心血管介入治疗患者日间手术管理模式的探讨

Application of day surgery management mode in patients with cardiovascular interventional treatment

目的探讨开展心血管介入治疗患者日间手术管理模式，评价日间手术的安全性，以及对平均住院日、住院平均费用的影响。方法2015年1月～2016年12月选择符合纳入标准的宁波市第一医院心血管内科择期行心血管介入治疗的患者1578例，使用随机数字表分为对照组和观察组，每组789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，比较两组手术的安全性、并发症、住院日和住院费用的差异。结果观察组住院天数均为1d，平均住院费用为3083元，而对照组的平均住院天数为（5．34±0．73）d，平均住院费用为（3713．70±21．06）元，均高于观察组，差异有统计学意义（P〈0．05）。对照组发生桡动脉穿刺处出血5例，前臂血肿9例，碘过敏反应1例，并发症发生率为1．9％；观察组发生桡动脉穿刺处出血3例，前臂血肿6例，碘过敏反应2例，并发症发生率为1．4％；两组比较差异无统计学意义（P〉0．05）。结论在心血管介入治疗患者中开展日间手术管理模式，能在保证手术疗效及患者安全的同时，缩短平均住院日，降低住院费用。

Objective To discuss the application of day surgery management mode in patients with cardiovascular interventional treatment, evaluate the safety of day surgery and its effects on the average inhospital days and expenses. Methods A total of 1 578 patients who received cardiovascular interventional therapy in the Department of Cardiology in Ningho First Hospital from January 2015 to December 2016 were included in the study. They were randomly divided into the observation group and the control group, 789 cases respectively. Patients in the control group received normal in-hospital operation mode, while patients in the observation group used day surgery mode. The safety, complications, average in-hospital days and expenses were compared between two groups. Results The average in-hospital days and expenses were 1 d and 3 083 Yuan in the observation group; in the control group, average in-hospital days and expenses were （5.34 ±0.73） d and （3 713.70 ± 21.06） Yuan, which were significantly higher than those in the observation group （P 〈 0.05）. There were 5 cases of bleeding in the puncture site of the radial artery, 9 eases of forearm hematoma, and 1 case of Iodine allergic reaction with a complication incidence of 1.9% in the control group. In the observation group, there were 3 cases of bleeding in the puncture site of the radial artery, 6 cases of forearm hematoma, and 2 cases of Iodine allergic reaction with a complication incidence of 1.4%. No significant difference in the complications of patients was observed between two groups （P 〉 0.05）. Conclusions The day surgery mode of patients with cardiovascular interventional treatment, which can ensure the therapeutic effect and the safety of patients, is feasible and can reduce the averaze in-hosoital days and exoenses.