腹腔镜腹股沟疝修补术日间手术模式的临床效益评价

Clinical benefits analysis of day surgery for laparoscopic inguinal herniorrhaphy

目的比较日间手术模式和住院手术模式在腹腔镜腹股沟疝修补术的临床效益。方法选取2017年1~12月昆明医科大学第二附属医院就诊的120例单侧腹股沟疝患者作为研究对象。将所有患者按照随机数字表法随机分成日间手术模式组和住院手术模式组,各60例。观察2组患者的手术时间、术中出血量、术后下床活动时间、尿潴留发生率、阴囊积液发生率、异物感发生率、总并发症发生率、医疗费用及满意度。结果所有患者均顺利完成手术,半年随访期内无复发。日间手术模式组与住院手术模式组患者的手术时间、术中出血量、术后下床活动时间、尿潴留发生率、阴囊积液发生率、异物感发生率、总并发症发生率比较,差异均无统计学意义(P>0.05)。日间手术组患者住院时间要明显比住院手术组患者短,日间手术组患者总住院费比住院手术组患者低,日间手术组患者对治疗过程满意程度明显高于对照组患者,差异均有统计学意义(P<0.05)。结论日间手术模式下行腹腔镜腹股沟疝修补术安全有效,且可降低总费用,加快周转率,提高了医疗资源的利用率,提高了患者的满意度。

Objective To compare the clinical benefits of laparoscopic inguinal herniorrhaphy between day surgery mode and inpatient surgery mode.Methods A total of 120 cases of unilateral inguinal hernia who treated in Second Affiliated Hospital of Kunming Medical University from January 2017 to December 2017 were collected prospectively,and they were randomly divided into 2 groups:day surgery group(60 cases)and inpatient surgery group(60 cases).The operative time,blood loss,postoperative ambulation time,incidence of urinary retention,incidence of scrotal effusion,incidence of foreign body sensation,incidence of total complications,medical expenses and satisfaction between the two groups were compared.Results The operation was successfully completed in both groups.No recurrence was found during 6 months follow-up.There were no significant differences in operation time,intraoperative bleeding volume,postoperative ambulation time,incidence of urinary retention,incidence of scrotal effusion,incidence of foreign body sensation,and incidence of total complications between the two groups(P>0.05).However,the duration of hospitalization in the day surgery group was shorter than that in the inpatient surgery group(P<0.05).The total cost of hospitalization in the day surgery group was lower than that in the inpatient surgery group(P<0.05),and the score of satisfaction in the day surgery group was significantly better than that in the inpatient surgery group(P<0.05).Conclusion Laparoscopic inguinal herniorrhaphy in the day surgery mode is safe and effective,and can reduce the total cost,speed up turnover rate,improve the utilization of medical resources,and improve patient satisfaction.