients with biliary calculi

作　　者：王梽[1] 傅军[1] 何守敏[1] 陈云风 王守铭[1] WANG Zhi;FU Jun;HE Shoumin;CHEN Yunfeng;WANG Shouming(Department of General Surgery,the People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fuzhou 350004,China)

机构地区：[1]福建中医药大学附属人民医院普外科,福建福州350004

出　　处：《中国现代医生》2021年第22期114-118,共5页China Modern Doctor

摘　　要：目的探讨多学科协作模式在高龄胆道结石患者围术期全程管理中的应用。方法采用回顾性队列研究,选取2018年1月至2019年12月在我科行手术治疗的80岁以上胆总管结石患者92例为研究对象,按诊疗模式分为传统组(n=41)和MDT组(n=51),分别以传统及MDT模式诊疗,比较两组住院、围术期各项指标和围术期并发症等情况。结果①住院相关指标:传统组与MDT组术后ICU住院时间分别为(3.48±0.89)d、(1.26±0.25)d;术后总住院时间分别为(8.36±1.23)d、(5.48±1.32)d;住院费用分别为(3.87±0.45)万元、(3.34±0.56)万元,差异均有统计学意义(P<0.05)。②术前、术中相关指标:传统组与MDT组术前等待时间分别为(5.54±1.26)d、(4.04±0.92)d;手术时间分别为(136.33±25.67)min、(118.24±23.34)min,差异均有统计学意义(P<0.05)。③术后恢复指标:传统组与MDT组肛门排气时间分别为(2.26±0.25)d、(1.17±0.23)d;下床活动时间分别为(2.84±0.34)d、(2.38±0.27)d;差异均有统计学意义(P<0.05)。④围术期并发症及相关情况:传统组与MDT组术后并发症(局部、全身)、院内感染、围术期死亡、医患纠纷例数比较,差异均有统计学意义(P<0.05)。结论与传统模式相比,多学科协作模式在高龄胆道结石患者围术期全程管理,有明显优势,值得推广。Objective To explore the application of multidisciplinary collaboration mode in perioperative whole-course management of elderly patients with biliary calculi.Methods A retrospective cohort research was conducted and a total of 92 patients with choledocholithiasis over 80 years old undergoing surgical treatment admitted to our department from January 2018 to December 2019 were selected as the research objects.They were divided into the conventional group(n=41)and the multidisciplinary team mode(MDT)group(n=51)according to the diagnosis and treatment mode.The conventional group was treated with the conventional mode,while the MDT group was treated with the MDT mode.The indexes of hospitalization,perioperative period and perioperative complications of the two groups were compared.Results①In aspects of the related indexes of hospitalization,the postoperative ICU hospitalization time of the conventional group and the MDT group was(3.48±0.89)d and(1.26±0.25)d,respectively.The total postoperative hospitalization time was(8.36±1.23)d and(5.48±1.32)d,respectively.The hospitalization expenses were(3.87±0.45)million CNY and(3.34±0.56)million CNY,respectively,with statistically significant differences(P<0.05).②In aspects of related indexes before and during operation,the preoperative waiting time in the conventional group and the MDT group was(5.54±1.26)d and(4.04±0.92)d respectively.The operation time was(136.33±25.67)min and(118.24±23.34)min,respectively,with statistically significant differences(P<0.05).③In aspects of postoperative recovery indexes,the anal exhaust time of the conventional group and the MDT group was(2.26±0.25)d and(1.17±0.23)d,respectively.The time of getting out of bed was(2.84±0.34)d and(2.38±0.27)d,respectively,with statistically significant differences(P<0.05).④In aspects of perioperative complications and related conditions,there were statistically significant differences between the conventional group and the MDT group in postoperative complications(topical and systemic),the

关 键 词：高龄患者 胆结石 围术期 多学科协作 

分 类 号：R575.6[医药卫生—消化系统]