摘要
目的探讨应用多学科诊疗(Multidisciplinary team,MDT)提高肌层浸润性膀胱癌根治性手术术后患者生存质量的临床价值。方法选取安徽医科大学第一附属医院高新院区泌尿外科2015年2月-2018年2月收治的80例肌层浸润性膀胱癌患者为研究对象,以随机数字表法分为联合组、常规诊疗组,每组各40例。联合组、常规诊疗组患者均接受膀胱癌根治性手术治疗,术后常规诊疗组患者接受常规围术期综合管理,联合组患者接受基于MDT的全程管理。对比联合组、常规诊疗组术后3年复发、转移、生存情况,采用癌症患者生存质量测定量表(EORTC QLQ-C30)分析其生活质量变化。结果与常规诊疗组比较,联合组手术时间、术中出血量、胃肠功能恢复时间、住院时间均更低,差异有统计学意义(P<0.05)。与常规诊疗组的22.50%比较,联合组术后并发症发生率更低(5.00%),差异有统计学意义(P<0.05)。与常规诊疗组比较,联合组术后3年生存率更高(72.50%vs 55.00%,其复发率更低(17.50%vs 30.00%),差异有统计学意义(P<0.05)。联合组、常规诊疗组患者术后1年生活质量各维度评分均较术前升高,与常规诊疗组相比,联合组术后1年生活质量各维度评分均更高,差异有统计学意义(P<0.05)。结论在常规诊疗方案的基础上结合MDT能够在一定程度上提高肌层浸润性膀胱癌根治性手术效率,促进患者术后恢复,提高患者生存及生活质量。
Objective To explore the clinical value of Multidisciplinary team(MDT)in improving the life quality of patients with muscle layer invasive bladder cancer after radical surgery.Methods A total of 80 patients with muscle inva-sive bladder cancer in the hospital from February 2015 to February 2018 were randomly divided into union group andconventional treatment group by random number table method with 40 cases in each group.Union group and routine di-agnosis and treatment group received radical operation for bladder cancer,routine diagnosis and treatment group re-ceived routine perioperative comprehensive management,and union group received whole process management basedon MDT.The recurrence,metastasis and survival of union group and conventional treatment group were compared,andthe changes of quality of life were analyzed.Results Compared with the routine treatment group,operation time,intra-operative blood loss,recovery time of gastrointestinal function and hospitalization time of the combined group were alllower(P<0.05).Compared with the routine treatment group 22.50%,the incidence of postoperative complications inthe combined group was lower 5.00%(P<0.05).Compared with the routine treatment group,the 3-year survival rateof the combined group was higher 72.50%vs 55.00%,and the recurrence rate was lower 17.50%vs 30.00%(P<0.05).The scores of all dimensions of quality of life in the combined group and the routine treatment group were higherthan before.Compared with routine treatment group,the scores of all dimensions of quality of life in the combinedgroup were higher after operation(P<0.05).Conclusion Based on the routine diagnosis and treatment plan plus MDTcan improve the efficiency of radical surgery for muscle layer invasive bladder cancer and promote postoperative recov-ery,thus it will improve the quality of of patient’s life.
作者
袁媛
朱玲玲
胡月
韩江英
YUAN Yuan;ZHU Lingling;HU Yue;HAN Jiangying(Department of Urology,First Affiliated Hospital of Anhui Medical University Gaoxin Campus,Hefei 230088,China)
出处
《新疆医科大学学报》
CAS
2021年第12期1364-1368,共5页
Journal of Xinjiang Medical University
基金
安徽省中央引导地方科技发展项目(YN2019032)。
关键词
多学科诊疗
肌层浸润性膀胱癌
根治性手术
生存质量
multidisciplinary diagnosis and treatment
muscular layer invasive bladder cancer
radical surgery
quality of life
