在 laparoscopic 胆囊切除术后亲自访问诊所:从COVID-19流行病中吸取的教训
Lucas Fair1, John J Squiers2, Jennifer Misenhimer2
1Department of Surgery, John Peter Smith Hospital, Fort Worth, Texas; Department of Surgery, Baylor University Medical Center, Dallas, Texas; Department of Surgical Research, Baylor Scott & White Research Institute, Dallas, Texas.
The Journal of surgical research
|July 30, 2023
概括
在腹腔镜胆囊切除术 (LC) 后进行例行个人随访并非必不可少. 手术后诊所访问并没有减少再入院,这表明远程医疗可能是LC患者的合适替代方案.
科学领域:
- 一般外科 整体外科
- 胃肠病学 胃肠病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在拉巴镜胆囊切除术 (LC) 后的日常面对面诊所预约缺乏明确的实用性,特别是随着远程医疗的使用增加.
- 随着COVID-19大流行,术后护理的交付发生了变化,需要重新评估传统的随访协议.
研究的目的:
- 评估在流行病相关变化之前,对LC患者进行例行个人随访的价值.
- 为了确定是否回归标准的个人手术后护理是合理的.
主要方法:
- 2018年4月至2020年2月期间对LC患者的随访遭遇的回顾性审查.
- 分析常规的2至4周的个人术后诊所访问,非常规的随访定义为新订单,转诊,再入院或恶性瘤识别.
主要成果:
- 在661名LC患者中,68%参加了例行随访;9%进行了非例行访问.
- 临床医生和非临床医生之间再接收率没有显著差异 (P=0.12).
- 随访并没有影响再接收几率 (OR:0.705;P=0.29).
结论:
- 非例行性随访的低发病率表明,可能不需要例行性面对面访问.
- 手术后临床出诊没有显示与LC后再入院减少的相关性.
- 建议在LC患者出院后一周内考虑进行远程医疗访问.
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