摘要
目的探讨胸腔镜肺结节日间手术患者围手术期精细化管理的效果。方法回顾性分析2019年6月-2020年10月四川大学华西医院日间手术中心收治的胸腔镜肺结节日间手术患者,收集手术量、患者一般资料,分析患者术后管道管理、疼痛管理、饮食管理方面的精细化管理效能,以及术后随访及满意度调查情况。结果共纳入162例胸腔镜肺结节日间手术患者,其中正常拔管出院的150例患者术后安置胸腔引流管时间为5~22 h,平均(10.88±3.54)h。单因素和多因素logistic回归分析结果显示,性别、年龄、手术方式、术后即刻疼痛评分与延迟拔出胸腔引流管(安置胸腔引流管时间>10 h)无相关性(P>0.05)。术后疼痛数字评分最低为0分(无痛),最高为4分(中度疼痛)。术后12例(7.4%)患者转科,2例(1.2%)患者留置尿管,11例(6.8%)患者非计划再就诊,6例(3.7%)患者非计划再入院,患者满意度调查均为满意。结论在日间手术胸腔镜肺结节患者中实施精细化管理,患者在出院前能拔除引流管,术后无严重疼痛发生,随访满意度好。
Objective To explore the effect of perioperative fine management on patients undergoing videoassisted thoracoscopic surgery(VATS)for pulmonary nodule in day surgery mode.Methods We retrospectively analyzed the data of patients undergoing VATS for pulmonary nodule in Day Surgery Center of West China Hospital,Sichuan University between June 2019 and October 2020.The number of VATS procedures and general data of patients were collected.The effects of fine management on postoperative intrathoracic drain management,pain management,and diet management,as well as the postoperative follow-up and satisfaction survey were analyzed.Results A total of 162 patients were enrolled.The duration of postoperative chest drainage of 150 VATS patients who discharged from the hospital with normal extubation lasted for 5 to 22 h with an average of(10.88±3.54)h.Univariate analyses and multivariate logistic regression analysis showed that gender,age,method of surgery,and immediate postoperative pain score were not associated with delayed removal of thoracic drainage tube(>10 h)(P>0.05).The lowest score of numerical rating scale for pain intensity was 0(painless)and the highest was 4(moderate pain).After surgery,12 patients(7.4%)were transferred out of the day surgery department,2 patients(1.2%)were indwelled postoperative urinary catheter,11 patients(6.8%)had unplanned revisit,and 6 patients(3.7%)had unplanned readmission.Patient satisfaction surveys were all satisfactory.Conclusions The implementation of fine management in VATS for pulmonary nodule in day surgery mode is beneficial for ensuring that patients can remove the drainage tube before discharge from the hospital,without severe pain after the operation and with good follow-up satisfaction.
作者
张黎
刘洋
黄明君
戴燕
蒋丽莎
车国卫
ZHANG Li;LIU Yang;HUANG Mingjun;DAI Yan;JIANG Lisha;CHE Guowei(Day Surgery Center,West China Hospital,Sichuan University/West China School of Nursing,Sichuan University,Chengdu,Sichuan 610041,P.R.China;Day Surgery Center,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China;Department of Thoracic Surgery,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China)
出处
《华西医学》
CAS
2021年第2期183-189,共7页
West China Medical Journal
基金
国家自然科学基金(71804118)
四川省科学技术厅项目(2018ZR0129)。
关键词
电视胸腔镜手术
肺结节
日间手术
精细化管理
Video-assisted thoracoscopic surgery
Pulmonary nodule
Day surgery
Fine management
