NET+MDT诊疗模式对急性胰腺炎患者营养状况及生活质量的影响

The influence of NET+MDT diagnosis and treatment model on nutritional status and quality of life of patients with acute pancreatitis

目的探讨基于互联网的多学科诊疗模式(NET+MDT)对急性胰腺炎患者营养状况及生活质量的影响。方法根据我院NET+MDT实施时间点(2018年6月)将53例急性胰腺炎病例分为实施前组(n=20)和实施后组(n=33)。实施前组病例均根据重症急性胰腺炎的常规诊疗模式治疗,实施后组病例给予NET+MDT诊疗模式。分析实施前组和实施后组的临床总有效率、疗效性评估指标、营养相关代谢指标、生活质量、并发症、预后情况等观察指标的差异。结果实施后组临床总有效率(87.88%)显著优于实施前组(60.00%)(χ^(2)=5.526,P<0.05);实施后组的腹痛消失时间、饮食复常时间、ICU驻留时间、血淀粉酶复常时间、总住院时间均短于实施前组(P均<0.05);与治疗前比较,实施前组和实施后组治疗7 d的营养相关代谢指标(TRF、ALB、PAB)均显著下降(P均<0.05),但实施后组下降幅度明显高于实施前组(P均<0.05);与治疗前比较,实施前组和实施后组治疗7 d的躯体功能评分、社交能力评分、物质能力评分及生活质量总评分均显著提升(P均<0.05),但实施后组上升幅度明显低于实施前组(P均<0.05);实施后组的并发症发生率(9.09%)、再入院率(3.03%)、死亡率(0)低于实施前组(35.00%、25.00%、15.00%)(P均<0.05)。结论与常规急性胰腺炎的诊疗模式相比,采用NET+MDT诊疗模式疗效确切,可改善临床疗效性评估指标,明显改善患者生活质量,避免营养状况降低,降低并发症发生率和改善临床预后。

Objective To observe the effects of internet-based multidisciplinary diagnosis and treatment(NET+MDT)on the nutritional status and quality of life of patients with acute pancreatitis.Methods According to the implementation time of NET+MDT in our hospital(Jun.2018),53 cases of acute pancreatitis were divided into the preimplementation group(n=20)and the post-implementation group(n=33).All patients in the group before implementation were treated according to the routine diagnosis and treatment model of severe acute pancreatitis,and patients in the post-implementation group were given the NET+MDT.The differences in total clinical efficiency,efficacy evaluation index,nutrition-related metabolic index,quality of life,complications and prognosis were analyzed between the two groups.Results The clinical efficacy of the post-implementation group(87.88%)was significantly better than that of the pre-implementation group(60.00%)(χ2=5.526,P<0.05).The duration of abdominal pain disappearance,diet recovery,ICU stay,blood amylase recovery,and total hospital stay of the post-implementation group were all shorter than those of the pre-implementation group(all P<0.05).Compared with the situation of before treatment,the nutrition-related metabolic indexes(TRF,ALB,PAB)were significantly decreased in the pre-implementation group and the post-implementation group for 7 days(all P<0.05),but the decrease rate in the post-implementation group was significantly lower than that in the pre-implementation group(all P<0.05).Compared with the situation of before treatment,the somatic function score,social ability score,social ability score and total quality of life score of the pre-implementation group and the post-implementation group were significantly improved(all P<0.05),but the increase rate of the postimplementation group was significantly higher than that of the pre-implementation group(all P<0.05).The complication rate(9.09%),readmission rate(3.03%)and mortality rate(0)of the post-implementation group were lower than those of the pre-implementation group(35.00%,25.00%and 15.00%)(all P<0.05).Conclusion Compared with the conventional diagnosis and treatment model of acute pancreatitis,NET+MDT has exact effect,which can improve the clinical efficacy evaluation index,significantly improve the quality of life,avoid the reduction of nutritional status,re-duce the incidence of complications and improve the clinical prognosis.