多学科团队诊疗模式在急诊患者中应用的范围综述

doi:10.3761/j.issn.2096-7446.2025.01.019

摘要/Abstract

摘要：

目的对多学科团队诊疗模式在急诊患者中应用的研究进行范围审查，为医护人员实施多学科团队诊疗模式及相关研究提供参考依据。方法依据范围综述的研究理论框架，系统检索中国知网、万方数据库、中国生物医学文献数据库、维普数据库、Web of Science、PubMed、Embase、Cochrane Library 8个中英文数据库，检索时限为建库至2023年12月16日。按照纳入和排除标准筛选文献，对纳入文献进行质量评价后汇总分析。结果共纳入14篇文献，多学科团队诊疗模式在急诊患者中主要应用于脑卒中患者、创伤患者及上消化道出血患者；主导人群一般为医生主导、护士主导或医护共同主导；团队成员及职责按科室或职务划分；启动时机主要包括确诊后启动、医生评估后启动、相关评分结果达到某一数值时启动或急诊滞留时间≥72 h时启动；干预环节主要分为院前急救、院内分诊评估、转运过程、留观期处理、术前评估、术后护理和出院随访阶段；效果评价主要是对各环节所用时间、治疗效果及患者或家属满意度方面进行评价。结论多学科团队诊疗模式能够提升急诊患者诊疗和护理效果，缩短急救时间，提升患者满意度。未来需进一步完善多学科团队诊疗模式的实施策略，探索规范化、整体化的单病种多学科诊疗模式，构建全面、科学的过程评估体系，开展高质量的随机对照研究以验证其应用效果。

关键词: 多学科团队, MDT, 急诊室, 医院, 急救, 护理

Abstract:

Objective To review the application of the multidisciplinary team（MDT） diagnosis and treatment model in emergency patients，to provide a reference for clinical medical staff to carry out the MDT diagnosis and treatment model and related research. Methods According to the research method of scoping review，a literature search was performed in the CNKI，Wanfang Data，CBM，VIP，Web of Science，PubMed，Embase，Cochrane Library. The retrieval time limit was from the establishment of the databases to December 16th，2023. Literature was screened according to inclusion and exclusion criteria，the quality of the included literature was evaluated，and summarized. Results A total of 14 articles were included. MDT diagnosis and treatment model were mainly used in emergency patients with stroke，trauma and upper gastrointestinal bleeding. MDT was generally led by doctors，nurses or both. Team members and responsibilities were divided by department or position. The starting time mainly included the time after diagnosis，after evaluation by the doctor，when the relevant score reaches a certain value，or the emergency stay time ≥72 h. The main intervention segment included pre-hospital，triage and evaluation in-hospital，transfer process，observation period treatment，preoperative evaluation，postoperative care and discharge follow-up stage. The outcome evaluation indicators included the time spent in each segment，treatment effect and patients’ or their relatives’ satisfaction. Conclusion The MDT diagnosis and treatment model can improve the effects of treatment and nursing in emergency patients，shorten emergency department length of stay，and improve patient satisfaction. In the future，it is necessary to continuously improve the implementation strategy of the multidisciplinary team diagnosis and treatment model，explore a standardized and integrated multi-disciplinary diagnosis and treatment model for single diseases，build a comprehensive and scientific process evaluation system，and conduct high-quality randomized controlled studies to verify its application effect.

Key words: Multidisciplinary Team, MDT, Emergency Service, Hospital, First-Aid, Nursing Care

景晨阳, 吉莉, 陈闪, 何国宝, 汪托红, 樊落. 多学科团队诊疗模式在急诊患者中应用的范围综述[J]. 中华急危重症护理杂志, 2025, 6(1): 114-119.

JING Chenyang, JI Li, CHEN Shan, HE Guobao, WANG Tuohong, FAN Luo. The application of multidisciplinary team diagnosis and treatment model in emergency patients：a scoping review[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(1): 114-119.

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