甲状腺日间手术模式涉及的相关问题探讨
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程若川, Email: cruochuan@foxmail.com

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Discussion on the relevant issues involved in ambulatory thyroidectomy
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    摘要:

    随着甲状腺癌发病率与手术量急剧增加,对24 h内完成入、出院的甲状腺日间手术的需求也日益升高。目前日间手术已在国内外少数先进医疗单位实施,并认为是在严格控制适应证的情况下,具有安全高效、方便快捷的特点,能明显降低住院时间和住院费用,提高患者满意度的先进管理模式。然而在我国现有的医疗体制和医患环境下,真正建立和推广日间手术模式尚面临手术并发症、医保政策、医院管理制度、术后康复管理、医疗文书书写以及医学伦理等诸多问题。现阶段日间手术仅适合在有丰富外科经验的甲状腺诊疗中心进行有条件的临床探索。

    Abstract:

    With the rapid increase in incidence of thyroid cancer and the volume of thyroidectomy, the demands for ambulatory thyroidectomy are growing, where the processes of admission, surgery and discharge are completed within 24 h. At present, ambulatory thyroidectomy mode has been undertaken at a few advanced medical institutions in China and other countries, which is considered as an advanced management mode, owning the advantages of being safe, high-efficient and convenient as well as reducing the length of hospital stay and hospitalization costs, and improving the patients’ satisfaction under strict indication criteria. However, the substantive development and popularization of the ambulatory thyroidectomy mode will be confronted with many difficulties and problems under our existing health care system and doctor-patient relationship conditions, such as surgery complications, health insurance policy, hospital management system, postoperative recovery management, medical document writing and medical ethics. So, ambulatory thyroidectomy is currently only suitable for being conducted as clinical research at thyroid centers with sufficient surgical experience under reliable conditions.

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程若川, 刁畅, 方向.甲状腺日间手术模式涉及的相关问题探讨[J].中国普通外科杂志,2019,28(5):519-523.
DOI:10.7659/j. issn.1005-6947.2019.05.001

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  • 收稿日期:2018-11-27
  • 最后修改日期:2019-04-22
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  • 在线发布日期: 2019-05-25