多学科合作在神经肿瘤外科手术部位感染管理中的应用

Application of multidisciplinary cooperation in the management of surgical site infection in neurosurgery

目的:探讨多学科合作(MDT)对于神经肿瘤外科手术部位感染管理的影响。方法:选取114例行神经肿瘤外科手术的开颅患者,按随机数字表法分为对照组56例观察组58例,对照组按照神经肿瘤外科手术部位常规模式进行管理,医生、护士、检验员、药剂师及抗感染人员均各自执行工作,观察组采用包含护士、医生、检验员、药剂师及抗感染人员等MDT模式,对神经肿瘤外科手术部位进行管理。患者出院时,对比两组患者的满意度、平均住院日及MDT团队成员在两种模式中的自我效能感。手术30天后,对比两组患者的手术部位感染发生率。结果:观察组手术部位感染发生率低于对照组,患者平均住院天数少于对照组,而患者满意度评分高于对照组,观察组中MDT成员的一般自我效能评分明显高于对照组,差异均有统计学意义(P<0.05)。结论:MDT应用于神经肿瘤外科手术部位感染管理中,使患者得到更加系统、规范、科学、全面的治疗,利于患者康复,提高了患者的住院满意度,同时也提升了医务人员的自我效能感。

Objective:To explore the effect of multidisciplinary cooperation on the management of surgical site infection(SSI)in neurosurgery.Methods:According to the method of random number table,114 craniotomy patients undergoing neuro-tumor surgery were divided into two groups,56 cases in the control group and 58 cases in the observation group.The control group was managed in a usual way,all staffs including doctors,nurses,inspectors,pharmacists,and nosocomial infection managers worked separately in the group.While in the observation group,the multidisciplinary team of doctors,nurses,inspectors,pharmacists,and nosocomial infection managers was formed to manage SSI.The degree of satisfaction,the average length of hospitalization and the self-efficacy of team members in the two groups were compared at discharge.The incidence of SSI were compared 30 days after surgery.Results:The incidence of SSI and the average length of hospitalization in the observation group was lower than that of the control group,the score of patient satisfaction was higher.The general self-efficacy score of members in the observation group was significantly higher than that of the control group(P<0.05).Conclusion:Application MDT model for SSI management in neurosurgery,patients can receive more systematic,standardized,scientific,and comprehensive treatment,which is conducive to patient recovery,improves patient satisfaction and also improves the self-efficacy of medical personnel.