乳腺癌全麻日间手术管理模式的临床及社会价值  

Clinical and Social Value of Day Surgery for Breast Cancer

作　　者：郭丝锦 樊菁 张聚良 李南林 易军 黄美玲 王廷 凌瑞 Guo Sijin;Fan Jing;Zhang Juliang(Xijing Hospital,The Air Force Medical University,Xi’an,Shaanxi,710032,China;不详)

机构地区：[1]空军军医大学西京医院,陕西西安710032

出　　处：《中国医院管理》2023年第4期57-61,共5页Chinese Hospital Management

基　　金：国家自然科学基金项目(81572917);国家重点研发计划(2016YFC0901304)。

摘　　要：目的评价乳腺癌日间手术的可行性与安全性。方法纳入2017年1月—2021年3月在医院接受乳腺手术的5550名患者,分为日间手术组及常规手术组。比对两组患者术后恢复、依从性、满意度和接受度、成本—效果分析、心理等方面。结果日间手术组患者手术前后平均住院日明显短于常规手术组,日间手术组患者术后患肢恢复优于对照组,术后明显疼痛人数少于常规手术组。两组患者在淋巴水肿中发现差异有统计学意义(P=0.012)。超过95%的日间手术患者按计划出院,有72例转为常规手术,有6例计划外再入院,与对照组相似。日间手术效果比明显低于对照组,增量成本—效果比为3718.96。日间手术患者的焦虑和抑郁明显降低。98.5%的患者对日间模式满意,超过90%的患者认为乳腺日间模式缩短了住院时间,对后续治疗无不良影响。结论乳腺癌日间手术模式安全、可行,在不增加再入院率以及并发症的前提下,可明显缩短住院时间,提高社会经济效益。Objective To evaluate the feasibility and safety of day surgery for breast cancer.Methods A total of 5550 patients who underwent breast surgery in hospital from January 2017 to March 2021 were included and divided into day surgery group and conventional surgery group.Postoperative recovery,compliance,satisfaction and acceptance,cost-effectiveness analysis,and psychology were compared between the two groups.Results The average length of hospital stay before and after operation in the day surgery group was significantly shorter than that in the conventional surgery group.The recovery of the affected limb in the day surgery group was better than that in the control group,and the number of patients with obvious postoperative pain was less than that in the conventional surgery group.Significant differences were found between the two groups in lymphedema(P=0.012).More than 95%of the day surgery patients were discharged as planned,72 were converted to conventional surgery,and 6 had unplanned readmissions,similar to the control group.The day to day surgery effect ratio was significantly lower than the control group,and the incremental cost-effectiveness ratio was 3718.96.Anxiety and depression were statistically significantly lower in day surgery patients.98.5%of patients were satisfied with the daytime pattern and over 90%believed that the breast daytime pattern shortens the length of hospital stay and has no adverse effect on subsequent treatment.Conclusion Day surgery for breast cancer is safe and feasible,and can significantly shorten the length of hospital stay and improve social and economic benefits without increasing the readmission rate and complications.

关 键 词：乳腺癌 全麻日间手术 常规手术 可行性 安全性 个性化护理 

分 类 号：R197.323.2[医药卫生—卫生事业管理]