多学科协作联合集束化管理模式对胃肠手术患者的影响

Effects of MDT combined with clustered management mode on patients undergoing gastrointestinal surgery

目的探讨多学科协作(multidisciplinary teamwork,MDT)诊治联合集束化护理模式对胃肠道手术患者的影响。方法选取2020年8月至2021年2月行胃肠手术患者212例,随机分为试验组和对照组,每组106例。试验组采用多学科协作诊治联合集束化护理模式进行临床诊治及护理干预,对照组采用功能诊疗模式。比较2组患者胃肠功能恢复及下床时间;比较2组患者生活质量(SF-36)评分(躯体功能、躯体角色、肌体疼痛、总的健康状况、活力、社会功能、情绪角色和心理健康8个维度);炎性指标:WBC、PCT的恢复速率;早期炎性肠梗阻的发生率。结果试验组肠鸣音恢复时间、排气和排便时间、下床活动时间均短于对照组(P<0.05);试验组SF-36各项评分均高于对照组(P<0.05)。试验组炎性指标(WBC、PCT)恢复速率明显快于对照组(P<0.05);试验组患者早期炎性肠梗阻的发生率明显低于对照组(P<0.05)。结论胃肠术后应用多学科协作联合集束化护理模式可促进各项指标的恢复,提高患者生存质量。

Objective To investigate the effects of multidisciplinary teamwork(MDT)combined with clustered nursing mode on patients undergoing gastrointestinal surgery.Methods A total of 212 patients who underwent gastrointestinal surgery in our hospital from August 2020 to February 2021 were enrolled in the study,who were randomly divided into experimental group and control group,with 106 cases in each group.The Patients in experimental group were treated by multidisciplinary collaborative diagnosis and treatment combined with a clustered nursing intervention,however,the patients in control group were treated by functional diagnosis and treatment mode.The recovery of gastrointestinal function and the time to get out of bed.and the quality of life(SF-36)scores from 8 dimensions including physical function,physical role,body pain,general health status,vitality,social function,emotion role and mental health,as well as the levels of WBC,PCT and the incidence of early inflammatory intestinal obstruction were observed and compared between the two groups.Results The recovery time of bowel sounds,the time of exhaust,defecation,and the time of getting out of bed in experimental group were significantly shorter than those in control group(P<0.05),and the scores of SF-36 in experimental group were significantly higher than those in control group(P<0.05).The various inflammatory indexes including WBC,CRP in experimental group were superior to those in control group(P<0.05).In addition the incidence of early inflammatory intestinal obstruction in experimental group was significantly lower than that in control group(P<0.05).Conclusion The application of multidisciplinary cooperation and clustered nursing model after gastrointestinal surgery can promote the recovery of various indexes,and can improve the life quality of patients.