·论著·日间手术腹腔镜胆囊切除1240例社会和经济效益评价刘博李成刚陈继业刘洋孟翔飞董家鸿黄志强【摘要】目的评价日间手术腹腔镜胆囊切除(LC/DS)的社会效益和经济效益。方法回顾性分析2009年11月至2010年12月我院1240例LC/DS和同期476例行常规LC手术患者临床资料,将两组患者中转开腹率、并发症、住院时间、住院费用和患者满意度等进行比较。结果1240例LC/DS患者平均年龄52畅3岁,1236例LC/DS手术成功,4例中转开腹,去除2例胆囊癌后中转开腹率为0畅16%(2/1240),6例(0畅48%)发生并发症,无胆管损伤和胃肠脏器损伤等严重并发症。476例常规LC患者平均年龄51畅9岁,中转开腹8例(1畅68%),11例(2畅31%)发生并发症,包括1例胆管损伤和1例结肠损伤。LC/DS组与常规LC组患者无手术死亡病例发生。LC/DS组与常规LC组患者比较结果:中转开腹率分别为0畅16%和1畅68%(P=0畅0008),并发症6例和11例(P=0畅0010),住院时间(1畅6±0畅6)d和(4畅8±0畅9)d(P=0畅0000),住院费用(8028±338)元和(9016±266)元(P=0畅0000),患者满意度95畅4%和95畅7%(P=0畅723)。结论日间手术腹腔镜胆囊切除住院时间明显缩短,治疗费用显著下降,医疗资源利用率大幅提高。这种手术模式值得我国推广。【关键词】日间住院治疗;胆囊切除术,腹腔镜;费用效益分析Evaluationonsocialandeconomicbenefitsofdaysurgerylaparoscopiccholecystectomyin1240patientsLIUBo,LICheng唱gang,CHENJi唱ye,LIUYang,MENGXiang唱fei,DONGJia唱hong,HUANGZhi唱qiang.DepartmentofHepatobiliarySurgery,GeneralHospitalofChinesePeople′sLiberationArmy,Beijing100853,ChinaCorrespondingauthor:LIUBo,Email:jnliubo@sohu.com【Abstract】ObjectiveToevaluatethesocialandeconomicbenefitsofdaysurgerylaparoscopiccholecystectomy(LC/DS).MethodsClinicaldatumof1240patientsundergoingLC/DSand476casesundergoingroutineLCatGeneralHospitalofChinesePeople′sLiberationArmyfromNovember2009toDecember2010wereretrospectivelystudied.Rateofconversiontoopenprocedure,complications,lengthofstayinhospital,medicalcostsandpatientsatisfactionratewerecomparedbetweenpatientsreceivedLC/DSandroutineLC.DatawasanalyzedusingSPSS16畅0,differencesbetweentwogroupswereassessedusingttestsforcontinuousvariablesandchi唱squaretestsforcategoricalvariables.ResultsTheaverageageinpatientsofLC/DSgroupwas52畅3years.1236caseswerepreformedbyLCandconversiontolaparotomyoccurredin4patients,theconversionratewas0畅16%astwocasesofgallbladdercarcinomawereexcluded.Six(0畅48%)complicationsdeveloped.Theseverecomplicationsofbileductinjuryandstomachorbowelinjurydidno...