中国小儿日间手术发展的基本现状调查与思考  

Current status and development of pediatric ambulatory surgery in China

作　　者：鲍益耀 胡书奇 黄寿奖[1] 赖登明 赵晓霞[1] 吕成杰[1] 钱云忠[1] 钭金法[1] Bao Yiyao;Hu Shuqi;Huang Shoujiang;Lai Dengming;Zhao Xiaoxia;Lyu Chengjie;Qian Yunzhong;Tou Jinfa(The Children's Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,Hangzhou 310052,China)

机构地区：[1]浙江大学医学院附属儿童医院、国家儿童健康与疾病临床医学研究中心,杭州310052

出　　处：《中华小儿外科杂志》2020年第8期692-697,共6页Chinese Journal of Pediatric Surgery

摘　　要：目的调查中国小儿日间手术开展的基本现状,为专家共识的制定提供参考。方法通过万方数据、维普数据、知网数据,搜索主题为"小儿、儿童+日间手术、一日手术、一日外科",回顾文献并分析总结;根据文献回顾发现的问题设计表格,通过微信链接进行调查,通过Excel及IBM SPSS 22.0统计软件分析数据。结果文献回顾显示共108家单位,发表151篇文章,其中指南1篇(0.7%),综述21篇(13.9%),临床研究123篇(81.5%),学位论文3篇(2.0%),科普文章3篇(2.0%)。发表时间最早于1966年,其中近三年的文章74篇(49.0%)。文章单位来源主要是三甲医院115篇(76.2%),以综合性医院93篇(61.6%)为主。研究内容包括护理37篇(24.5%),麻醉48篇(31.8%),临床总结43篇(28.5%),管理20篇(13.2%);需要特别指出的是3篇(2.0%)关注心理疏导,14篇(9.3%)关注ERAS理念在小儿日间手术应用。问卷调查共收到有效问卷72份,包括64家(88.9%)三甲医院,43家(59.7%)综合医院;另外,其中有59家(81.9%)成立了日间手术管理委员会或工作组,49家(68.1%)由外科医生担任日间手术中心主任,34家(47.2%)有独立日间手术中心,58家(80.6%)开展麻醉门诊。在管理方面,70家(97.2%)有日间手术术前评估方案,69家(95.8%)有围术期患儿教育,61家(84.7%)存在医生准入标准,62家(86.1%)有随访制度,59家(81.9%)有日间手术绩效考核方案,51家(70.8%)有质量考核方案,46家(63.9%)有日间手术信息管理系统。结论小儿日间手术近年来发展迅速,患儿的安全是首位的,所以日间手术的制度需严格制定并切实执行。三甲医院是小儿日间手术开展的主体机构,建议多开展多中心和ERAS在日间手术中的应用研究,加快制定小儿日间手术的规范,并向基层医院推广。To explore current status of pediatric ambulatory surgery in China's Mainland and provide references for formulating an expert consensus.Methods The literatures with such keywords as ambulatory surgery,one-day surgery and one-day operation for pediatrics were retrieved from the databases of Wanfang DATA,VIP Database for Chinese Technical Periodicals and CNKI(China National Knowledge Infrastructure).Based upon the outstanding issues,a questionnaire was designed and completed via a WeChat link.Data analysis was performed with Excel and IBM SPSS 22.0 statistical software.Results A total of 151 articles were published by 108 organizations,including 1(0.7%)guideline,21(13.9%)reviews,123(81.5%)clinical trials,3(2.0%)dissertations and 3(2.0%)popular science articles.However,there was no multi-center research.Since the first paper was published in 1996,74 articles(49%)were published in recent 3 years.For institutions,115(76.2%)from class IIIA hospitals and 93(61.6%)from general hospitals;For research areas,nursing(37),anesthesia(48),clinical summary(43)and management(20),especially psychology(3)and ERAS(14).A total of 72 questionnaires were received.There were 64 class IIIA hospitals(88.9%)and 43 at general hospitals(59.7%).Moreover,59(81.9%)hospitals set up day surgery management committees or working groups,49(68.1%)surgeons acted as the directors of day surgery centers,34(47.2%)hospitals were independent day surgery centers and 58(80.6%)operated anesthesia clinics.For management,preoperative evaluation plans were conducted at 70(97.2%)hospitals,perioperative patient education was implemented at 69(81.9%)hospitals,surgeon admission standards were applied at 61(84.7%)hospitals,62(86.1%)operated follow-up systems,59(81.9%)implemented day surgery performance assessment programs,51(70.8%)had quality assessment program and 46(63.9%)operated day surgery information management systems.Conclusions With a rapid development of pediatric ambulatory surgery,safety always comes first.The system of ambulatory surgery should be stric

关 键 词：日间手术 儿童 问卷调查 

分 类 号：R726[医药卫生—儿科]