多学科诊疗模式在非小细胞肺癌手术治疗过程中的应用价值

Clinical application of multidisclplinary team in the surgical treatment for non-small cell lung cancer

目的探讨多学科诊疗模式在非小细胞肺癌手术治疗过程中的临床应用价值。方法回顾性分析兰州大学第一医院2014年1月至2018年5月收治的经胸腔镜辅助下(video-assisted thoracoscopic surgery,VATS)行肺叶切除术的非小细胞肺癌(non-small cell lung cancer,NSCLC)患者80例的临床资料,其中男56例、女24例,年龄(59±10)岁;经多学科讨论(multidisclplinary team,MDT)后行手术患者35例,单一科室诊治模式下手术患者45例。比较两组患者临床效果。结果同单一科室诊疗模式相比,MDT模式下行胸腔镜下肺叶切除的非小细胞肺癌患者在手术时间、术中出血量、胸腔引流量、术后引流时间、住院天数、住院费用及肺不张、感染、术后胸腔出血等并发症发生率方面的差异有统计学意义(P<0.05),而在术中中转开胸比例及切口延迟愈合、术后肺漏气的发生率方面差异无统计学意义(P>0.05)。结论 MDT模式能够减轻非小细胞肺癌手术治疗的患者手术创伤、促进患者快速康复,值得在临床推广应用。

Objective To investigate the clinical value of multidisclplinary team(MDT) in the application of non-small cell lung cancer(NSCLC). Methods We retrospectively analyzed the postoperative clinical data of 80 patients with NSCLC in the First Hospital of Lanzhou University between January 2014 and May 2018. There were 56 males, 24 females at age of 59±10 years. Forty five patients were performed lobectomy with conventional model, 35 patients were also performed lobectomy after MDT discussion. The clinical effect of the two groups was compared. Results Compared to conventional model, MDT can shorten operation time, intraoperative blood loss, postoperative chest drainage,catheterization time, complications, length of stay and hospital costs. But there was no significant difference in intraoperative transthoracotomy proportion, delayed wound healing and postoperative pulmonary leakage between the two groups. Conclusion The efficacy of MDT in the surgical treatment of NSCLC is satisfactory. The MDT is valuable during operation, which reduces surgical trauma and accelerate patients' recovery, and deserves the clinical promotion.