优化当天出院的甲状腺切除术:确定结果,意外入院和患者体验
W MacFaul1, M Wojtowicz1, B Puttergill1
1Stoke Mandeville Hospital, UK.
Annals of the Royal College of Surgeons of England
|July 15, 2025
概括
通过适当的方案和患者选择,可以实现高率的成功日间甲状腺切除术. 大多数患者对当天出院感到满意,而非计划性入院没有明确的预测因素.
科学领域:
- 外科手术 手术手术
- 内分泌学 在内分泌学.
- 患者的治疗结果.
背景情况:
- 在英国,日复一日的甲状腺切除术越来越受到重视,其目标是实现30%的零入住率.
- 巴金汉郡医疗保健信托目前超过了这个目标,超过70%的零入住率.
- 这项研究分析了每天的甲状腺切除术结果,以告知扩展的实践.
研究的目的:
- 为了分析成功治疗的一日病例甲状腺切除术患者的情况.
- 评估意外住院的原因和并发症率.
- 评估患者对当天出院程序的满意度.
主要方法:
- 从2020年至2024年对甲状腺切除术患者的回顾性队列审查.
- 涉及两名外科医生:一个有丰富的日常病例经验和一个新采用者.
- 分析患者人口统计,入院原因,并发症和满意度调查.
主要成果:
- 在336名患者中,有84%的患者在当天出院;有11%的患者计划过夜.
- 老年患者 (62岁与50岁相比) 和较高的ASA等级更有可能在一夜之间入院.
- 非计划入院 (4%) 是由于麻醉问题,出血或大腺体,所有入院时间都小于48小时;没有发生术后出血.
- 超过80%的受访患者更喜欢在同一天出院,并报告足够的疼痛控制.
结论:
- 日间甲状腺切除术的高率是可行的,有了强大的协议和仔细的患者选择.
- 患者的满意度很高,同日出院的甲状腺切除术.
- 预测意外入院的预测因素仍然不清楚,需要持续保持警.
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