膝关节镜日间手术的实践分析  

Knee arthroscopy-assisted ambulatory surgery:Practice and considerations

作　　者：天天 嵇武[2] 刘玉秀[3] 史兆荣[4] 顾旭东[5] 王北岳[6] 

机构地区：[1]南京医科大学医政学院 [2]南京军区南京总医院普通外科,南京210002 [3]南京军区南京总医院医务部,南京210002 [4]南京军区南京总医院院部,南京210002 [5]南京军区南京总医院日间手术中心,南京210002 [6]南京军区南京总医院骨科,南京210002

出　　处：《医学研究生学报》2018年第3期309-312,共4页Journal of Medical Postgraduates

基　　金：江苏省重点研发计划-面上项目(BE2016746)

摘　　要：目的日间手术凭借简便的程序和高效资源利用,成为提高医疗效率的有效手段,文章对膝关节镜日间手术实施效果进行分析思考,旨在完善日间手术日常工作。方法选取我院2017年3月至8月开展膝关节镜下半月板切除、修整术和膝关节镜下关节腔清理术患者共188例,将行膝关节镜日间手术的97例患者作为日间组,同期在骨科行膝关节镜手术的91例患者作为对照组。对比两种手术模式下患者平均各项住院费用、平均住院天数以及术后并发症。结果日间组平均住院时间[(25.5±0.8)h]短于对照组[(95.0±41.3)h],两组差异有统计学意义(P<0.05)。日间组平均住院费用[(22231.7±7152.2)元]明显低于对照组[(28699.6±11331.12)元],差异有统计学意义(P<0.05)。依据术后第1天、第3天的随访,日间组和对照组各出现1例并发症情况,两组并发症发生率均为1%。日间组1例患者因为家庭护理不当发生出血症状,对照组1例患者发生腿部的肿胀症状。结论日间手术模式是一种高效的医疗手段,在现有基础上,以加速康复外科理念为核心,以精细化医疗为手段,以个性化医疗为目标,不断完善日间手术。Objective Ambulatory surgery（AS）,with its simple procedures and efficient utilization of resources,is an effective means of improving medical efficiency.The aim of this study was to improve the daily procedures of AS by analyzing the performance and results of knee arthroscopy-assisted AS.Methods This study included 188 cases of knee arthroscopic surgery performed from March to August 2017,97 of them treated in the Ambulatory Surgery Center（group A） and the other 91 in the conventional ward（group B）.We compared the average hospital stay,hospitalization expenses,and postoperative complications between the two groups of patients.Results Compared with group B,group A showed a significantly shorter hospital stay（[95.0±41.3] vs [25.5±0.8] h,P0.05） and lower hospitalization expenses（[28 699.6±11331.1] vs [22231.7±7152.2] RMB,P0.05）.No statistically significant difference was observed in the incidence rate of postoperative complications at 1 and 3 days after surgery,1 case of bleeding in group A and 1 case of leg swelling in group B.Conclusion Ambulatory surgery in our hospital needs to be further improved on the basis of accelerated rehabilitation surgery as the core concept,precision medicine as the approach,and individualized treatment as the goal.

关 键 词：膝关节镜 日间手术 医疗质量 

分 类 号：R197[医药卫生—卫生事业管理]