华西医学

华西医学

儿童专科医院日间手术管理经验

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目的探讨儿童专科医院日间手术管理经验。方法为满足患者需求,武汉儿童医院于 1981 年开始一日小儿外科手术,2001 年正式成立日间手术中心,进行集中收治、集中管理,并于近 3 年增加集中收、分散治的混合管理,同时优化日间手术管理流程,严格执行相关准入与评估制度,确保医疗质量与医疗安全。结果该院 2001 年起共完成日间手术 12 万余例,未出现死亡等严重并发症,术后常见并发症发生率<0.8%,并发症出现时间主要在术后 12 h 内。至 2018 年,该院日间手术量占年择期手术总量的 29.57%,整体并发症发生率低于同病种传统住院模式。结论专科医院尤其是儿童专科医院单一病种量大,患者手术需求大,手术同质化程度高,手术效果好,有开展日间手术的迫切需求和优势。日间手术真正体现以患者为中心的服务理念,专科适合先在发展较好的科室开展,积累经验后,在全院的其他专科推广,逐步提高日间手术在择期手术中的占比。

ObjectiveTo explore the management experience of day surgery in children specialized hospitals.MethodsWuhan Children’s Hospital began one-day pediatric surgery in 1981. In 2001, one-day surgery center was formally established to centralize treatment and management. In the past three years, the mixed management of centralized and decentralized treatment was increased. At the same time, the one-day surgery management process was optimized, the relevant access and evaluation system was strictly implemented, to ensure the medical quality and medical safety.ResultsSince 2001, more than 120 000 cases of day surgery had been performed in the hospital, without death or other serious complications. The incidence of common postoperative complications was less than 0.8%, and the time of occurrence of complications was mainly within 12 hours after surgery. By 2018, the number of day surgeries in the hospital accounted for 29.57% of the annual elective surgeries, and the overall incidence of complications was lower than the traditional hospitalization mode of the same disease.ConclusionsThe concept of patient-centered service is truly embodied in day surgery. Specialized hospitals, especially children’s hospitals, have a large number of single diseases, a large demand for patients’ surgeries, a high degree of homogeneity of surgeries, good surgical results, and urgent needs and advantages to carry out day surgery. Day surgery is suitable to start in developed departments, and be promoted in other specialties of the hospital when experience has been accumulated, so as to increase the proportion of day surgery in elective surgery gradually.

关键词: 日间手术; 管理; 儿童专科医院

Key words: Day surgery; Management; Children’s hospital

引用本文: 卞红强, 马敬伟, 杨泳茹. 儿童专科医院日间手术管理经验. 华西医学, 2019, 34(2): 193-197. doi: 10.7507/1002-0179.201901077 复制

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