摘要
目的比较静脉曲张日间手术和住院手术患者的术中指标、术后指标和经济成本,探究在中国大规模开展静脉曲张日间手术的安全性和效益性。方法回顾性收集2016年1月至2019年1月期间四川大学华西医院收治的下肢静脉曲张患者的临床资料,根据入院临床流程分为住院手术组和日间手术组,并采用倾向评分匹配法(PSM)进行匹配。比较2组患者的术中指标、术后指标和经济成本。结果共1806例静脉曲张患者进入研究,PSM匹配后2组各纳入患者502例。匹配后2组患者的性别、年龄、民族、婚姻状态、工作状态、居住地点、医保类型、美国麻醉医师协会分级、手术腿数和合并症(包括高血压、糖尿病、冠心病和呼吸系统疾病)比较差异均无统计学意义(P>0.05),具有可比性,基线一致。与住院手术组比较,日间手术组患者的住院时间短,术中输液量少,总费用、床位费、护理费、药物费、检查费、医保报销费用和自付费用均较低(P<0.05)。结论静脉曲张日间手术在保证了治疗安全性和疗效的同时,还能从一定程度上减少医保支付。
Objective To compare the intraoperative,postoperative indicators and economic costs of varicose veins patients between day surgery and inpatient surgery,and to explore the safety and benefit of large-scale varicose veins day surgery in China.Methods A retrospective study was conducted to collect varicose veins patients in West China Hospital of Sichuan University from January 2016 to January 2019.Patients were divided into the day surgery group and the inpatient surgery group,and the subjects were matched by the propensity score matching(PSM)method according to the basic characteristic data.Intraoperative and postoperative indicators and economic costs were compared between the two groups.Results A total of 1806 varicose vein patients were enrolled in the study,and 502 patients were enrolled in each of the two groups after PSM matching.After matching,there were no statistically significant differences in gender,age,nationality,marriage status,working status,residence,number of operative legs,medical insurance type,grade of American Society of Anesthesiologists,and complications(including hypertension,diabetes,coronary heart disease,and respiratory system diseases)between the two groups(P>0.05),which were comparable and the differences were not statistically significant.Compared with the inpatient surgery group,the day surgery group had shorter hospital stay,less intraoperative infusion volume,lower total cost,bed cost,nursing cost,drug cost,examination cost,medical insurance, and out-of-pocket (P<0.05). Conclusion The varicose veins day surgery is not only safe and effective, but also can reducethe medication insurance payment.
作者
黄明君
蒋静文
戴燕
马洪升
赵纪春
HUANG Mingjun;JIANG Jingwen;DAI Yan;MA Hongsheng;ZHAO Jichun(Day Surgery Center,West China Hospital,Sichuan University,Chengdu 610041,P.R.China;West China School of Nursing in Sichuan University,Chengdu 610041,P.R.China;Big Data Center,West China Hospital,Sichuan University,Chengdu 610041,P.R.China;Department of Vascular Surgery,West China Hospital,Sichuan University,Chengdu 610041,P.R.China)
出处
《中国普外基础与临床杂志》
CAS
2021年第1期58-62,共5页
Chinese Journal of Bases and Clinics In General Surgery
关键词
静脉曲张
日间手术
住院手术
倾向评分匹配法
varicose vein
day surgery
inpatient surgery
propensity score matching
