【摘要】 目的分析某肿瘤医院1180例外科患者住院时间超30d的原因并提出对策。方法对2015年某三级甲等肿瘤医院1180例住院超30d外科患者的临床资料进行回顾性分析。结果从科室上看,住院时间超30d占比排名前三位的科室依次是:妇瘤外科(35.25%)、胃肠外科(13.14%)、乳腺外科(11.19%)。从原因构成上看,疾病自身原因(49.92%)是导致住院时间超30d的主要原因,其中占比排名前三位的原因依次是:治疗周期较长(19.58%)、术后化疗或放疗(11.78%)、病情复杂涉及多学科诊疗(9.83%);其次是院方原因(47.63%),其中占比排名前三位的原因依次是:出现并发症(11.95%)、内科转科(10.26%)、术后感染或切口感染(7.71%)。结论由于肿瘤治疗的多学科模式,肿瘤患者较易出现住院时间超30d。通过加强疑难患者治疗管理、提高疑难病例诊疗能力、加快治疗前诊断和治疗方案确定、提高转科效率、加强围手术期管理、实行快速康复外科、加强医患沟通等措施是减少肿瘤外科患者住院时间超30天的重要途径。更多还原

【Abstract】 Objective To analyze the reason of hospital stay over 30 days of 1180 surgical inpatients and find countermeasures to improve the utilization efficiency of medical resources. Methods The clinical data of 1180 surgical inpatients staying over 30 days in some third-gradeclass-A Cancer hospital were analyzed retrospectively in 2015. Results Most surgical inpatients staying over 30 days belonged to anterior three departments:Gynecologic Oncology(35.25%),Gastrointestinal Surgery(13.14%),Breast surgery(9.06%). The factors of disease itself(49.92%)was the main cause of inpatients staying over 30 days,the top three reasons in it were longer treatment period(19.58%),postoperative chemotherapy or radiotherapy(11.78%),and multidisciplinary treatment resulted from the complexity of disease(9.83%). The factors of hospital(47.63%) were the second cause of inpatients staying over 30 days,the top three reasons in them were complications(11.95%),transfer from internal medicine to surgery(10.26%),postoperative infection or incision infection(7.71%). Conclusion Due to the multidisciplinary model of cancer therapy,cancer inpatients are more prone to stay over 30 days. Strengthening management of difficult and complicated cases,improving the ability of diagnosis and treatment of difficult and complicated cases,speeding up the diagnosis and treatment,improving the efficiency of transfer,strengthening management of perioperative period,carrying out enhanced recovery after surgery and strengthening communication between doctor and patient are the effective ways to solve the problem of hospital stay over 30 days of surgical cancer inpatients.更多还原