Schäfer M K, Wittenmeier E
Klinik für Anästhesiologie, Klinikum der Johannes Gutenberg-Universität, Mainz.
Anaesthesist. 2003 Nov;52(11):1046-54. doi: 10.1007/s00101-003-0595-7.
Ambulatory surgical care is intended to save healthcare expenditure from the economical viewpoint. From the patients point of view significant advantages as well as specific disadvantages of ambulatory surgery are known. The increase in the volume and complexity of procedures provided in an ambulatory setting are driven by improvements in anesthesia and surgical technique as well as by changes in financing and reimbursement. Therefore careful quality control and scientific evidence for the safety of increasingly used complex surgical procedures for higher risk patients is essential. Reducing the surgical trauma by minimally invasive surgical techniques and very good controllability by modern anesthesia concepts is making the management of the postoperative period crucial for successful ambulatory surgery. Most of the complications and common problems during the postoperative period, such as pain, nausea and vomiting, are not specific for ambulatory surgery, but management places an increasing burden of responsibility not only on general and specialised physicians, but also on other health professionals, patients, and family members.
从经济角度来看,门诊手术护理旨在节省医疗保健支出。从患者的角度来看,门诊手术既有显著的优点,也有特定的缺点。门诊手术中所提供的手术量和复杂性的增加,是由麻醉和手术技术的改进以及融资和报销方式的变化所推动的。因此,对于越来越多地用于高风险患者的复杂手术程序的安全性,进行仔细的质量控制并提供科学依据至关重要。通过微创手术技术减少手术创伤,以及借助现代麻醉理念实现良好的可控性,使得术后管理对于门诊手术的成功至关重要。术后期间的大多数并发症和常见问题,如疼痛、恶心和呕吐,并非门诊手术所特有,但管理不仅给普通医生和专科医生,也给其他医疗专业人员、患者及其家属带来了越来越大的责任负担。