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A Multidisciplinary Team Approach to the Treatment of Liver Cirrhosis

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 t...

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Autores principales: Zhang, Yue-Rong, Wang, Hui, Zhou, Ning, Zhang, Yao-Di, Lin, Yan, Wu, Li-Yang, Wei, Shi-Fang, Ma, Yan-Yun, Wang, Chun-Xia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8548059/
https://www.ncbi.nlm.nih.gov/pubmed/34712056
http://dx.doi.org/10.2147/JIR.S328334
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author Zhang, Yue-Rong
Wang, Hui
Zhou, Ning
Zhang, Yao-Di
Lin, Yan
Wu, Li-Yang
Wei, Shi-Fang
Ma, Yan-Yun
Wang, Chun-Xia
author_facet Zhang, Yue-Rong
Wang, Hui
Zhou, Ning
Zhang, Yao-Di
Lin, Yan
Wu, Li-Yang
Wei, Shi-Fang
Ma, Yan-Yun
Wang, Chun-Xia
author_sort Zhang, Yue-Rong
collection PubMed
description 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.
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spelling pubmed-85480592021-10-27 A Multidisciplinary Team Approach to the Treatment of Liver Cirrhosis Zhang, Yue-Rong Wang, Hui Zhou, Ning Zhang, Yao-Di Lin, Yan Wu, Li-Yang Wei, Shi-Fang Ma, Yan-Yun Wang, Chun-Xia J Inflamm Res Original Research 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. Dove 2021-10-22 /pmc/articles/PMC8548059/ /pubmed/34712056 http://dx.doi.org/10.2147/JIR.S328334 Text en © 2021 Zhang et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Zhang, Yue-Rong
Wang, Hui
Zhou, Ning
Zhang, Yao-Di
Lin, Yan
Wu, Li-Yang
Wei, Shi-Fang
Ma, Yan-Yun
Wang, Chun-Xia
A Multidisciplinary Team Approach to the Treatment of Liver Cirrhosis
title A Multidisciplinary Team Approach to the Treatment of Liver Cirrhosis
title_full A Multidisciplinary Team Approach to the Treatment of Liver Cirrhosis
title_fullStr A Multidisciplinary Team Approach to the Treatment of Liver Cirrhosis
title_full_unstemmed A Multidisciplinary Team Approach to the Treatment of Liver Cirrhosis
title_short A Multidisciplinary Team Approach to the Treatment of Liver Cirrhosis
title_sort multidisciplinary team approach to the treatment of liver cirrhosis
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8548059/
https://www.ncbi.nlm.nih.gov/pubmed/34712056
http://dx.doi.org/10.2147/JIR.S328334
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