2018例口腔颌面外科日间手术临床分析

Clinical analysis of 2018 cases of oral and maxillofacial ambulatory surgery

目的:总结中南大学湘雅医院口腔颌面外科开展日间手术的临床经验,探讨日间手术在口腔颌面外科的应用效果与安全性。方法:回顾分析2014年7月—2019年6月在中南大学湘雅医院日间手术中心进行治疗的所有口腔颌面外科患者的临床资料,包括患者年龄、性别、疾病名称、麻醉与手术方式或取消原因、住院时间、延期出院原因、术后并发症发生情况及医疗费用等。选取其中手术量最多的8种疾病,以普通住院病房为对照,比较同类型疾病平均住院时间与医疗费用的差异。采用SPSS 23.0软件包对数据进行统计学分析。结果:在纳入研究期间的5年内,中南大学湘雅医院共完成口腔颌面外科日间手术2018例,疾病类型以口腔颌面部软组织肿物、牙及颌骨病变、唾液腺疾病为主。患者年龄2~77岁,平均34.45岁,男女比例为6:4。手术取消率1.13%,术后并发症发生率0.64%,平均住院时间0.89 d,延迟出院率0.40%。与普通病房相比,同类型疾病住院时间与医疗费用均显著降低(P<0.05)。结论:口腔颌面外科能够实施日间手术的疾病类型多,患者依从性好,住院时间短,医疗资源利用率高。在规范管理的前提下,安全可行,值得进一步推广应用。

PURPOSE:To summarize the clinical experience of oral and maxillofacial ambulatory surgery in Xiangya Hospital,Central South University(CSU),and to explore its application value and safety.METHODS:A retrospective clinical study was conducted among patients who underwent oral and maxillofacial surgeries at Center of Ambulatory Surgery of Xiangya Hospital,CSU,from July 2014 to June 2019.The patients'data were analyzed,including age,gender,diagnosis,anesthesia type and surgical method or cancellation reason of operation,hospital stay,causes of delayed discharge,postoperative complications and medical expenses.Moreover,the top 8 diseases treated the most by ambulatory surgery were identified,and the data of hospital stay and medical expenses were analyzed and compared with those of patients with the same diseases from general inpatient ward.The differences between the groups were analyzed by two independent sample t test,and the data were analyzed with SPSS 23.0 software package.RESULTS:During this five-year study,in total 2018 cases of oral and maxillofacial ambulatory surgeries were performed.The major types of diseases were soft tissue neoplasms in oral and maxillofacial region,dental and jaw lesions and salivary gland diseases.The age of patients ranged from 2 to 77 years,with an average of 34.45 years.The ratio of male to female was 6:4.The operation cancellation rate was 1.13%,the incidence of complications was 0.64%,the average hospital stay was 0.89 days,and the delayed discharge rate was 0.40%.Compared to patients with the same diseases from the general ward,the hospital stay and medical expenses were significantly reduced(P<0.05).CONCLUSIONS:Varies types of oral and maxillofacial diseases can be treated by ambulatory surgey,with advantages such as favorable patient compliance,shorter hospitalization and high utilization rate of medical resources.On the premise of standardized management,oral and maxillofacial ambulatory surgery is safe and feasible,and it is worthy of further promotion and application.