按疾病诊断相关分组付费下两种不同胸腔镜手术在自发性气胸病人的临床效果比较  

Comparison of clinical effects of two different thoracoscopic surgery under DRGs in patients with spontaneous pneumothorax

作　　者：邵广强 庞大志 张吉天 刘智海 刘茹太洋 王红霞 SHAO Guangqiang;PANG Dazhi;ZHANG Jitian(Department of Thoracic Surgery,the University of Hong Kong-Shenzhen Hospital,Shenzhen 518000,China)

机构地区：[1]香港大学深圳医院胸外科,518000 [2]香港大学深圳医院呼吸内科,518000

出　　处：《临床外科杂志》2022年第7期644-647,共4页Journal of Clinical Surgery

基　　金：广州呼吸健康研究院何建行教授胸部肿瘤和胸部外科团队(SZSM202011002)。

摘　　要：目的探讨按疾病诊断相关分组(DRGs)付费下两种不同胸腔镜手术在自发性气胸病人的临床效果。方法2014年4月1日~2020年5月30日我院胸外科就诊断原发性气胸病人120例,均行胸腔镜手术,其中按照术中是否应用低成本胸腔镜手术方法分为低成本组及常规组。分别统计两组病人手术需要的时间、术后胸腔引流管留置时间、术后住院时间、手术及相关耗材合计费用、住院总费用、术后并发症发生率及气胸复发率等指标。结果所有病人均顺利完成手术,无死亡或者严重并发症病例。试验组及对照组的住院总费用比较,差异有统计学意义(P<0.05),平均值及IQR值为分别为12998元(10645,14427元)和32121元(25383,33152元);手术及相关耗材费比较差异有统计学意义(P<0.05),平均值及IQR值分别为为8104元(6430,7247元)和26158元(20492,27256元)。两组术后并发症及气胸复发例数比较,差异无统计学意义(P>0.05)。结论低成本胸腔镜手术治疗自发性气胸临床应用安全、可行,对比常规胸腔镜手术组,能够降低费用。Objective To investigate and compare the clinical effects of two different thoracoscopic surgery under DRGs in patients with spontaneous pneumothorax.Methods From April 1,2014 to May 30,2020,120 patients with primary pneumothorax who underwent thoracoscopic surgery in the Department of thoracic surgery,Hong Kong University-Shenzhen Hospital.All patients underwent thoracoscopic surgery.They were divided into low-cost group and conventional group according to whether low-cost thoracoscopic surgery was used or not during the operation.The time required for surgery,postoperative thoracic drainage tube indwelling time,postoperative hospitalization days,total cost of surgery and related consumables,total hospitalization costs,postoperative complications and recurrence rate of pneumothorax were calculated respectively.Results All patients successfully completed the operation without death or serious complications.The comparison of total hospitalization cost between experimental group and control group showed significant difference(P<0.05),The average and IQR values were 12998 yuan(10645,14427 yuan)versus 32121 yuan(25383,33152 yuan).There were significant differences in the cost of operation and related consumables(P<0.05).The average and IQR value was 8104 yuan(6430,7247 yuan)to 26158 yuan(20492,27256 yuan).There was no significant difference in the number of postoperative complications and pneumothorax recurrence between the two groups(P>0.05).Conclusion The clinical application of low-cost VATS in the treatment of spontaneous pneumothorax is safe and feasible.Compared with the conventional VATS group,it can significantly reduce the cost of patients.

关 键 词：低成本胸腔镜手术 缠绕式高张力打结法 结扎 气胸 肺大疱 

分 类 号：R655[医药卫生—外科学]