基于加速康复外科理念的乳腺良性肿瘤日间手术临床路径探索

Clinical Pathway of Ambulatory Surgery for Benign Breast Tumors Based on the Concept of Enhanced Recovery after Surgery

目的探讨基于加速康复外科理念的乳腺良性肿瘤日间手术临床路径措施及效果。方法将2018年11月-2019年8月收治的120例基于ERAS临床路径体系的乳腺良性肿瘤日间手术病例作为ERAS临床路径组,将2018年1月-10月收治的126例传统手术病例作为对照组,分析两组患者在平均住院时间、术前住院时间、手术时间、术中出血量、住院费用、床位周转次数、非计划二次手术例数、患者满意度等指标的差异。结果ERAS临床路径组与对照组的手术时间与术中出血量差异无统计学意义(P>0.05);但平均住院时间、术前住院时间、住院费用、非计划二次手术例数显著低于对照组(P<0.05),床位周转次数、患者满意度显著高于对照组(P<0.05)。结论相比传统临床路径,基于加速康复外科理念的日间手术临床路径模式更有利于日间手术患者的术后康复,进而提升医疗质量水平,提高患者满意度。

Objective To explore the measures and effect of the clinical pathway of ambulatory surgery for benign breast tumor based on the concept of enhanced recovery after surgery(ERAS).Methods A total of 120 patients admitted from November 2018 to August 2019 who underwent ambulatory surgery for benign breast tumors based on the ERAS clinical pathway system were selected as the ERAS clinical pathway group,and 126 patients admitted from January 2018 to October 2018 who underwent traditional surgery were selected as the control group.The differences in average length of stay,preoperative length of stay,operative time,intraoperative blood loss,hospitalization cost,number of bed turnover,unplanned secondary operations,patient satisfaction and other indicators between the two groups were analyzed.Results There was no statistically significant difference on the operation time and intraoperative blood loss between the clinical pathway group and the traditional surgery group(P>0.05).However,the average length of stay,preoperative length of stay,hospitalization expenses and the number of unplanned secondary operations of the clinical pathway group were significantly lower than those of the control group,the number of beds tornover and patient satisfaction was significantly higher than that of the control group(P<0.05).Conclusion Compared with the traditional clinical pathway,the clinical pathway model of ambulatory surgery with the concept of ERAS is more beneficial to the postoperative recovery of patients undergoing ambulatory surgery,which improves the level of medical quality,improves patient satisfaction.