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目的比较多学科协作模式(multi-disciplinary team,MDT)与传统单一外科模式诊治肢端肥大症的疗效差异,探讨MDT模式对于肢端肥大症的诊疗价值。方法回顾性分析245例肢端肥大症患者,根据诊治模式分为传统单一学科模式组(对照组)和MDT组,比较两组的随访率、合并症检出率、手术入路选择、手术全切率、内分泌缓解率、并发症发生率等的差异。结果 MDT组的合并症检出率高于对照组;MDT组的经颅手术比例有较对照组下降的趋势(1.4%vs 6.7%,χ~2=3.39,P=0.066);MDT组的全切率高于对照组(80.3%vs.65.1%,χ~2=6.184,P=0.013);两组的手术后内分泌缓解率无显著差异(70.1%vs.59.3%,χ~2=2.644,P=0.104);综合治疗后MDT组的末次随访内分泌缓解率高于对照组(81.1%vs.67.4%,χ~2=5.185,P=0.023)。结论 MDT模式能够提高肢端肥大症患者的合并症检出率,降低经颅手术比例,提高手术全切率及综合治疗后内分泌缓解率,优于传统的单一学科诊疗模式。
Objective To compare the curative effects of multidisciplinary team (MDT) with traditional single surgical modality in diagnosis and treatment of acromegaly and to explore the value of MDT in the diagnosis and treatment of acromegaly. Methods A total of 245 patients with acromegaly were retrospectively analyzed. According to the diagnosis and treatment mode, the patients were divided into the traditional single subject model group (control group) and MDT group. The follow-up rate, the rate of comorbidity, surgical approach, Cutting rate, endocrine remission rate, the incidence of complications such as the difference. Results The incidence of comorbidities in MDT group was higher than that in control group. The proportion of transcranial tumors in MDT group was lower than that in control group (1.4% vs 6.7%, χ ~ 2 = 3.39, P = 0.066) The rates of postoperative endocrine remission were no significant difference between the two groups (70.1% vs.59.3%, χ ~ 2 = 2.644, P = 0.013) P = 0.104). The final follow-up endocrine remission rate in MDT group was higher than that in control group (81.1% vs.67.4%, χ ~ 2 = 5.185, P = 0.023) after comprehensive treatment. Conclusions The MDT model can improve the detection rate of comorbidities, reduce the proportion of transcranial operations, improve the rate of total wound resection and the rate of endocrine remission after comprehensive treatment, which is superior to the traditional single subject treatment model.