日间手术在膝关节置换术中的实践:一项关于成本效益与术后疗效的研究  

Daytime surgery in knee replacement:A study of cost-effectiveness and postoperative outcomes

作　　者：文鹏飞 刘林 杨明义 杨鹏 南凯 张伪松 杨治 许鹏 Wen Pengfei;Liu Lin;Yang Minyi;Yang Peng;Nan Kai;Zhang Weisong;Yang Zhi;Xu Peng(Department of Joint Surgery,Honghui Hospital,Xi'an Jiaotong University,Xi'an Shaanxi,710054,China)

机构地区：[1]西安市红会医院关节外科,陕西西安710054

出　　处：《生物骨科材料与临床研究》2025年第2期30-34,共5页Orthopaedic Biomechanics Materials and Clinical Study

基　　金：西安市卫生健康委员会青年培育项目(2023qn17);陕西省重点研发计划项目社会发展领域(2023-YBSF‑099)。

摘　　要：目的通过临床数据分析,对比日间手术与传统住院手术在膝关节置换手术中的早期疗效、成本效益和安全性。方法回顾性分析2023年6月至2023年12月于西安市红会医院因膝关节骨关节炎行初次膝关节置换手术的患者资料,其中日间手术组患者112例,常规住院组患者444例。收集患者的信息进行统计分析,包括一般资料,日间手术失败情况,患者的住院天数,住院费用,患者术前、术后3个月的疼痛视觉模拟评分与美国特种外科医院膝关节功能评分,以及90 d内再次住院情况。结果共有5例参与日间手术的患者转为常规住院治疗,失败率为4.3%。日间手术组的术前等待时间、术后住院时间及总住院时间均显著低于常规住院组患者(P<0.05)。在住院总费用方面,日间手术组显著低于常规住院组,平均可节省4247元,差异具有统计学意义(P<0.05)。在术后短期随访中,两组患者的VAS评分和HSS评分比较,差异无统计学意义(P>0.05)。日间手术组再入院率为1.8%,常规住院组为1.4%,两组间比较差异无统计学意义(P>0.05)。结论日间膝关节置换可缩短住院时间,降低患者住院医疗成本,且与常规住院行膝关节置换有着一致的疗效和安全性。Objective To compare the early efficacy,cost-effectiveness,and safety of daytime surgery with traditional inpatient surgery for knee replacement by clinical data analysis.Methods A retrospective analysis was conducted on patients who underwent primary knee replacement for knee osteoarthritis at the Xi'an Honghui Hospital from June 2023 to December 2023.In this study,112 cases were daytime surgery patients and 444 cases were inpatients.Patient information was collected for statistical analysis,including general data,cases of failed day surgery,length of hospitalization,hospitalization costs,preoperative and postoperative 3-month visual analog scale pain scores(VAS)and Hospital for Special Surgery knee scores(HSS),as well as readmission rate within 90 days.Results A total of 5 patients who participated in daytime surgery were transferred to routine hospitalization treatment,with a failure rate of 4.3%.The preoperative waiting time,postoperative length of stay,and total hospital stay of patients were all significantly lower in daytime surgery group than in the routine inpatient group(P<0.05).Total hospital costs were significantly lower in the daytime surgery group than in the routine inpatient group,with an average savings of 4247 yuan(P<0.05).In the shortterm postoperative follow-up,there was no statistically significant difference in VAS and HSS scores between the two groups(P>0.05).The readmission rate was 1.8%in the daytime surgery group and 1.4%in the routine inpatient surgery group,with no statistically significant difference between the two groups(P>0.05).Conclusion Daytime knee replacement can shorten the hospital stay,reduce the inpatient medical costs for patients,and has consistent efficacy and safety compared with routine hospitalization for knee replacement.

关 键 词：日间手术 膝关节置换 快速康复 成本效益 住院时间 关节功能 

分 类 号：R687.4[医药卫生—骨科学]