【摘要】 背景多学科团队(MDT)协作诊治模式已成为国际医学领域积极倡导的重要医学新模式,使传统的个体式、经验式医疗模式转变为现代的小组协作、决策模式,旨在为患者提供优质的服务。目的调查并分析综合性医院多学科综合门诊病例特点。方法选取2018-07-24至2019-01-31就诊于浙江大学医学院附属第一医院多学科综合门诊符合纳入标准的患者145例,通过医院MDT平台系统收集患者的一般情况(包括性别、年龄)、患病情况、申请MDT的原因、MDT参加科室、MDT建议,并对患者资料进行回顾性分析。结果 145例患者中,男66例(45.5%),女79例(54.5%),45岁及以上人群104例(71.7%)。其中,疑似肿瘤病例97例(66.9%),非肿瘤病例48例(33.1%)。申请门诊MDT的目的主要是需进一步明确诊断(99例,68.3%)和希望优化治疗方案(124例,85.5%)两方面,而同时存在明确诊断和优化治疗方案需求者87例(60.0%)。MDT后治疗建议完善检查78例(53.8%)、定期复查45例(31.0%)、药物治疗45例(31.0%)和建议手术治疗39例(26.9%)。结论 MDT门诊就诊人群以中老年人为主,就诊目的主要为确诊是否为肿瘤,其在疑难病患者、肿瘤患者和共病患者的诊治上更有优势。另外,超过一半患者需完善检查,因此需对MDT进行严格审核。更多还原

【Abstract】 Background In contrast to the traditional individual care and experience-based care,multidisciplinary team(MDT) model is a new care delivery model that is actively recommended internationally,which is aimed at providing quality care for patients using based on team collaboration. Objective To investigate the clinical profile of patients treated in the MDT clinic in a general hospital. Methods A total of 145 eligible outpatients were recruited from the MDT Clinic,the First Affiliated Hospital,Zhejiang University School of Medicine between July 24 th,2018 and January 31 st,2019. Data were collected through the electronic MDT platform,including basic demographics(sex,age),diagnosis,reasons for visiting the MDT clinic,departments involved in the consultation and care suggestions,and were analyzed retrospectively. Results Of the patients,45.5%(66/145) were men,54.5%(79/145) were women;71.7%(104/145) aged over 45 years old;66.9%(97/145) had a suspected tumor,and 33.1%(48/145) had one or more non-tumor illnesses. The major reasons for visiting the MDT clinic were hoping to get a definite diagnosis after further consultation[68.3%(99/145)] and/or to obtain a modified regimen[85.5%(124/145)],and 60.0%(87/145) of the patients visiting the MDT clinic for the above-mentioned two reasons. The recommendations given by the MDT clinic included having a further examination[53.8%(78/145)],regular review [31.0%(45/145)],pharmacological treatment[31.0%(45/145)],and surgical treatment[26.9%(39/145)]. Conclusion The majority of patients encountered by the MDT clinic were middle-aged and elderly,and the main reason for treatment was to determine whether there is a tumor,for the MDT clinic has advantages in the diagnosis and treatment of difficult and complicated diseases,such as tumor,and comorbidities. In addition,more than half of the patients were recommended to have a further examination,so the prescriptions of the MDT clinic need to be strictly reviewed.更多还原