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

王梽　傅军　何守敏　陈云风　王守铭

[關键词] 高龄患者;胆结石;围术期;多学科协作

[中图分类号] R575.6          [文献标识码] B          [文章编号] 1673-9701（2021）22-0114-05

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

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

[Abstract] 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. Results ①In 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 number of nosocomial infections， the number of postoperative deaths and the number of disputes between doctors and patients（P<0.05）. Conclusion Compared with the conventional mode， the multidisciplinary collaboration mode has obvious advantages in perioperative whole-course management of elderly patients with biliary calculi， which is worthy of promotion.