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当前位置：当代护理 > 2025年 6卷 (1)期

Open Access Article

Contemporary Nursing. 2025; 6: (1) ; 32-37 ; DOI: 10.12208/j.cn.20250008.

Study on the effect of MDT on the first postoperative mobility of patients with posterior fossa tumor
多学科团队诊疗模式在后颅窝肿瘤患者术后首次下床活动中作用的研究

作者： 黄凤, 石晓梅 *, 刘艳, 王晓林

济南市人民医院山东济南

*通讯作者：石晓梅,单位：济南市人民医院山东济南；

发布时间: 2025-01-13 总浏览量: 164

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摘要

目的探讨多学科团队（Multidisciplinary Team, MDT）诊疗模式的临床特点及在后颅窝肿瘤患者术后首次下床活动中的影响。方法采用方便抽样的方法收集实验组和对照组自2024年7月-9月所有手术治疗的后颅窝肿瘤患者的术后首次下床活动时间、住院天数、住院总费用及患者满意度。实验组为中心院区神经外科采用MDT诊疗模式，对围术期进行不同的干预措施：术前健康宣教，联合营养科、内分泌科将患者的术前状态控制到最佳水平。早期下床活动的方法及益处，血栓的预防；营养评估与支持。术中手术室及麻醉科采用头皮浸润和阻滞；全身麻醉、区域阻滞及两者的联合使用等的麻醉方式；微创手术；避免低温；液体平衡等保证患者的最佳手术环境。术后联合康复科给患者最及时的康复护理。非阿片类镇痛；呼吸道管理；大小便管理及并发症康复。对照组为东院区神经外科，采用单科诊疗，给与患者常规护理措施。结果共调查实验组患者33人，术后首次下床活动时间（2.42±1.30）天、住院天数（7.18±2.79）天，住院费用(54281.89±40045.05)元，患者满意度（99.24±1.62）分，；对照组共调查患者34人，术后首次下床活动时间（3.85±1.31）天、住院天数（10.65±3.64）天，住院费用(82121.57±20390.9)元，患者满意度（95.09±3.03）分。结论基于本研究结果，建议在神经外科临床实践中推广MDT模式，以改善后颅窝肿瘤患者的术后康复效果。未来的研究应进一步探索MDT模式在不同类型神经外科手术中的应用效果，并评估其成本效益。

关键词： 后颅窝肿瘤；幕下肿瘤；MDT；下床活动

Abstract

Objective To explore the clinical characteristics of the multidisciplinary team (MDT) diagnosis and treatment model and its impact on the first postoperative ambulation of patients with posterior fossa tumors.
Methods A convenient sampling method was used to collect the time of first postoperative ambulation, hospitalization days, total hospitalization costs and patient satisfaction of all patients with posterior fossa tumors who underwent surgery from July to September 2024 in the experimental group and the control group. The experimental group was the neurosurgery department of the central hospital area, which adopted the MDT diagnosis and treatment model and carried out different intervention measures in the perioperative period: preoperative health education, and combined with the nutrition department and the endocrinology department to control the patient's preoperative state to the optimal level.
Methods and benefits of early ambulation, prevention of thrombosis; nutritional assessment and support. During the operation, the operating room and anesthesia department used scalp infiltration and block; general anesthesia, regional block and the combination of the two anesthesia methods; minimally invasive surgery; avoidance of hypothermia; fluid balance and other methods to ensure the best surgical environment for patients. After surgery, the rehabilitation department was combined to provide patients with the most timely rehabilitation care. Non-opioid analgesia; respiratory management; urination and defecation management and rehabilitation of complications. The control group was the Department of Neurosurgery of the East Hospital, which adopted single-department diagnosis and treatment and gave patients routine nursing measures.
Results A total of 33 patients in the experimental group were investigated, with the time of first postoperative bed-out time (2.42±1.30) days, hospitalization days (7.18±2.79) days, hospitalization costs (54281.89±40045.05) yuan, and patient satisfaction (99.24±1.62 points); a total of 34 patients in the control group were investigated, with the time of first postoperative bed-out time (3.85±1.31) days, hospitalization days (10.65±3.64) days, hospitalization costs (82121.57±20390.9) yuan, and patient satisfaction (95.09±3.03 points).
Conclusion Based on the results of this study, it is recommended to promote the MDT model in the clinical practice of neurosurgery to improve the postoperative rehabilitation effect of patients with posterior cranial fossa tumors. Future studies should further explore the application effect of the MDT model in different types of neurosurgery and evaluate its cost-effectiveness.

Key words： Posterior fossa tumor; Infratentorial tumor; MDT; Ambulation

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引用本文

黄凤, 石晓梅, 刘艳, 王晓林, 多学科团队诊疗模式在后颅窝肿瘤患者术后首次下床活动中作用的研究[J]. 当代护理, 2025; 6: (1) : 32-37.

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