多学科团队工作模式下老年肺部感染并发多器官功能不全综合征的预防干预研究

摘要

目的：探讨多学科团队工作模式下老年肺部感染并发老年多器官功能不全综合征（MODSE）的预防干预，为早期预防老年肺部感染并发MODSE奠定基础。方法选取解放军白求恩国际和平医院干部病房2010年10月至2014年3月住院并筛查出住院期间肺部感染并发MODSE的高危病例57例，采用多学科协作的团队工作方式，建立MODSE多学科团队预防干预模式，应用多学科团队预防干预模式对其中23例老年肺部感染并发MODSE高危病例进行干预，并与34例实施常规干预的老年肺部感染并发MODSE高危病例进行比较。结果在多学科干预组（MIG）23例老年肺部感染并发MODSE的高危病例中，有2例并发MODSE，MODSE发病率为8.70%；常规干预组（CIG）34例老年肺部感染并发MODSE的高危病例中，有11例并发MODSE，MODSE发病率为32.35%。MIG组老年肺部感染并发MODSE高危病例的MODSE发病率低于CIG组（χ2＝4.361，P＝0.037）。结论多学科团队预防干预模式能充分利用医院各学科的技术优势，使MODSE高危病例得到最佳干预治疗，从而达到早期保护各器官功能、减少MODSE的发生。%Objective To explore the intervention to prevent multiple organ dysfunction syndrome in the elderly (MODSE) caused by pulmonary infection under the guide of multidisciplinary team work mode and find a basis for early prevention of the syndrome. Methods The multidisciplinary team prevention model was established to prevent MODSE caused by pulmonary infection. A total of 57 patients (over 65 years old) of high risk for MODSE due to pulmonary infection admitted in our ward from October 2010 to March 2014 were recruited in this study. Twenty-three of them underwent the intervention based on the multidisciplinary team prevention model, and assigned as multidisciplinary intervention group (MIG). Another 34 cases were treated by conventional intervention to prevent MODSE, and named as conventional intervention group (CIG). The incidence of MODSE was observed and compared between the 2 groups. Results In the MIG, there were 2 patients having MODSE, with an incidence of 8.70%. In the CIG, totally 11 patients (32.35%) suffered from MODSE. The incidence of MODSE was significantly lower in the MIG than CIG (Chi-square=4.361, P=0.037). Conclusion The multidisciplinary team prevention model can make full use of technical advantages of various disciplines, give optimal treatment to the high risk patients of MODSE caused by pulmonary infection, and thus reduce the occurrence of MODSE.