摘要
目的探讨在全腔镜皮下腺体切除术治疗男性乳腺发育症中优化手术操作程序对其手术效果的影响。方法回顾性收集了2014年1月至2017年3月期间在成都市第三人民医院行全腔镜皮下腺体切除治疗的男性乳腺发育症患者217例,根据是否优化了手术操作程序(以2015年4月1日为界)分为优化组和未优化组,2015年4月1日以前的患者未优化,以后的患者实施了手术操作程序优化。利用倾向评分匹配的方法,根据年龄、体质量指数及乳房大小行1∶1配对,比较2组患者的手术时间、术后住院时间、治疗费用及患者自评的美容效果。结果共配对47对,匹配后2组患者一般临床资料比较差异均无统计学意义(P>0.05)。优化组患者的手术时间、术后住院时间及住院费用明显短或少于未优化组,分别为(139.90±37.18)min比(175.20±46.99)min(P=0.002)、(7.13±1.46)d比(8.47±2.71)d(P=0.021)及(11 426.80±1 861.19)元比(12 315.75±1 306.64)元(P=0.036),优化组患者术后1周时的外观效果满意度评分明显高于未优化组[(7.33±1.16)分比(5.97±1.16)分(P<0.001)]。结论在全腔镜皮下腺体切除术治疗男性乳腺发育症中优化手术操作程序可缩短手术时间、减少治疗费用及提高患者满意度。
Objective To investigate effect of optimizing operation procedure （OOP） on surgical outcomes of complete endoscopic subcutaneous mastectomy （CESM） in treatment of gynecomastia. Methods A total of 217 patients with gynecomastia underwent CESM from January 2014 to March 2017 in the Third People＇s Hospital of Chengdu were collected according to the criteria for inclusion and exclusion, further, based on a propensity score-matching model, a total of 94 patients were evenly assigned to OOP group （April 2015 later） and non-OOP group （before April 2015）. The CESM with or without OOP was performed in the OOP group or the non-OOP group, respectively. The operative time, postoperative length of stay, treatment expenses, and favorable cosmetic effect were compared in these two groups. Results The differences in the general clinical data in both groups were not statistically significant （P〉0.05）. The operative time （min） was shorter （139.90±37.18 versus 175.20±46.99, P=0.002）, the postoperative length of stay （d） was shorter too （7.13±1.46 versus 8.47±2.71, P=0.021）, and the treatment expenses （yuan） were more less （11 426.80± 1 861.19 versus 12 315.75±1 306.64, P=0.036） in the OOP group as compared with the non-OOP group. Meanwhile the favorable cosmetic effect of the self-evaluation score in the OOP group was significantly higher than that in the non-OOP group （7.33＋1.16 versus 5.97±1.16, P〈0.05）. Conclusion This study demonstrates that using optimizing standard CESM could shorten operative time, reduce treatment expenses, and improve satisfaction of patients.
出处
《中国普外基础与临床杂志》
CAS
2018年第3期334-337,共4页
Chinese Journal of Bases and Clinics In General Surgery
