非住院患者手术后转归评估方法的系统回顾

背景鉴于非住院手术的死亡率和并发症发生率都很低，因此应该将患者的生活质量（比如出院后恢复日常活动的能力）作为非住院手术和麻醉的终极评估指标。本文对非住院患者手术后恢复质量的各种评估方法进行了系统回顾，旨在为科研和麻醉质量控制评估方法的恰当选择提供指导。方法由MEDLINE，EMBASE，CINAHL，HAPI，PsyclNFO，科学探索史网站，Biosys Previews Search，Health Star和ASSIA数据库中系统检索文献，筛选出有关评估非住院患者手术和麻醉后恢复情况与转归的文献。从适宜性、可靠性、有效性、应答性、准确性、可解释性、可接受性和可行性8个方面对这些文献进行评估。结果有7篇文献符合本综述的入选标准。各评估方法的质量不尽相同。结论只有一种评价方法，即40项手术后恢复质量评分表，能够完全符合8个方面的要求，但是该方法并非专门为非住院手术和麻醉所设计。

BACKGROUND： Mortality and morbidity in ambulatory surgery are rare, and thus the patient＇s quality of life （i. e., the ability to resume normal activities after discharge home） should be considered one of the principle end-points after ambulatory surgery and anesthesia. We conducted a systematic review of the instruments to measure the quality of recovery of ambulatory surgical patients in order to advise on the selection of appropriate measures for research and quality assurance. METHODS： A systematic literature search of MEDLINE, EMBASE, CINAHL, HAPI, PsycINFO, Web of Science Search History, Biosys Previews Search, HealthStar, and ASSIA was performed to identify patient-based outcome measures to assess postoperative recovery from ambulatory anesthesia. The instruments were assessed for eight criteria： appropriateness, reliability, validity, responsiveness, precision, interpretability, acceptability, and feasibility. RESULTS： Seven articles met the inclusion criteria set for the review. The quality of the identified instruments was variable. CONCLUSIONS： Only one instrument, 40-item Quality of recovery score, fulfilled all eight criteria, however this instrument was not specifically designed for ambulatory surgery and anesthesia.