日间手术管理模式在达芬奇机器人手术治疗儿童动脉导管未闭中的临床应用  

Clinical application of the day surgery management model in the treatment of patent ductus arteriosus with Da Vinci robotic surgery in children

作　　者：刘喜旺[1] 范祥明 俞建根[1] 高强[1] 应力阳[1] Liu Xiwang;Fan Xiangming;Yu Jian′gen;Gao Qiang;Ying Liyang(Department of Cardiac Surgery,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心脏外科,国家儿童健康和疾病临床医学研究中心,杭州310052

出　　处：《中华实用儿科临床杂志》2025年第1期21-26,共6页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的探讨日间手术管理模式在达芬奇机器人手术治疗儿童动脉导管未闭中应用的可行性、实用性及安全性。方法非随机对照研究。回顾性收集2020年8月至2023年12月在浙江大学医学院附属儿童医院行达芬奇机器人手术治疗动脉导管未闭患儿的临床资料。根据患儿是否完成24 h内出院分为日间组和非日间组。采用t检验、χ^(2)检验比较2组患儿的一般临床资料、围术期并发症及预后;并对2组治疗效果进行满意度调查。结果共有276例患儿纳入本研究。患儿的中位年龄为34(6~154)个月;中位体重为13.5(6.2~63.2)kg;中位手术时间为45(23~90)min。其中日间组患儿135例,非日间组患儿141例。2组患儿的月龄分别为(43.7±30.8)个月比(42.4±30.2)个月,体重分别为(15.0±6.4)kg比(14.8±6.9)kg,差异均无统计学意义(均P>0.05)。2组患儿的围术期资料及围术期并发症发生率差异均无统计学意义(均P>0.05),但日间组患儿的住院时间明显少于非日间组患儿[(1.0±0)d比(2.5±0.9)d],差异有统计学意义(t=-20.993,P<0.001),并且日间组患儿的住院费用亦明显低于非日间组患儿[(5.08±0.11)万元比(5.35±0.39)万元,t=-10.040,P<0.001]。2组患儿家庭均对临床结果满意,且满意率调查差异无统计学意义(χ^(2)=0.501,P=0.479)。结论达芬奇机器人手术治疗儿童动脉导管未闭的日间手术管理模式是安全、可行的,在一定程度上减少了患儿的住院时间及治疗费用,减轻治疗负担。ObjectiveTo explore the feasibility,practicality,and safety of the day surgery management model for the treatment of patent ductus arteriosus with Da Vinci robotic surgery in children.MethodsA non-randomized controlled study was conducted.The clinical data of children with patent ductus arteriosus who underwent Da Vinci robotic surgery at Children′s Hospital,Zhejiang University School of Medicine from August 2020 to December 2023 were collected and retrospectively analyzed.The patients were divided into day surgery group and non-day surgery group according to whether they had discharged within 24 hours.t-test and Chi-square tests were used to compare the differences in clinical features,perioperative complications and prognosis between the two groups of patients.In addition,the satisfaction of the treatment effect was surveyed.ResultsA total of 276 children were included in this study,with an age ranging from 6 to 154 months with a median of 34 months.The weight ranged from 6.2 to 63.2 kilograms,with a median of 13.5 kilograms.The operation time ranged from 23 to 90 minutes,with a median of 45 minutes.One hundred and thirty-five patients underwent day surgery and 141 patients underwent non-day surgery.The average age and average weight of the patients in the day surgery and non-day surgery groups was(43.7±30.8)months vs.(42.4±30.2)months and(15.0±6.4)kg vs.(14.8±6.9)kg,respectively.There was no statistically significant difference in age and weight between the two groups(all P>0.05).There was no difference in perioperative data and incidence of perioperative complications between the two groups(all P>0.05).However,the length of hospital stay of the day surgery group was significantly shorter than that of the non-day surgery group[(1.0±0)days vs.(2.5±0.9)days,t=-20.993,P<0.001],and the hospitalization cost of the day surgery group was also significantly lower than that of the non-day surgery group[(50800±1100)yuan vs.(53500±3900)yuan,t=-10.040,P<0.001].Both families of the two groups were satisfied with

关 键 词：儿童 日间手术 达芬奇机器人手术 动脉导管未闭 

分 类 号：R726.5[医药卫生—儿科]