标准作业程序在外科手术中的应用实践—以腹腔镜胆囊切除为例

Application of standard operating procedure in surgical operation-taking laparoscopic cholecystectomy as an example

目的:以腹腔镜胆囊切除术(LC)为例总结标准作业程序(SOP)管理模式在外科手术精细化管理中的应用经验。方法:回顾分析2016年8月至2021年12月行LC的8486例患者的临床资料,自2018年8月应用SOP管理理念与模式采用标准化规范后施行的5433例LC作为研究组,规范实施前的3053例LC作为对照组,对比分析两组术后并发症、再次手术情况、住院时间、住院总费用、药品费用、耗材费用等指标。结果:对照组术后并发症发生率(0.82%vs.0.17%)、再次手术率(0.23%vs.0.04%)、住院时间、住院总费用、药品费用、材料费用高于研究组。结论:SOP管理模式在技术成熟、操作规范、治疗标准的外科手术中具有提高医疗质量、提升运营效率、降低成本消耗的效果,同时在新医保支付模式下将成本控制环节前移,充分发挥了SOP在“控费降本”中的优势,适于在外科手术精细化管理中推广应用。

Objective:To summarize the application experience of the standard operating procedure(SOP)management model in refined surgical management with laparoscopic cholecystectomy(LC)as an example.Methods:The clinical data of 8486 patients who underwent LC from Aug.2016 to Dec.2021 were retrospectively analyzed.Control group included 3053 patients without SOP before Aug.2018,and study group contained 5433 patients after implementation of standardization according to SOP management concepts and models.A contrastive analysis was conducted on postoperative complications,reoperation,hospital stay,total hospitalization expenses,cost of drug and consumables.Results:In the control group,the incidence of postoperative complications(0.82%vs.0.17%),the i ncidence of reoperation(0.23%vs.0.04%),the hospital stay,total hospitalization cost,drug expenses and material costs were higher than those in study group.Conclusions:SOP management model has the effects of improving medical quality,enhancing operational efficiency and reducing cost consumption in surgical operations with mature technology,standardized operation and standard treatment.Simultaneously,the cost control link is moved forward under the new medical insurance payment model,which gives full play to the SOP's advantages in"cost control and cost reduction".SOP is suitable for popularization in refined surgical management.