日间手术开展远端型尿道下裂手术的可行性分析

Feasibility analysis of distal hypospadias during ambulatory surgery

目的探讨在我国开展远端型尿道下裂日间手术的有效性及可行性。方法回顾性分析广州市妇女儿童医疗中心2017年1月至2019年12月收治行日间手术的远端型尿道下裂患儿55例与同期住院手术的远端型尿道下裂患儿306例临床资料,收集患儿的年龄、手术时间、出血量、住院时间及费用、术后并发症等指标,评估两组间的差异。结果所有病例尿道口开口均位于阴茎体远端,两组手术年龄差异无统计学意义(P>0.05),手术时间、出血量、术后并发症差异亦无统计学意义(均P>0.05);与住院手术组相比,日间手术组住院时间缩短87%(P<0.05),住院费降低50.9%(P<0.05)。结论对远端型尿道下裂患儿行日间手术安全、有效,可缩短住院时间,减少医疗费用,提高医院床位的使用率和周转率,节约医疗成本,使国家、医院和患儿三方均获益,值得临床推广。

Objective To explore the effectiveness and feasibility of ambulatory surgery for distal hypospadias in China.Methods From January 2017 to December 2019,retrospective analysis was performed for 55 children with distal hypospadias undergoing ambulatory surgery and 306 children with distal hypospadias undergoing inpatient surgery.Age,operative duration,bleeding volume,length of hospital stay,expenditure,postoperative complications and other parameters were evaluated.Results No inter-group statistical difference existed in operative age(P>0.05).Urethral openings were located at the distal end of penis.No statistical differences existed in operative duration,bleeding volume or postoperative complications(P>0.05).As compared with inpatient surgery,length of hospital stay decreased by 87%(P<0.05)and hospitalization expenditure declined by 50.9%(P<0.05).Conclusions Both safe and effective for children with distal hypospadias,ambulatory surgery may shorten length of hospital stay,lower expenditure,improve the utilization/turnover rate of hospital beds and benefit all involved parties.It is worthy of wider clinical popularization.