【摘要】 目的探讨日间手术模式在小儿外科中的应用价值。方法回顾性分析小儿外科652例日间手术病例临床资料,其中男497,女155例,平均年龄(1.8±0.8)岁;腹腔镜下腹股沟斜疝疝囊高位结扎术439例,腹腔镜下鞘状突高位结扎术161例,Bianchi睾丸下降固定术18例,腹腔镜下睾丸下降固定术5例,多指切除术15例,鳃裂囊肿切除术6例,甲舌囊肿(瘘管)切除术5例,腹腔镜下精索静脉高位结扎术3例。患儿门诊被确认进入日间手术程序后,经预约入院、入院宣教、术前准备、住院手术、家庭康复等程序完成疾病的治疗、康复。统计该组病例的平均手术时间、延迟手术例数、退出手术例数、平均住院费用、并发症发生情况。结果 21例延迟手术,延迟原因为上呼吸道感染和皮疹;9例退出日间手术程序,1例因为阴囊血肿退出,4例因为严重上呼吸道感染转入内科治疗退出,余下4例均为家属自身原因退出。所有进入日间手术程序患儿均顺利完成手术,术后出现伤口感染4例,阴囊血肿1例。结论日间手术模式适合在小儿外科中开展,可缩短住院时间,降低医疗费用,是一种安全、有效、便捷、人性化的治疗模式,在医院多部门的配合下可顺利完成。更多还原

【Abstract】 Objective To explore the value of applying mode of ambulatory surgery in pediatric surgery. Methods The clinical data of 652 cases of ambulatory surgery [male: 497; female: 155; mean age:(1.8 ±0.8)years old] in the pediatric surgery were retrospectively analyzed. The surgeries included high ligation of indirect inguinal hernia sac under laparoscopy(n=439), high ligation of processus vaginalis under laparoscopy(n=161), Bianchi orchiopexy for low cryptorchidism(n=18), laparoscopic orchiopexy(n =5),surgical excision for polydactyly(n=15), surgical excision for branchial cleft cysts(n=6), surgical excision for thyroglossal cyst(fistula)(n=5), and high ligation of spermatic vein under laparoscopy(n=3). After the child was confirmed to receive ambulatory surgery in the Outpatient Department, he or she completed the treatment and rehabilitation by admission reservation, health education, preoperative preparation, in-hospital surgery, and family care, etc. The average operation time, number of cases of delayed operation, number of withdrawal cases, average hospitalization expenses and incidence of complications were recorded for this group. Results A total of 21 children delayed the operation due to upper respiratory infection(URI) and rash; nine children withdrew from the ambulatory surgery,including one case due to scrotal hematoma, four cases due to severe URI(transferred to medical treatment later) and four cases due to family members’ reasons. All children who entered the procedure of ambulatory surgery completed the operation successfully,withfour cases of wound infection and one case of scrotal hematoma after the operation. Conclusion The mode of ambulatory surgery is suitable for pediatric surgery, which can shorten the length of stay and decrease the medical cost. It is a treatment mode with safety and effectiveness, as well as convenience and humanization, which can be completed successfully with the cooperation of multiple departments of the hospital.更多还原