Comparative study on clinical effect of multidisciplinary treatment model and traditional consultation model in treatment of dangerous upper gastrointestinal hemorrhage / 中华危重病急救医学

ABSTRACT

Objective:To compare the difference of clinical effects between multidisciplinary treatment (MDT) mode and traditional consultation mode in diagnosis and treatment of patients with dangerous upper gastrointestinal hemorrhage.Methods:The clinical data of patients with dangerous upper gastrointestinal hemorrhage admitted to the department of emergency and critical care medicine of Yichang Central People's Hospital from January 2018 to December 2019 were analyzed retrospectively, taking 30 patients in traditional consultation mode from January 2018 to December 2018 as traditional consultation group, and 26 patients in MDT mode from January 2019 to December 2019 as MDT group. The recovery time of vital signs, length of intensive care unit (ICU) stay, length of hospital stay, medical expenses, rebleeding rate, surgical operation rate, amount of blood transfusion, hospital mortality, and clinical effect of the two groups were observed.Results:The recovery time of vital signs, length of ICU stay and length of hospital stay in the MDT group were significantly shorter than those in the traditional consultation group (days: 1.62±1.30 vs. 2.20±0.93, 10.04±2.82 vs. 13.27±2.86, 3.50±1.63 vs. 4.70±2.17, both P < 0.05), and the medical expenses, rebleeding rate and blood transfusion volume were lower than those in the traditional consultation group [medical expenses (ten thousands Yuan): 6.40±3.07 vs. 8.56±4.07, rebleeding rate: 15.38% (4/26) vs. 43.33% (13/30), blood transfusion volume (U): 5.54±3.20 vs. 7.71±3.83, plasma volume (mL): 330.77±258.87 vs. 458.33±322.73, cold precipitation volume (U): 4.52±4.15 vs. 6.67±4.85, platelet volume (U): 0.40±0.19 vs. 0.77±0.60, all P < 0.05]. The clinical total efficiency in the MDT group was significantly higher than that in the traditional consultation group (88.5% vs. 80.0%, P < 0.05). There was no significant difference in the surgical operation rate and hospital mortality between the two groups. Conclusions:Compared with the traditional consultation mode, MDT mode can significantly shorten the recovery time of vital signs, the length of ICU stay, the length of hospital stay, reduce blood transfusion volume, medical expense and rebleeding risk of patients with upper gastrointestinal hemorrhage, and has better clinical effect. However, there is no significant difference in surgical operation rate and hospital mortality between the two modes.