临床肝胆病杂志2025，Vol.41Issue(10)：2068-2074,7.DOI:10.12449/JCH251017
多学科管理模式对门静脉高压患者预后的影响
Effect of the multidisciplinary management model on the prognosis of patients with portal hypertension
摘要
Abstract
Objective To investigate the effect of the multidisciplinary team(MDT)management model in improving the prognosis of patients with cirrhotic portal hypertension.Methods A total of 86 patients with cirrhotic portal hypertension who were admitted to Shenzhen Third People's Hospital from May 2022 to July 2024 were enrolled,and according to whether the MDT treatment regimen was implemented,they were divided into execution group with 51 patients and non-execution group with 35 patients.Baseline clinical data were collected,and the patients were observed in terms of gastrointestinal bleeding,hepatic encephalopathy,liver cancer,and death from admission to the end of follow-up(January 2025).The independent-samples t test was used for comparison of normally distributed continuous data between two groups,and the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data between two groups;the chi-square test or the Fisher's exact test was used for comparison of categorical data between groups.The Kaplan-Meier method was used to plot survival curves for the cumulative incidence rates of endpoint events(gastrointestinal bleeding,hepatic encephalopathy,liver cancer,and death),and the Log-rank test was used for comparison between groups.The Cox proportional-hazards regression model analysis was used to investigate the effect of MDT management on the prognosis of patients.Results There were significant differences between the execution group and the non-execution group in diameter of the portal vein(t=1.216,P=0.017)and ascites(χ2=4.515,P=0.034)at baseline.The patients were followed up for 14.6±6.2 months,and the survival curve analysis showed that there was a significant difference in the cumulative incidence rate of gastrointestinal bleeding between the two groups(χ2=4.573,P=0.024),while there were no significant differences in the incidence rates of other outcome events between the two groups(all P>0.05).The Cox regression analysis showed that the execution group had a reduced risk of gastrointestinal bleeding(hazard ratio=0.262,95%confidence interval:0.110-0.630,P=0.003).Conclusion Implementation of the MDT treatment regimen can significantly reduce the short-term risk of gastrointestinal bleeding in patients with cirrhotic portal hypertension,while its long-term benefits require further follow-up verification.关键词
肝硬化/高血压,门静脉/多学科诊疗/预后Key words
Liver Cirrhosis/Hypertension,Portal/Multidisciplinary Diagnosis and Treatment/Prognosis引用本文复制引用
赖长祥,王方,唐奇远,李知玉,蒋育进,周旋,冼文杰,陈瑞坤,吴晓娟,何清..多学科管理模式对门静脉高压患者预后的影响[J].临床肝胆病杂志,2025,41(10):2068-2074,7.基金项目
深圳市第三人民医院院内课题(25270G1010) （25270G1010）
深圳市医学重点学科建设基金(SZXK076) In-hospital Research Project of Shenzhen Third People's Hospital(25270G1010) （SZXK076）
Key Medical Discipline Construction Fund of Shenzhen(SZXK076) （SZXK076）
