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泌尿系结石日间手术患者延迟出院的危险因素分析 被引量:5

Analysis of risk factors for delayed discharge of patients undergoing day surgery for urinary stones
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摘要 目的探讨泌尿系结石日间手术患者延迟出院的危险因素。方法回顾性分析广州医科大学附属第一医院泌尿外科2019年1—12月泌尿系结石日间手术的749名患者的电子病历资料,根据患者出院时间将其分为延迟出院组(71例)和正常出院组(678例),对2组患者的一般资料、术后1 h生命体征和常见血液学指标等进行比较,用logistic回归分析研究患者术后延迟出院的危险因素。结果泌尿系结石日间手术患者延迟出院的发生率为9.5%。Logistic回归分析显示年龄(OR=3.209,95%CI:1.621~6.352,P=0.001)、PCNL治疗(OR=2.212,95%CI:1.290~3.793,P=0.004)、体温(OR=4.363,95%CI:1.967~9.682,P<0.001)、中性粒细胞比率(neutrophil ratio,NEUT;OR=1.973,95%CI:1.156~3.370,P=0.013)、血红蛋白(hemoglobin,Hb;OR=2.776,95%CI:1.170~6.582,P=0.020)和血清钾(serum potassium,K^(+);OR=2.680,95%CI:1.162~6.177,P=0.021)是患者延迟出院的独立危险因素。结论高龄、行PCNL、术后1 h体温>38℃、NEUT>70%、Hb<90 g/L和低血钾的日间手术患者延迟出院风险增加,医护人员应重点关注并及时应对,以减少日间手术风险,提高其质量和安全性。 Objective To explore the risk factors delayed discharge of patients undergoing day surgery for urinary stones.Methods The electronic medical records of 749 patients undergoing day surgery for urinary stones in the First Affiliated Hospital of Guangzhou Medical University in 2019 were retrospectively collected.Patients were divided into delayed discharge group(71 cases)and normal discharge group(678 cases).The general data,1 hour postoperative vital signs and common hematological indexes were compared between the two groups.Logistic regression analysis was used to explore the risk factors of patients'delayed discharge.Results The incidence of delayed discharge of patients undergoing day surgery for urinary stones was 9.5%.Logistic regression analysis showed that age(OR=3.209,95%CI:1.621-6.352,P=0.001),PCNL treatment(OR=2.212,95%CI:1.290-3.793,P=0.004),temperature(OR=4.363,95%CI:1.967-9.682,P<0.001),neutrophil ratio(OR=1.973,95%CI,1.156-3.370,P=0.013),hemoglobin(OR=2.776,95%CI:1.170-6.582,P=0.020)and serum potassium(OR=2.680,95%CI:1.162-6.177,P=0.021)were independent risk factor for patients"delayed discharge.Conclusion Patients with advanced age,undergoing PCNL,1 hour postoperative temperature>38 ℃,neutrophil ratio>70%,hemoglobin<90 g/L and hypokalemia have an increased risk of delayed discharge.Medical workers should focus on and respond in time to reduce the risk of day surgery and improve their quality and safety.
作者 邱玲 刘春香 朱玮 钟文 郑玉玲 郝凤玲 QIU Ling;LIU Chun-xiang;ZHU Wei;ZHONG Wen;ZHEN Yu-ling;HAO Feng-ling(Department of Urology,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou,Guangdong 510230,China;不详)
出处 《中华全科医学》 2021年第8期1265-1268,共4页 Chinese Journal of General Practice
基金 国家自然科学基金青年基金项目(81800625)。
关键词 泌尿系结石 日间手术 延迟出院 生命体征 血液学指标 Urinary stones Day surgery Delayed discharge Vital signs Hematological indexes
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