管建松 戎祯祥 梁裕团 麦显强

[摘要]目的 探讨多学科协作综合医疗（MDT）在消化门诊患者负面情绪改善的效果。方法 将我院门诊2017年7～12月就诊的80例伴心理障碍消化疾病患者作为研究组，2017年1～ 6月就诊的75例伴心理障碍消化疾病患者作为对照组。对照组接受传统诊疗服务，研究组采用MDT模式干预，比较两组的效果。结果 研究组治疗后的焦虑自评量表（SAS）评分及抑郁自评量表（SDS）评分均显著低于治疗前（P<0.001）；研究组治疗后的SAS及SDS评分均显著低于对照组（P<0.01）；对照组治疗后的SF-36总分高于治疗前，研究组治疗后的生理功能（PF）、总体健康（GH）、活力（VT）、精神健康（MH）及总分显著高于治疗前（P<0.05）；研究组治疗后的GH、VT、MH及总分均显著高于对照组，差异均有统计学意义（P<0.05）。结论 MDT模式在消化门诊应用可显著改善患者的负面情绪，提升健康状况。

[关键词]多学科协助综合医疗；消化门诊；负面情绪；效果

[中圖分类号] R197.1 [文献标识码] A [文章编号] 1674-4721（2018）5（a）-0028-04

[Abstract]Objective To explore the effect of multidisciplinary teamwork（MDT） in improvement of negative emotions in gastroenterology outpatients.Methods Altogether 80 patients with digestive diseases accompanied by mental disorder who were treated in outpatient department of gastroenterology of our hospital from July to December in 2017 were selected as the study group；another 75 patients with digestive diseases accompanied by mental disorder who were treated in our hospital from January to June 2017，were selected as the control group.The control group was received traditional diagnosis and treatment service；while，the study group were treated with MDT mode intervention.The effect was compared between the two groups.Results The post-treatment self-rating anxiety scale （SAS） and self-rating depression scale （SDS） scores of the study group were significantly lower than those before treatment（P<0.001）.The SAS and SDS scores of the study group were significantly lower than those of the control group（P<0.01）.The post-treatment total score of SF-36 （36-item short form health survey） of the control group was higher than that before the treatment.The post-treatment physical functioning（PF），general health（GH）， vitality（VT），mental health（MH） and total score of the study group were significantly higher than those before the treatment（P<0.05）.The post-treatment GH，VT，MH and total score of the study group were significantly higher than those of control group after treatment，the differences were statistically significant（P<0.05）.Conclusion Application of MDT mode in outpatient department of gastroenterology can significantly improve patient′s negative emotions and improve their health.

[Key words]Multidisciplinary teamwork；Outpatient Department of Gastroenterology；Negative emotions；Effect

消化内科疾病易引发焦虑、抑郁、恐惧、躯体化、倦怠等不良负面情绪[1-2]。负面情绪不仅降低治疗依从性，不利于疾病的治疗及转归，还经神经内分泌系统影响肠胃运动，进一步加重病情，导致生活质量进一步下降[3]。多学科协作综合医疗模式（multi-disciplinary team，MDT）是针对某种临床疾病，通过至少两个及以上学科的会诊讨论，发现在疾病诊疗过程的疑难问题，制定合理、有效的治疗方案，以更好促进疾病转归[4]。为更好地改善我院消化内科住院患者的负面情绪，提升配合依从性，降低负面情绪对神经内分泌系统的影响，促进患者良好转归，本研究分析了MDT的应用效果，现报道如下。

1资料与方法

1.1一般资料

将我院消化门诊2017年7～12月就诊的80例伴心理障碍消化疾病患者作为研究组，2017年1～6月就诊的75例伴心理障碍消化疾病患者作为对照组。对照组男30例，女45例；年龄25～64岁，平均（36.24±6.28）岁；诊断：功能性消化不良34例，胃肠功能紊乱25例，消化性溃疡12例，其他4例；……