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多学科团队对口腔颌面外科疾病患者的意义:中国一家综合医院的观察性回顾性研究

Significance of Multidisciplinary Teams for Patients with Oral and Maxillofacial Surgical Diseases: An Observational Retrospective Study in a General Hospital in China.

作者信息

Chen Junpeng, Yao Qiuyun, Wang Xirui, Jiang Jinpeng, Zhu Huiyong, Yu Dan

机构信息

Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, People's Republic of China.

出版信息

J Multidiscip Healthc. 2024 Dec 30;17:6187-6198. doi: 10.2147/JMDH.S504720. eCollection 2024.

Abstract

OBJECTIVE

The multidisciplinary team (MDT) approach is increasingly being utilized in the management of complex head and neck diseases. This study analyzed the benefits of MDT for patients with head and neck diseases as primary or secondary conditions and categorized MDT meetings into two types: head and neck surgery initiation (HNI) and head and neck surgery participation (HNP). The study further explored the characteristics of these MDT meetings and the factors influencing patient compliance, aiming to optimize MDT treatment models to maximize patient benefits.

DESIGN

Retrospective analysis.

METHODS

MDT meetings from January 2021 to December 2023 were reviewed. The meetings and patients were classified into the HNI group and the HNP group. Various factors, including general patient conditions, disease characteristics et al were analyzed using chi-square tests and point biserial correlation tests. -values < 0.05 were considered statistically significant.

RESULTS

A total of 292 MDT cases were analyzed, comprising 127 cases in the HNI group and 165 cases in the HNP group. In the HNI group, the initial diagnosis was modified in 11 cases (8.7%), with 92 patients (72.4%) receiving major recommendations for their treatment plans. In the HNP group, the initial diagnosis was modified in 28 cases (17.0%). The head and neck surgeons had a major impact on treatment plans in 47 cases (28.5%). Notably, patients with head and neck tumors received more major recommendations (0.05) in the HIN group, and patients who had tumors (0.05) and from outpatient departments (0.05) exhibited poor compliance with recommendations.

CONCLUSION

The MDT approach in general hospitals has improved the rationality of medical decision-making, especially in rare diseases, tumors, and systematic conditions compared to MDT in a single center, with head and neck surgeons playing vital roles. MDT models can be further explored and established.

摘要

目的

多学科团队(MDT)方法在复杂头颈疾病的管理中越来越多地被采用。本研究分析了MDT对头颈疾病患者作为主要或次要病症的益处,并将MDT会议分为两种类型:头颈外科启动(HNI)和头颈外科参与(HNP)。该研究进一步探讨了这些MDT会议的特点以及影响患者依从性的因素,旨在优化MDT治疗模式以最大化患者受益。

设计

回顾性分析。

方法

回顾了2021年1月至2023年12月的MDT会议。会议和患者被分为HNI组和HNP组。使用卡方检验和点二列相关检验分析了包括患者一般情况、疾病特征等各种因素。P值<0.05被认为具有统计学意义。

结果

共分析了292例MDT病例,其中HNI组127例,HNP组165例。在HNI组中,11例(8.7%)的初始诊断被修改,92例患者(72.4%)在治疗计划方面得到了主要建议。在HNP组中,28例(17.0%)的初始诊断被修改。头颈外科医生对47例(28.5%)的治疗计划有重大影响。值得注意的是,头颈肿瘤患者在HIN组中获得了更多主要建议(P<0.05),患有肿瘤(P<0.05)且来自门诊部门(P<0.05)的患者对建议的依从性较差。

结论

与单一中心的MDT相比,综合医院的MDT方法提高了医疗决策的合理性,特别是在罕见疾病、肿瘤和系统性疾病方面,头颈外科医生发挥着至关重要的作用。可以进一步探索和建立MDT模式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc8b/11697645/1f986ef5bf4a/JMDH-17-6187-g0001.jpg

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