削减成本和碳排放:对尾切除术的例行组和节省测试进行重新评估
Obed Amoako-Adjei1, Alexia Defer2, Bishow Karki3,2
1General Surgery/Trauma and Orthopaedics, Mid Yorkshire NHS Teaching Trust, Wakefield, GBR.
Cureus
|November 18, 2025
概括
在尾切除术前进行常规的组和保存 (G&S) 测试提供了最小的临床益处,但产生了巨大的成本和环境影响. 为了效率和可持续性,建议在尾切除患者中采用选择性,基于风险的G&S测试方法.
科学领域:
- 手术瘤学手术瘤学
- 医疗保健管理的管理
- 临床病理学 临床病理学
背景情况:
- 常规的手术前组和保存 (G&S) 测试是尾切除术前的标准做法,以确保血液可用性.
- 在尾切除术中输血率极为罕见,质疑常规G&S测试的必要性.
- 该研究评估了在可持续医疗保健的背景下,G&S测试的临床效用,成本和环境影响.
研究的目的:
- 重新评估为尾切除术进行常规的手术前组和保存 (G&S) 检测的必要性.
- 分析G&S测试的临床效用,财务成本和环境影响.
- 为了确定选择性,基于风险的测试策略是否更合适.
主要方法:
- 在宾德菲尔德医院进行了265次尾切除术的回顾性审查.
- 收集的数据包括人口统计,美国麻醉学会 (ASA) 级别,白细胞计数 (WCC) 和C反应蛋白 (CRP).
- 统计分析包括t测试和千平方测试;计算了财务和碳足迹估计.
主要成果:
- 没有发生手术内或手术后立即输血 (0%的输血率).
- 复杂的尾炎病例显示WCC,CRP和患者年龄显著增加.
- 常规G&S测试的估计年度成本为14,116英,碳足迹为190.06公斤CO2e.
结论:
- 在尾切除术前进行常规的手术前G&S检测,其临床益处可以忽略不计,且会产生重大财务和环境成本.
- 炎症标志物升高,ASA等级较高,年龄较大预测复杂的尾炎,支持选择性测试策略.
- 将G&S测试限制在高风险患者身上,可以提高效率,并为国家卫生服务 (NHS) 的可持续性目标做出贡献.
关键词:
进行尾切除术.他们的碳足迹.效率 效率 效率 效率 效率 效率 效率组建并保存一个组.腹腔镜检查 腹腔镜检查 腹腔镜检查在手术前进行手术前测试.可持续性 可持续性 可持续性输血是输血的方法之一.更多相关视频
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