门诊与住院甲状腺手术的对照研究  

A case-control study on outpatient and inpatient thyroid surgery

作　　者：韦瑶[1] 王少华[1] 王丹[1] 于泽平[1] 李宁[1] 黎介寿[1] 

机构地区：[1]南京军区南京总医院解放军普通外科研究所

出　　处：《医学研究生学报》2012年第8期824-827,共4页Journal of Medical Postgraduates

基　　金：南京军区医学科学技术研究"十一五"计划课题基金(06MA112)

摘　　要：目的门诊甲状腺手术在带来巨大社会效应的同时,其安全性受到广泛关注,文中通过对比门诊甲状腺手术(outpatient thyroid surgery,OTS)及住院甲状腺手术(inpatient thyroid surgery,ITS)患者术中、术后情况,探讨开展OTS的可行性、安全性及临床疗效。方法共收治95例甲状腺疾病患者,分为OTS组(45例)和ITS组(50例),比较2组患者的手术时间、手术切口长度、术中出血量、术后并发症发生率、术后留院时间及总医疗费用等。结果 2组患者手术均获得成功。2组患者平均手术时间分别为(42.86±15.11)min和(41.75±12.37)min;手术切口长度(4.37±0.96)cm和(4.52±1.04)cm;术中出血量(11.58±5.40)ml和(12.14±4.98)ml;术后留院时间(19.23±4.11)h和(47.04±11.04)h;总医疗费用(13251.46±1809.34)元和(17187.37±1653.46)元;2组患者术后均无声音嘶哑、饮水呛咳、手足抽搐等并发症发生。2组患者在手术时间、切口长度、术中出血量、手术并发症发生率等方面,差异无统计学意义(P>0.05)。OTS组较ITS组明显缩短了留院观察时间,降低了医疗费用(P<0.05)。结论在有符合入组标准的患者、专业人员配置等条件下,开展OTS安全可行,并可降低医疗费用,节约医疗资源,使患者尽早回归社会生活。Objective Outpatient thyroid surgery （OTS） has prevailed for a few years, but accompanied with many arguments at the same time. This article discusses the feasibility, safety and the clinical effect of OTS by comparing its intra- and post-operative data with those of inpatient thyroid surgery （ITS）. Methods Ninety-five patients with thyroid diseases were assigned to receive OTS （n = 45） and ITS （n = 50）. We compared the mean operation time, incision length, intra-operative blood loss, postoperative hospital observation time, total expenses and postoperative complications between the two groups. Results Operations were all successful. The mean operation time, incision length, intra-operative blood loss, postoperative observation time, total expenses in the OTS and ITS groups were （42.86±15.11） versus （41.75 ±12.37） min, （4.37±0.96） versus （4.52±1.04） em, （11.58±5.40） versus （12.14 ±4.98） ml, （19.23±4.11） versus （47.04±11.04） h, and （13251.46 ± 1809.34） versus （ 17187.37 ±1653.46） Yuan. No hematoma, hypocalcaemia or wound infection occurred in either group. There were no statistically significant differences between the two groups in the mean operation time, incision length and intra-operative blood loss （P 〉0. 05）, but the mean postoperative observation time and total expenses were significantly decreased in the OTS group as compared with the ITS group （ P〈 0.05 ）. Conclusion With the criteria fulfilled for patient selection and the surgical team, OTS is safe and feasible, with advantages of lower cost, shorter hospital stay and earlier recovery.

关 键 词：门诊甲状腺手术 住院甲状腺手术 加速康复外科 

分 类 号：R619[医药卫生—外科学]