摘要
目的应用决策树方法为1例急诊上消化道出血患者选择最佳诊治方案。方法按照临床事件发生的时间和逻辑顺序,经过明确决策问题、绘出决策树图形、明确各结局出现概率、对最终结局用适宜的效用值赋值、计算并确定最佳策略等6个步骤构建完整的决策树,从中找到该病例的最佳诊疗方案。结果上消化道出血患者是否在超早期(6小时内)行内镜治疗对预后影响不大。内镜治疗失败的患者采用介入治疗较直接手术探查死亡率低。结论通过绘制决策树进行临床决策分析,能帮助医生理清思路,全面而清晰地看待临床问题,并最终为患者选择一条最佳治疗路线。
Objective To apply the method of evidence-based medicine to identify the best therapy option for an emergency patient with upper gastrointestinal hemorrhage.Methods According to time and logical sequence of clinical events,a complete decision tree was built after the following steps to find the best treatment： clear decision-making,drawing decision tree graphics,listing the outcome probability,giving appropriate values to the final outcome,calculating and determining the best strategies.Results The performance of endoscopic therapy for the patient with upper gastrointestinal hemorrhage within the first six hours had little effect on the prognosis.Interventional therapy after the failure of endoscopic therapy had less mortality than direct surgical exploration.Conclusion Making clinical decision analyses via drawing the decision tree can help doctors clarify their ideas,get comprehensive views of clinical problems,and ultimately choose the best treatment strategy for patients.
出处
《中国循证医学杂志》
CSCD
2011年第5期591-593,共3页
Chinese Journal of Evidence-based Medicine
关键词
上消化道出血
临床决策分析
决策树
Upper gastrointestinal hemorrhage
Clinical decision analysis
Decision tree
