日间腹腔镜胆囊切除术可行性研究

A feasibility study of day-case laparoscopic cholecystectomy

目的 探讨医院日间腹腔镜胆囊切除术的安全性和可行性。方法 选择2018年在我院行腹腔镜胆囊切除的患者40例,随机分配到日间腹腔镜胆囊切除术组(day-case laparoscopic cholecystectomy,DCLC)及常规腹腔镜胆囊切除术组(routine laparoscopic cholecystectomy,RLC),每组20例。所有患者均行腹腔镜胆囊切除术,DCLC组24h内出院,RLC组视患者术后恢复情况出院。观察比较两组患者疼痛评分、恶心呕吐评分、患者满意度评分及住院时间和住院费用。结果 两组患者术后皆无手术相关并发症。患者疼痛评分、恶心呕吐评分差异无统计学意义(P>0.05),DCLC组患者出院当天满意度评分高于RLC组,差异有统计学意义(P<0.05);而DCLC组住院时间和住院费用低于RLC组,差异有统计学意义(P<0.05)。结论 日间腹腔镜胆囊切除术安全、方便可行。不同医院应根据自己的医疗资源和管理经验,制定自己的日间腹腔镜胆囊切除术流程。

Objective To discuss the safety and feasibility of day-case laparoscopic cholecystectomy.Methods 40 patients underwent laparoscopic cholecystectomy in our hospital during 2018 were randomly assigned to day-case laparoscopic cholecystectomy group(DCLC)and routine laparoscopic cholecystectomy group(RLC).Each group included 20 cases.All patients underwent laparoscopic cholecystectomy.Patients in DCLC group were discharged within 24 hours,and RLC group were discharged by postoperative recovery of the patients.Visual analogue scale,nausea and vomiting score,patient satisfaction score,hospitalization time and hospitalization expense were compared between the two groups.Results There were no operative complications in both groups.There was no significant difference in VAS and PONV s core.T he s atisfaction s core o n t he d ay o f d ischarge o f D CLC g roup w as s ignificant h igher t han t hat of RLC group(P<0.05),and the hospitalization time and cost were significant lower than that of RLC group(P<0.05).Conclusion DCLC is safe,convenient and feasible.Different hospitals should make their own clinical pathway of DCLC according to their own surgical skill and clinical management experience.