远程影像及多学科协作团队在青海省肝棘球蚴病诊疗中的价值探讨

Exploring the value of remote imaging and multi-disciplinary team in diagnosis and treatment of hepatic echinococcosis in Qinghai Province

为探索远程影像联合多学科协作团队(MDT)在青海省肝棘球蚴病诊疗中的价值,对2019年4月—2020年2月青海大学附属医院影像中心远程会诊的经基层医院由熙康会诊平台传入的100例拟手术的肝棘球蚴病病例进行回顾性分析,采集病例的临床、影像等资料,分析肝棘球蚴病的分型、分期,以及经过MDT后患者诊疗方案的改变情况等。结果显示,100例肝棘球蚴病病例经过远程影像及MDT后,混合棘球蚴病患者1例,转诊至上级医院行手术治疗;肝细粒棘球蚴病患者44例,其中34例在当地医院行属地化手术治疗,6例转诊至上级医院行手术治疗,4例进行药物治疗;肝多房棘球蚴病患者55例,其中30例在当地行属地化手术治疗,10例转诊至上级医院行手术治疗,15例进行药物治疗。有48例病例经远程影像会诊后更改了筛查初诊分期并调整了诊疗方案。提示远程影像及棘球蚴病MDT的开展,在提升青海省牧区基层医院肝棘球蚴病诊断及治疗水平中具有巨大的价值,为属地化手术的顺利开展及青海地区的棘球蚴病手术病例清零提供重要保障,节省了医疗资源及费用。

To explore the value of remote imaging combined with multi-disciplinary treatment(MDT)in the diagnosis and treatment of hepatic echinococcosis in Qinghai Province,retrospective analysis was performed of 100 hepatic echinococcosis patients being anticipating surgery,of them the clinical images and information were trans-ferred from primary hospital to Xikang group consultation platform of the imaging center in Qinghai University Affiliated Hospital from April 2019 to February 2020.The clinical and imaging data were collected to analyze the classification and staging of hepatic echinococcosis,and the changes of diagnosis and treatment plan after MDT.The analysis showed that after remote imaging and MDT,of the 100 hepatic echinococcosis cases,one case of mixed echinococcosis was referred to superior hospital for surgical treatment;of 44 hepatic cystic echinococcosis patients,34 were treated by surgery in local hospitals,6 were referred to superior hospitals for surgical treatment,and 4 were treated with medication;of 55 hepatic alveolar echinococcosis cases,30 patients received surgery locally,10 patients were referred to the upper hospital for surgery,and 15 patients received drug treatment.After remote imaging con-sultation,the cyst classification at initial screening,and the scheme of diagnosis and treatment were adjusted for 48 cases.It was demonstrated that the remote imaging and MDT has great potential in improving the diagnosis and treatment of hepatic echinococcosis in primary hospitals in pastoral areas of Qinghai Province,providing basis for the successful development of localized surgery and zero-clearance of surgical echinococcosis cases in Qinghai area,and saving the medical resources and costs as well.