白内障日间手术模式的探讨

Exploration the mode of the daytime operation in patients with cataract

目的：探讨白内障日间手术和住院手术两种模式的差异,为临床白内障手术选择最优的方式提供依据。方法将2014年8—12月在南京医科大学第一附属医院眼科就诊并拟行手术的200例白内障患者按手术模式分为对照组和观察组,每组100例,对照组采取常规住院手术模式,观察组采取日间手术模式,比较两组的住院天数、医疗总费用、并发症发生率、治疗效果和满意度。结果观察组住院天数均为1 d,医疗总费用为（7100±80）元,低于对照组的（5±0.3）d,（8150±120）元,差异有统计学意义（t值分别为8.376,6.529；P〈0.05）。对照组并发症发生率为6.0%,观察组为5.0%,两组比较差异无统计学意义（χ^20.096,P=0.756）。术后1周复查,对照组视力恢复至0.5以上患者比例为89.0%,观察组比例为87.0%；术后1个月对照组视力恢复至0.5以上患者比例为97.0%,观察组为96.0%,差异均无统计学意义（χ^2分别为0.189,0.148；P 〉0.05）。观察组与对照组满意度分别为98.0%,91.0%,观察组高于对照组,差异有统计学意义（χ^24.714,P〈0.05）。结论白内障选择日间手术的模式,能有效提高床位周转率,缩短住院天数,降低医疗费用,简化就医流程,满足患者快捷、经济、实用的护理要求,缓解医患矛盾。

Objective To explore the differences between daytime and hospitalization cataract surgery and provide the basis for selection of optimal way. Methods We chose 200 surgery patients with cataract in the First Affiliated Hospital of Nanjing Medical University from August 2014 to December 2014 and randomly divided them into control group （100 cases, regular hospitalization surgery） and observation group （100 cases, daytime surgery） . Then, we compared the hospitalization days, medical expenses, incidence of complication, treatment effects and patients′ satisfaction. Results There was one day for hospitalization and （ 7 100 ± 80 ） yuan for medical expense in the observation group lower than these in the control group [（5 ± 0. 3） d,8 150 yuan], and the differences were statistically significant （t=8. 376, 6. 529; P〈0. 05）. At one week and one month after operation, the proportions of patients whose vision recovered to over 5. 0 were 89. 0% and 97. 0% in the observation compared with those in the control group（87. 0%,96. 0%）, and there were no significant differences （χ^2=0. 189, 0. 148;P〉0. 05）. The satisfaction was 98. 0% in the observation group higher than that in the control group （χ^2=4. 714,P〈0. 05）. Conclusions Daytime cataract surgery can improve the bed turnover rate, shorten the hospitalization days, reduce the medical expenses, simplify the medical treatment process, meet the patient′s needs for fast, economical and practical nursing, and ease the medical disputes.