腹腔镜微创手术对普外科平均住院日影响的研究

Study on the Effect of laparoscopic minimal invasive operation on the average length of stay in patients of general surgery

目的:为了评价微创技术在普外科应用对缩短平均住院日及降低成本和医疗费用的作用。方法:回顾性分析我院普外科从2000年至20008年6月的住院患者病例数据。结果:2000～2008年6月我院普外科的平均住院日从15.01天下降为7.39天。腹腔镜胆囊切除平均住院日由7.41天降为3.10天,腹腔镜胆囊切除患者的费用由2005年的10736.79元下降为2008年6月的7426.13元。腹腔镜结直肠癌手术的平均住院日腹腔镜组较开腹组相比下降3.1天;手术的高危患者比率增加;腹腔镜组总并发症的发生率降低;同时腹腔镜组较开腹组的护理时间减少486分钟。结论:通过流程改造和新技术的广泛使用,缩短了平均住院日,降低了医疗费用。

Objectives： To evaluate the effect of minimal invasive surgery in shortening the average length of stay, savingmedical costs and improving medical efficiency. Methods： The data of patients in our hospital from January 2000 to June 2008 werecollected and analyzed retrospectively. Results： The average length of stay was 15.01 days in 2000, and this was reduced to 7.39 days in the first half of 2008.The average stay of patients of laparoscopic cholecystectomy was reduced from 7.4 1days to 3.10 days in the same time. The total medical costs of patients who received laparoscopic cholecystectomy was 10736.79 RMB in2005, and this was 7426.13 RMB in the first six months in 2008.The average length of stay in laparoscopic colorectal surgery was3.1 days shorter than that in open surgery. With the increase of proportion of patients with high risk, the rate of complicationwas lower in laparoscopic colorectal surgery than in open surgery. The care time in laparoscopic colorectal surgery was 484mshorter than that in open surgery. Conclusions： Process reengineering and widely using of new medical technology can reduce theaverage length of stay and save medical costs.