中国胸心血管外科临床杂志

中国胸心血管外科临床杂志

多学科诊疗模式在非小细胞肺癌手术治疗过程中的应用价值

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目的 探讨多学科诊疗模式在非小细胞肺癌手术治疗过程中的临床应用价值。 方法 回顾性分析兰州大学第一医院 2014 年 1 月至 2018 年 5 月收治的经胸腔镜辅助下(video-assisted thoracoscopic surgery,VATS)行肺叶切除术的非小细胞肺癌(non-small cell lung cancer,NSCLC)患者 80 例的临床资料,其中经多学科讨论(multidisclplinary team,MDT)后行手术患者 35 例,单一科室诊治模式下手术患者 45 例。比较两组患者临床效果。 结果 同单一科室诊疗模式相比,MDT 模式下行胸腔镜下肺叶切除的非小细胞肺癌患者在手术时间、术中出血量、胸腔引流量、术后引流时间、住院天数住院费用及肺不张、感染、术后胸腔出血等并发症发生率的差异有统计学意义(P<0.05),而在术中中转开胸比例及切口延迟愈合、术后肺漏气的发生率方面差异无统计学意义(P>0.05)。 结论 MDT 模式对非小细胞肺癌手术治疗的患者,能够减轻手术创伤、促进患者快速康复,值得在临床推广应用。

Objective To investigate the clinical value of multidisclplinary team (MDT) in the application of non-small cell lung cancer (NSCLC). Methods We retrospectively analyzed the postoperative clinical data of 80 patients with NSCLC and in the First Hospital of Lanzhou University between January 2014 and May 2018. Forty five patients were performed lobectomy with conventional model, 35 cases were also performed lobectomy after MDT discussion. The mean operation time, intraoperative transthoracotomy proportion, intraoperative blood loss, postoperative chest drainage, catheterization time, postoperative complications, length of stay and hospital costs were compared between the two groups. Results Compared to conventional model, MDT can shorten operation time, intraoperative blood loss, postoperative chest drainage, catheterization time, complications, length of stay and hospital costs, but intraoperative transthoracotomy proportion, delayed wound healing and postoperative pulmonary leakage, in the two groups, with no significant difference. Conclusion The efficacy of MDT in the surgical treatment of NSCLC are satisfactory. The MDT is valuable during operation, which reduce surgical trauma and accelerate patients’ recovery, and deserves the clinical promotion.

关键词: 多学科诊疗; 非小细胞肺癌; 手术治疗

Key words: Multidisclplinary team; Non-small cell lung cancer; Surgical treatment

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