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小儿日间手术安全性分析 被引量:5

Safety analysis of pediatric day surgery
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摘要 目的探讨小儿日间手术的安全性。方法回顾性分析武汉儿童医院2001年1月至2019年12月集中收治管理模式下日间手术患儿的临床病例资料,出院后常规5次电话随访(随访过程中发现患儿出现异常情况或者并发症,增加随访次数,延长随访时间,直到患儿康复),通过分析术后并发症、病死率、非计划再手术、延迟出院、非计划再住院等指标评价小儿日间手术的安全性。结果集中管理模式下129869例小儿日间手术患儿,无严重并发症及死亡病例。14991例患儿术后出现不适症状,发生率为11.54%(14991/129869),伤口疼痛率为10.40%(13506/129869),手术后恶心呕吐发生率为0.37%(481/129869),术后常见并发症发生率为0.77%(1004/129869),其中发热发生率为0.39%,切口感染发生率为0.09%,切口出血发生率为0.06%,阴囊血肿发生率为0.13%,术后复发发生率为0.11%;延迟出院率为0.01%(16/129869);非计划再手术率为0.0008%(1/129869);非计划再住院率为0.02%(30/129869)。结论日间手术执行与传统住院手术同质化的围手术期管理制度,结合日间手术工作中严格的"三个准入"、"三个评估"标准、合理的住院留观时间、规范的出院随访和健康教育、快速康复外科理念的融入、建立健全的日间手术保障体系等,小儿日间手术模式是一种安全、可靠的手术模式。 Objective To explore the safety of pediatric day surgery.Methods Retrospective analysis was performed for clinical data of children undergoing day surgery from January 2001 to December 2019.Five routine telephone follow-ups were conducted after discharge.If there were abnormal conditions or complications,more follow-ups continued until a final recovery.The safety of pediatric day surgery was evaluated by analyzing postoperative complications,mortality,unplanned reoperation,delayed discharge,unplanned re-hospitalization and other indicators.Results A total of 129869 cases of day surgery were performed without mortality or other serious complications.There were 11.54%(14991/129869)cases with postoperative discomforts.Rate of wound pain was 10.40%(13506/129869),rate of postoperative nausea/vomiting 0.37%(481/129869)and incidence of common postoperative complications 0.77%(1004/129869).Rate of fever rate was 0.39%,rate of wound infection 0.09%,rate of wound bleeding 0.06%,rate of scrotum hematoma 0.13%and rate of postoperative recurrence 0.11%.And rate of delayed discharge was 0.01%(16/129869),rate of unplanned reoperation 0.0008%(1/129869)and rate of unplanned rehospitalization 0.02%(30/129869).Conclusions Under the perioperative management system plus strict standards of"Three Admissions"and"Three Assessments",reasonable inhospital observations,standard discharge follow-ups,health education,integrated concept of rapid rehabilitation surgery and establishing a sound guarantee system contribute to safety and reliability of pediatric day surgery.
作者 马敬伟 卞红强 段栩飞 王育继 刘希明 Ma Jingwei;Bian Hongqaing;Duan Xufei;Wang Yuji;Liu Ximing(Wuhan Children's Hospital(Wuhan Maternal&Children's Healthcare Center),Tongji Medical College,Huazhong University of Science&Technology,Wuhan 430016,China)
出处 《中华小儿外科杂志》 CSCD 北大核心 2020年第8期704-709,共6页 Chinese Journal of Pediatric Surgery
关键词 日间手术 手术后并发症 儿童 Ambulatory surgery Postoperative complications Child
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