摘要
目的基于倾向性评分匹配分析,探讨肺癌患者日间手术病房模式与传统住院模式的术后恢复、经济学效应及出院准备度的差异。方法采用便利抽样法,选取2022年8—12月在上海交通大学医学院附属胸科医院胸外科、日间手术病房预行胸腔镜的320例肺癌患者为研究对象。采用一般资料调查表、出院准备度量表对患者进行调查。比较肺癌患者日间手术病房模式与传统住院模式术后恢复指标、经济学指标及出院准备度。本研究共发放问卷320份,回收有效问卷308份,有效回收率为96.25%(308/320)。结果 308例肺癌患者中,日间手术病房模式组161例,传统住院模式组147例。通过倾向性匹配,共160例匹配成功,两组各80例。日间手术病房模式组首次下床时间、胸管留置时间、术后住院时间均小于传统住院模式组,差异有统计学意义(P<0.05)。两组术后并发症发生例数、不良反应例数、术后当天与第2天的疼痛评分比较差异均无统计学意义(P>0.05);日间手术病房模式组化验费、西药费、术后住院总费用均低于传统住院模式组,差异具有统计学意义(P<0.05)。日间手术病房模式组个人状态、适应能力以及出院准备度总分均低于传统住院模式组,差异有统计学意义(P<0.05)。结论基于加速康复外科肺癌日间手术病房模式能保障患者围手术期安全,促进患者早日康复,缩短住院时间,提高经济效应;然而相较传统住院模式,日间手术病房模式出院准备度仍存在提升空间,应加强对患者出院准备度的评估并实施有针对性的干预措施。
Objective To explore the differences in postoperative recovery,economic effects,and discharge readiness between the day surgical ward mode and the traditional hospitalization mode for lung cancer patients based on propensity score matching analysis.Methods From August to December 2022,320 lung cancer patients who underwent thoracoscopy in the Department of Thoracic Surgery and Day Surgery Ward of the Shanghai Chest Hospital,Shanghai Jiao Tong University School of Medicine were selected as the study subject by convenience sampling.The patients were surveyed using the General Information Questionnaire and the Readiness for Hospital Discharge Scale(RHDS).The differences in postoperative recovery indicators,economic indicators,and discharge readiness between the day surgical ward mode and the traditional hospitalization mode for lung cancer patients were compared.A total of 320 questionnaires were distributed,and 308 valid questionnaires were collected,with an effective response rate of 96.25%(308/320).Results Among 308 lung cancer patients,there were 161 in the day surgical ward mode group and 147 in the traditional hospitalization mode group.Through propensity matching,a total of 160 cases were successfully matched,with 80 cases in each group.The first time out of bed,chest tube retention time,and postoperative hospitalization time in the day surgical ward mode group were all shorter than those in the traditional hospitalization mode group,with statistically significant differences(P<0.05).There was no statistically significant difference in the incidence of postoperative complications,adverse reactions,and pain scores between the two groups on the first and second postoperative days(P>0.05).The laboratory expenses,Western medicine expenses,and total postoperative hospitalization expenses of the day surgical ward mode group were all lower than those of the traditional hospitalization mode group,and the differences were statistically significant(P<0.05).The individual status,adaptability,and discharge readiness scores of the day surgical ward mode group were lower than those of the traditional hospitalization mode group,with statistically significant differences(P<0.05).Conclusions The daytime surgical ward mode based on enhanced recovery after surgery for lung cancer can ensure the safety of patients during the perioperative period,promote early recovery,shorten hospitalization time,and improve economic effects.Compared to the traditional hospitalization mode,there is still room for improvement in the discharge readiness of the day surgical ward mode.It is necessary to strengthen the evaluation of patient discharge readiness and implement targeted interventions.
作者
葛玲
刘晓芯
居馨星
杨洁
冯竞
Ge Ling;Liu Xiaoxin;Ju Xinxing;Yang Jie;Feng Jing(Day Surgical Ward,Shanghai Chest Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200030,China;Nursing Department,Shanghai Chest Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200030,China;Second Chest Heart Ward,Shanghai Chest Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200030,China)
出处
《中华现代护理杂志》
2023年第25期3375-3380,共6页
Chinese Journal of Modern Nursing
基金
上海交通大学医学院护理学科人才队伍建设项目(沪交医[2020]42号)
上海市教委护理高原学科建设项目。
关键词
肺肿瘤
日间手术
出院准备度
倾向性评分匹配
Lung neoplasms
Day surgery
Discharge readiness
Propensity score matching
作者简介
通信作者:冯竞,Email:33160904@qq.com。
