儿童专科医院180例MDT病例回顾性分析

Retrospective Analysis of 180 Multidisciplinary Diagnosis and Treatment Mode in Children Sepcialized Hospital

目的分析多学科协作诊疗(Multi-disciplinary Diagnosis and Treatment,MDT)病例的特点,有效发挥MDT在儿童专科医院中的作用。方法回顾性分析2013年1月1日-2018年12月31日MDT病例180例。结果 (1) MDT病例在患儿性别分布上无差别。年龄﹤1岁和年龄1~3岁患儿组别占比明显高于年龄>3岁年龄患儿组。申请MDT科室中儿内科占80%,儿外科占20%。(2)申请原因方面,诊断不明确:儿内科占98.15%,儿外科占1.85%;治疗方案不明确:儿内科占82.15%,儿外科占17.85%。需要调整治疗方案:儿内科占35.71%,儿外科占64.29%。肿瘤:儿外科100%。(3)MDT科室主要为重症科和呼吸科。(4)转归方面,会诊后"痊愈"占23.89%,"好转"占60%,"转院"占13.88%,"放弃治疗"和"死亡"共占2.23%。结论儿童专科医院对于3岁以下患全身系统疾病、呼吸系统疾病以及神经系统疾病的患儿,应提倡进行MDT,以提高治疗效率。

Objective To analyze the characteristics of MDT cases,so as to explore the role of MDT in children’s hospital. Methods 180 cases of MDT from January 1,2013 to December 31,2018 were analyzed. Results(1) There was no statistically significant difference in the gender of the children. The proportion of children under the age of 1 year and those under the age of 1~3 years was significantly higher than that of children over the age of 3 years. Application for consultation departments accounted for 80% of pediatric medicine and 20% of pediatric surgery.(2) In the unclear diagnosis,Pediatric Internal Medicine Department accounted for 98.15%,and Pediatric Surgery Department accounted for 1.85%. In the unclear treatment plan,Pediatric Internal Medicine Department accounted for 82.15%,and Pediatric Surgery Department accounted for 17.85%. In treatment options needed to be adjusted,there was 35.71% in Pediatric Internal Medicine Department and 64.29% in Pediatric Surgery Department.(3) MDT Departments were mainly Intensive Care Medicine and Pheumology Department.(4) In terms of outcome, 23.89% of patients recovered after consultation, 60% improved,13.88% transferred and others 2.23%. Conclusion In order to improve clinical cure rate of patients,children under3 years old with systematic disease,disease of respiratory system and nervous system disease are suggested to make a MDT.