甲状腺日间手术规范化分析  

Analysis of the Standardization of Ambulatory Thyroid Surgery

作　　者：戴佳奇[1] 吴婷婷[1] 殷志强[1] 王家东[1] 张云[1] 

机构地区：[1]上海交通大学医学院附属仁济医院,上海200001

出　　处：《肿瘤学杂志》2015年第6期454-458,共5页Journal of Chinese Oncology

摘　　要：[目的]分析甲状腺肿瘤日间手术的优势,并比较专业组医师与非专业组医师的差异。[方法]收集2013年1~12月甲状腺肿瘤手术病例2765例,比较日间手术组（597例）与非日间手术组（2168例）的费用差异;在日间病例中,再根据主刀医生的专业分成专业组和非专业组,比较两组手术时间和术后并发症差异。[结果]日间手术组较非日间手术组费用低（10316.96±1042.07元vs 11269.82±1999.33元,P〈0.05）。日间病例中,专业组平均手术时间较非专业组明显缩短（31.63±13.74min vs 46.83±18.62min,P〈0.05）。而专业组的术后并发症发生率则明显低于非专业组,特别是暂时性喉返神经损伤和暂时性甲状旁腺机能减退的发生率（0.81%vs 3.92%,1.01%vs 5.88%,P均〈0.05）。[结论]日间手术模式可有效减少患者住院天数和住院费用,由专业组医师负责更能保证手术的安全,缩短手术时间。[Purpose] To analyze superiority of ambulatory thyroid surgery and the difference between specialists and other surgeons. [Methods] The 2765 cases with thyroid cancers were divided into ambulatory surgery group（597 cases） and non-ambulatory surgery group（2168 cases）.The differences in cost between the two groups were compared. All the ambulatory cases were divided into two groups（specialist group and non-specialist group）. The differences in operatiny time and postoperative complications were analyzed. [Results] The cost of ambulatory surgery group was significantly cheaper than that of non-ambulatory surgery group（10316.96 ±1042.07 yuan vs 11269.82±1999.33 yuan,P0.05）. Compared with non-specialist group,the average operatiny time of specialist group was shorter（31.63±13.74 min vs 46.83±18.62 min,P0.05） and the recurrence rate of postoperative complications was much lower,especially temporary laryngeal recurrent nerve injury and temporary parathyroid function（0.81% vs 3.92%,1.01% vs 5.88%,P 0.05）.[Conclusions] Ambulatory thyroid surgery mode reveals obvious advantages. It can effectively reduce hospitalization days and expenses. In order to ensure the safety and reduce the operatiny time,ambulatory surgery should be responsible by thyroid specialists.

关 键 词：甲状腺肿瘤 日间手术 安全性 术后并发症 

分 类 号：R736.1[医药卫生—肿瘤]