多学科团队诊疗模式在结直肠癌肝转移患者中的临床应用价值分析

Analysis on clinical application value of multidisciplinary team diagnosis and treatment mode in patients with colorectal cancer with hepatic metastasis

目的以结直肠癌肝转移患者作为研究对象,评价为患者提供多学科团队(MDT)诊疗模式的应用价值。方法将2016年1月~2019年4月在我院进行治疗的42例结直肠癌肝转移患者通过随机分组方法分成观察组(n=21)及参考组(n=21),参考组患者采用单学科诊疗模式,观察组患者采用MDT诊疗模式,比较两组患者预后情况。结果两组患者年龄、性别、原发灶部位等一般资料比较,差异无统计学意义(P>0.05)。手术总切除率为38.10%,其中,观察组手术切除率为52.38%,高于参考组的23.81%,差异有统计学意义(P<0.05)。随访结束时观察组1年死亡率为4.76%、2年死亡率为38.10%,生存期为(27.03±1.49)个月,参考组1年死亡率为9.52%、2年死亡率为61.90%,生存期为(20.32±1.45)个月,两组1年死亡率比较差异无统计学意义(P>0.05),观察组2年死亡率较参考组低且生存期较参考组长,差异有统计学意义(P<0.05)。结论结直肠癌肝转移患者应用多学科管理模式下多种方法序贯治疗能够取得确切疗效,有利于保证患者术前检查及术期化疗的规范性,可提高手术切除率,降低患者死亡率,具有较高的临床应用价值。

Objective To evaluate the clinical application value of multidisciplinary team(MDT)diagnosis and treatment mode in patients with colorectal cancer with hepatic metastasis.Methods A total of 42 patients with colorectal cancer with hepatic metastasis admitted to our hospital from January 2016 to April 2019 were divided into the observation group(n=21)and the reference group(n=21)by the random parallel grouping method.Patients in the reference group were treated with single-subject diagnosis and treatment mode,while those in the observation group were treated with MDT diagnosis and treatment mode.The prognosis of the two groups of patients was compared.Results There were no statistically significant differences between the two groups in general clinical data such as age,gender and primary focus(P>0.05).The total surgical resection rate was 38.10%,among which,the surgical resection rate of the observation group was 52.38%,and that of the reference group was 23.81%.The surgical resection rate of the observation group was higher than that of the reference group,with statistically significant difference(P<0.05).At the end of follow-up,the 1-year mortality and 2-year mortality of the observation group were 4.76%and 38.10%,and the survival time was(27.03±1.49)months,while those of the reference group was 9.52%and 61.90%,and the survival time was(20.32±1.45)months.There was no statistically significant difference in 1-year mortality between the two groups(P>0.05).The 2-year mortality of the observation group was lower than that of the reference group,the survival time was longer than that of the reference group,and the differences were statistically significant(P<0.05).Conclusion Sequential treatment of colorectal cancer with hepatic metastasis patients with multiple methods under multidisciplinary management mode can achieve exact therapeutic efficacy,which is conducive to ensuring the standardization of preoperative examination and intraoperative chemotherapy,improving the surgical resection rate and reducing the mortality rate of patients,and has high clinical application value.