日间手术模式在骨科四肢内固定取出术中的应用

Application of daytime operation mode in orthopedic internal fixation and removal of limbs

目的:探讨日间手术模式在骨科四肢骨折内固定取出手术中的应用效果。方法:选取采用日间手术模式开展的四肢骨折内固定取出术的患者157例为研究对象,统计其住院时间、住院费用、日间手术模式完成率、手术相关并发症发生率,并对出院时及术后3个月、末次随访视觉模拟评分(VAS)等进行研究分析。结果:其中156例顺利完成手术,平均住院时间为(28.56±10.15)h,平均住院费用为(5 072.89±1 279.91)元,1例因螺丝批不合适终止手术并退出日间手术,1例切口延迟愈合转为传统住院模式,日间手术完成率为98.72%,手术相关并发症发生率为1.27%。术后3个月的VAS评分优于出院时,末次随访VAS疼痛评分优于术后3个月,差异均有统计学意义(P<0.05)。结论:采用日间手术模式进行骨科四肢骨折内固定取出术安全、可靠,可缩短住院时间,降低住院费用,减轻患者负担,且有利于节约医疗资源。

Objective To explore the application of daytime surgery mode in orthopedics internal fixation removal surgery of limbs.Method 157 cases who had surgery to remove internal fixation of limbs were selected as the research object.The average time of hospitalization, the average hospitalization cost, the completion rate of daytime surgery mode, the incidence of surgery-related complications, the VAS score when discharged from hospital and 3 months after surgery, and the last VAS follow-up were studied and analyzed.Results 156 patients completed the operation with average hospital stay of(28.56±10.15) hours, the average hospitalization cost was(5 072.89±1 279.91) yuan.One patient terminated surgery and withdrew from daytime surgery mode because of the wrong screwdriver, and one delayed incision healing was converted to the traditional hospitalization mode.The daytime operation completion rate was 98.72% and incidence of surgery-related complications 1.27%.The VAS score was better at 3 months after surgery than those at postoperative time, and the VAS pain score at the last follow-up was better than that at 3 months after operation, both with statistically significant difference(P<0.05).Conclusion The internal fixation removal surgery of limbs in daytime surgery mode is safe and reliable, which can reduce the hospital stay, reduce hospitalization costs, reduce the burden of patients, and be conducive to save medical resources.