加速康复外科诊疗模式实践的效果及影响因素  

Effect and influencing factors of practice of enhanced recovery after surgery diagnosis and treatment model

作　　者：文政伟[1] 张冠荣[1] 吴粤[1] 袁向东[1] WEN Zhengwei;ZHANG Guanrong;WU Yue;YUAN Xiangdong(Guangdong Provincial People′s Hospital/Guangdong Academy of Medical Sciences,Guangzhou 510080,China)

机构地区：[1]广东省人民医院(广东省医学科学院),广州510080

出　　处：《实用医学杂志》2021年第11期1499-1503,共5页The Journal of Practical Medicine

摘　　要：目的梳理某三甲医院推广加速康复外科(ERAS)的工作经验,分析ERAS对患者治疗结局的影响。方法描述性分析全面推进ERAS的实施过程,纵向和横向比较分析2018-2019年全面实施ERAS前后手术患者平均住院时间、次均住院费用及构成和手术并发症等指标的变化情况。结果总体而言,ERAS术种患者的平均住院时间、费用和手术并发症发生率均较ERAS实施前明显下降,同比分别减少0.7 d、1.2%和41.5%;在12个代表性术种中,与2018、2019年非ERAS患者相比,ERAS患者的平均住院时间、次均住院费用、药品费用、耗材费用和手术并发症发生率均显著降低。结论推广ERAS诊疗模式可缩短手术患者住院时长、降低医疗费用和手术并发症,有利用于医院经济效益和社会效益的提升。Objective To review the experience of enhanced recovery after surgery(ERAS)in a tertiary hospital,and to analyze the influence factors of ERAS on treatment outcome of patients.Methods Descriptive analyses of the overall implementation process of ERAS,longitudinal and horizontal comparative analyses of the changes of the average hospitalization days,average hospitalization costs in composition and operative complica⁃tions of patients before and after the full implementation of ERAS from 2018 to 2019.Results Overall,the average hospitalization days,costs and the incidence of operative complications of patients with ERAS were significantly lower than those before the implementation of ERAS,which were decreased by 0.7 days,1.2%and 41.5%,respec⁃tively.Among the 12 representative types of operations,compared with non⁃ERAS patients in 2018 and 2019,the hospitalization days of stay,average hospitalization costs,drug costs,consumable materials and the incidence of surgical complications of ERAS patients were significantly lower than those of non⁃ERAS patients in 2018 and 2019.Conclusion The promotion of ERAS diagnosis and treatment mode can shorten the hospitalization days of surgical patients,reduce medical expenses and operative complications,and be beneficial to the improvement of economic and social benefits of the hospital.

关 键 词：加速康复外科 公共卫生 效果评价 影响因素 

分 类 号：R-1[医药卫生]