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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...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove
2021
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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. |
format | Online Article Text |
id | pubmed-8548059 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Dove |
record_format | MEDLINE/PubMed |
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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