COVID-19疫情防控常态化形势下门诊乳腺良性肿块麦默通手术的可行性分析

Feasibility analysis of mammotome operation for benign breast masses in outpatient department under the situation of normalization of prevention and control of COVID-19 epidemic

目的分析新型冠状病毒肺炎(COVID-19)疫情防控常态化形势下门诊乳腺良性肿块麦默通(MMT)手术的可行性。方法选取兰州市某三甲医院乳腺科2020年3月至6月收治的66例门诊乳腺良性肿块MMT手术患者为观察组,另选取同期41例住院乳腺良性肿块MMT手术患者为对照组。观察组采用门诊手术患者管理流程,对照组采用住院手术患者管理流程。比较两组的临床资料。结果107例乳腺良性肿块MMT手术患者均为女性、纤维腺瘤。两组的年龄、肿块大小、发病情况、基础疾病比较,差异无统计学意义(P>0.05)。两组的手术时间、术中出血量、术后并发症比较,差异无统计学意义(P>0.05);观察组的院内停留时间短于对照组,诊疗费用低于对照组,差异具有统计学意义(P<0.05)。两组术后血肿经医生指导按摩、热敷后明显好转。对照组陪护人员外出频次(9.66±4.21)次,观察组陪护人员外出频次0次。结论门诊乳腺良性肿块MMT手术具有安全性、可行性,简化了诊疗流程、缩短了患者院内停留时间、减少了医院人员流动量、降低了病区患者交叉感染率和术后感染率、降低了患者诊疗费用。对COVID-19疫情防控常态化形势下的院内疫情防控、基层医院医疗工作的正常开展均有积极作用。但本研究为小样本回顾性研究,有一定的局限性。

Objective To analyze the feasibility of mammotome(MMT)operation for benign breast masses in outpatient department under the situation of normalization of prevention and control of corona virus disease 2019(COVID-19).Methods Sixty-six MMT operation patients with benign breast masses admitted in outpatient department of a top three hospital in Lanzhou from March to June 2020 were selected as the observation group,and 41 MMT operation patients with benign breast masses in inpatients at the same period were selected as the control group.The observation group was treated with outpatient department operation management process,while the control group was treated with inpatient operation management process.The clinical data of the two groups were compared.Results All of 107 MMT operation patients with benign breast masses were female and fibroadenoma.There were no significant differences in age,tumor size,incidence and underlying diseases between the two groups(P>0.05).There were no significant differences in operation time,intraoperative blood loss and postoperative complications between the two groups(P>0.05);the length of stay in hospital of the observation group was shorter than that of the control group,and the cost of diagnosis and treatment was lower than that of the control group,and the differences were statistically significant(P<0.05).The hematoma in the two groups were significantly improved after massage and hot compress under the guidance of doctors.The frequency of the caregivers in the control group was(9.66±4.21),and that in the observation group was 0.Conclusion MMT operation for benign breast tumor in outpatient department is safe and feasible,which simplifies the diagnosis and treatment process,shorten the length of stay in hospital,reduces the flow of hospital personnel,reduces the cross infection rate and postoperative infection rate of patients in ward,and reduces the cost of diagnosis and treatment.It plays a positive role in the hospital epidemic prevention and control,and the normal development of medical work in primary hospital under the situation of normalization of prevention and control of COVID-19 epidemic.However,this study is a small sample retrospective study,which has some limitations.