摘要
目的探索乳腺微创旋切术(Mammotome minimally invasive operation,MMT)日归手术模式在日间手术中心临床应用中的可行性,总结开展日归手术模式的管理要点。方法纳入2019年6月1日—12月31日在四川大学华西医院行MMT的女性患者。根据患者手术模式分为日归组(行日归手术)和常规组(常规日间手术模式)。分析患者的围手术期资料。结果共纳入女性患者1297例。其中,日归组571例,常规组726例。两组在术前一般资料、术中出血量、手术时间及并发症发生率上比较,差异均无统计学意义(P>0.05);在肿块数量(χ^(2)=13.384,P<0.001)、病理分型(χ^(2)=11.990,P=0.007)、术式(χ^(2)=89.185,P<0.001)上比较,差异均有统计学意义。日归组住院时间短于常规组(Z=–29.746,P<0.001);日归组在病理活检费(Z=–8.549,P<0.001)、手术器械费(Z=–9.564,P<0.001)及住院总费用(Z=–10.378,P<0.001)上均少于常规组;此外,广义估计方程结果显示日归组术后疼痛评分低于常规组,差异有统计学意义(P<0.001)。结论MMT日归手术模式安全可行且具有高时间经济效益,值得日间手术中心推行,围手术期应保证医疗安全并重视高质量的健康宣教。
Objective To explore the utility and advantage of same-day surgery mode of Mammotome minimally invasive operation(MMT)in ambulatory surgery center,and summarize the key points of clinical management.Methods Female patients who underwent MMT in West China Hospital of Sichuan University between June and December 2019 were included.According to the operation mode,the patients were divided into same-day surgery group and routine group(routine day operation).The perioperative data were analyzed.Results A total of 1297 female patients were included.Among them,571 cases were in the same-day surgery group and 726 cases were in the routine group.There was no significant difference in baseline data,intra-operative bleeding volume,operation time,or complication rate between the two groups(P>0.05).There were significant differences in the number of masses(χ^(2)=13.384,P<0.001),pathological type(χ^(2)=11.990,P=0.007)and operation method(χ^(2)=89.185,P<0.001).The length of hospital stay in the same-day surgery group was significantly shorter than that in the routine group(Z=–29.746,P<0.001);the cost of biopsy(Z=–8.549,P<0.001),the cost of surgical instruments(Z=–9.564,P<0.001),and the total cost of hospitalization(Z=–10.378,P<0.001)in the same-day surgery group were less than those in the routine group.In addition,the result of generalized estimating equation showed that the postoperative pain scores of patients in the sameday surgery group were lower than those in the routine group(P<0.001).Conclusions The same-day surgery mode of MMT is safe and feasible with high time economic benefits,which is worthy promoting in ambulatory surgery center.Cautions should addressed with patients’safe and high-quality health education.
作者
王煜
刘洋
马洪升
戴燕
WANG Yu;LIU Yang;MA Hongsheng;DAI Yan(Day Surgery Center,West China Hospital,Sichuan University/West China School of Nursing,Sichuan University,Chengdu,Sichuan 610041,P.R.China;Day Surgery Center,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China)
出处
《华西医学》
CAS
2021年第2期178-182,共5页
West China Medical Journal
基金
国家自然科学基金(71804118)
四川省科学技术厅项目(2018ZR0129)。
关键词
乳腺微创旋切术
日间手术
应用
Mammotome minimally invasive operation
Ambulatory surgery
Application
