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A Multidisciplinary Team Approach to the Treatment of Liver Cirrhosis
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Authors Zhang YR, Wang H, Zhou N, Zhang YD, Lin Y, Wu LY, Wei SF, Ma YY, Wang CX
Received 7 July 2021
Accepted for publication 19 August 2021
Published 22 October 2021 Volume 2021:14 Pages 5443—5450
DOI https://doi.org/10.2147/JIR.S328334
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Ning Quan
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Yue-Rong Zhang,1 Hui Wang,2 Ning Zhou,2 Yao-Di Zhang,1,2 Yan Lin,1,2 Li-Yang Wu,1,2 Shi-Fang Wei,2 Yan-Yun Ma,2,3 Chun-Xia Wang3
1Department of Gastroenterology, University-Town Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 2Department of Infectious Diseases, The First People’s Hospital of Lanzhou, Gansu, 730050, People’s Republic of China; 3Department of Laboratory, The First People’s Hospital of Lanzhou, Gansu, 730050, People’s Republic of China
Correspondence: Yue-Rong Zhang
Department of Gastroenterology, University-Town Hospital of Chongqing Medical University, No. 55 University Town Middle Road, Shapingba District, Chongqing, 401331, People’s Republic of China
Tel/Fax +86 102365714142
Email [email protected]
Objective: To explore the feasibility of treating cirrhosis using a multidisciplinary team approach (MDT) and to pinpoint the key factors influencing its implementation.
Methods: The data of 307 patients with decompensated cirrhosis were studied retrospectively. Patients who received more than two treatment measures were assigned to the MDT group (n=228), and patients who received symptomatic medical drug treatment only were assigned to the traditional treatment group (n=79). The follow-up period ranged from 4 to 10 years, and the average follow-up period was 5.7 years. The results of the biochemical tests for hepatitis B virus deoxyribonucleic acid, hepatitis C virus ribonucleic acid, and autoantibodies to liver disease were analyzed.
Results: The differences in gender and Child–Pugh grade of liver function between the two groups were not statistically significant. The MDT group had obvious advantages over the traditional treatment group in occupational composition, etiology composition, 5-year survival rate and annual hospitalization times. The leading causes of death in the MDT group, in descending order, were liver cancer, infection, mesenteric thrombosis, and non-hepatic disease, and, in the medical treatment group, they were liver failure, gastrointestinal bleeding, infection, and liver cancer. There was a significant statistical difference between the two groups (p < 0.05). In the multidisciplinary treatment, etiological treatment was the most widely used treatment, accounting for 79.8%, followed by endoscopic treatment (33.3%), peritoneal drainage and ascites reinfusion (25%), splenectomy combined with devascularization (11.4%) and stem cell transplantation and liver transplantation (1.8%).
Conclusion: An MDT can improve the efficacy and prognosis of patients with cirrhosis and improve patient compliance. After multi-disciplinary intervention, the mortality spectrum of long-term survival patients with cirrhosis changes, and the mortality rate of liver cancer and non-liver disease increases.
Keywords: liver cirrhosis, decompensated period, multidisciplinary team mode, traditional treatment, retrospective study |
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发表于 2021-10-22 11:33
