多学科协作式延续性干预对老年神经胶质瘤患者术后并发症及生活质量的影响

Effects of multidisciplinary team continuous intervention on postoperative complication and quality of life in elderly patients with glioma

目的探讨多学科协作(MDT)式延续性干预对老年神经胶质瘤患者术后并发症及生活质量的影响。方法将106例老年神经胶质瘤患者根据干预方式的不同分为干预组(56例)和对照组(50例)。对照组患者接受常规术后干预,干预组患者接受MDT式延续性干预。比较两组患者的生活质量[日常生活活动量表(ADL)]、神经功能[美国国立卫生研究院卒中量表(NIHSS)和简易精神状态量表(MMSE)]、神经肽[β-内啡肽(β-EP)、神经降压素(NT)和精氨酸升压素(AVP)]水平及术后并发症发生情况。结果干预后1个月,两组患者身体机能、心理状况、社会能力和整体生活质量评分均较干预前升高,且干预组患者身体机能、心理状况、社会能力和整体生活质量评分均高于对照组,差异均有统计学意义(P﹤0.05)。干预后1个月,两组患者NIHSS评分均较干预前降低,MMSE评分均较干预前升高,且干预组患者NIHSS评分低于对照组,MMSE评分高于对照组,差异均有统计学意义(P﹤0.05)。干预后,两组患者β-EP、NT、AVP水平均较干预前升高,且干预组患者β-EP、NT、AVP水平均高于对照组,差异均有统计学意义(P﹤0.05)。干预组患者术后并发症总发生率低于对照组患者,差异有统计学意义(P﹤0.05)。结论MDT式延续性干预能够显著减少老年神经胶质瘤患者的术后并发症,提高生活质量,减轻炎症反应,促进神经功能恢复。

Objective To investigate the effects of multidisciplinary team(MDT)continuous intervention on postop-erative complications and quality of life in elderly patients with glioma.Method A total of 106 elderly patients with glio-ma were divided into intervention group(56 cases)and control group(50 cases)according to different intervention meth-ods.The control group received routine postoperative intervention,and the intervention group received MDT continuous intervention.The quality of life[activities of daily living(ADL)],neurological function[National Institutes of Health stroke scale(NIHSS)and mini-mental state examination(MMSE)],neuropeptide[β-endorphin(β-EP),neurotensin(NT)and arginine vasopressin(AVP)]levels and postoperative complications were compared between the two groups.Result One month after intervention,the scores of physical function,psychological status,social ability and overall quality of life in two groups were higher than those before intervention,and the scores of physical function,psychological status,so-cial ability and overall quality of life in intervention group were higher than those in control group,the differences were statistically significant(P<0.05).One month after intervention,the NIHSS scores of both groups were lower than those before intervention,the MMSE scores were higher than those before intervention,and the NIHSS score of the interven-tion group was lower than that of the control group,and the MMSE score was higher than that of the control group,the differences were statistically significant(P<0.05).After intervention,the levels ofβ-EP,NT and AVP in two groups were higher than those before intervention,and the levels ofβ-EP,NT and AVP in intervention group were higher than those in control group,the differences were statistically significant(P<0.05).The total incidence of postoperative complications in intervention group was lower than that in control group,and the difference was statistically significant(P<0.05).Conclu-sion MDT continuous intervention can significantly reduce postoperative complications in elderly patients with glioma,improve quality of life,reduce inflammation and promote the recovery of nerve function.