集中管理日间手术模式下胸腔镜手术与普通住院手术模式治疗肺结节的疗效及安全性比较

Comparison of the efficacy and safety of video-assisted thoracoscopic surgery in the treatment of pulmonary nodules between the centralized day case surgery mode and the general inpatient operation mode

目的:探讨集中管理日间手术模式下胸腔镜手术与普通住院手术治疗肺结节的疗效及安全性差异。方法:回顾性分析150例接受胸腔镜手术治疗的肺结节患者的临床资料,包括集中管理日间手术模式(观察组)与普通住院手术模式(对照组),每组各75例。比较两组患者手术与住院相关指标、出院时满意度及术后1个月内并发症发生情况。结果:两组患者手术时间、术中出血量、胸腔引流管安置时间及术后1 d NRS评分比较,差异均无统计学意义(P>0.05)。与对照组比较,观察组患者等床日、住院时间均更短(P<0.05),住院费用更低(P<0.05),患者对就医过程、出院指导的满意度评分均更高(P<0.05)。两组患者对医护人员服务态度、治疗效果的满意度评分,气胸、发热、胸腔积液、肺部感染、再入院率及并发症总发生率比较,差异均无统计学意义(P>0.05)。结论:集中管理日间手术模式下胸腔镜手术可有效缩短肺结节患者等床及住院时间,降低住院费用,提升满意度,且不增加术后并发症发生风险,是一种安全、可行的手术模式。

Objective:To compare the efficacy and safety of video-assisted thoracoscopic surgery in the treatment of pulmonary nodules between the centralized day case surgery mode and the general inpatient operation mode.Methods:Retrospective analysis was made on the clinical data of 150 patients with pulmonary nodules who received video-assisted thoracoscopic surgery.Among them,75 patients treated with centralized day case surgery mode(observation group)and 75 patients treated with general inpatient surgery(control group).The indexes related to operation and hospitalization,satisfaction at discharge and complications within 1 month after operation were compared between the two groups.Results:There was no significant difference between the two groups in the operation time,intraoperative bleeding,the placement time of the thoracic drainage tube,and the numerical pain score(NRS)1 d after the operation(P>0.05).The waiting days and hospitalization time of patients in the observation group were shorter than those in the control group(P<0.05),and the hospitalization expenses were lower than those in the control group(P<0.05).The satisfaction scores for the medical treatment process and discharge guidance of patients in the observation group were higher than those in the control group(P<0.05).There was no significant difference between the two groups in the scores of patients satisfaction with medical staff s service attitude and treatment effect(P>0.05).There was no significant difference in the incidence of pneumothorax,fever,pleural effusion,pulmonary infection,readmission rate and the total incidence of complications between the two groups(P>0.05).Conclusion:Video-assisted thoracoscopic surgery the centralized management of day case surgery mode can effectively shorten the waiting time and hospitalization time of patients with pulmonary nodules,reduce hospitalization costs,improve satisfaction,and does not increase the risk of postoperative complications.It is a safe and feasible operation mode.