South Thames Cleft Service, Guy's and St Thomas' NHS Trust, London, UK.
Int J Oral Maxillofac Surg. 2012 Oct;41(10):1238-43. doi: 10.1016/j.ijom.2012.05.024. Epub 2012 Jul 18.
This retrospective study evaluated variables associated with length of stay (LOS) in hospital for 406 admissions of primary cleft lip and palate and alveolus surgery between January 2007 and April 2009. Three patients were treated as day cases, 343 (84%) stayed one night, 48 (12%) stayed 2 nights and 12 (3%) stayed > 2 nights. Poisson regression analysis showed that there was no association between postoperative LOS and age, distance travelled, diagnosis and type of operation, with a p value > 0.2 for all variables. 60/406 patients stayed 2 nights or more postoperatively mostly due to poor pain control and inadequate oral intake. Patients with palate repair were more likely to have postoperative LOS > 1 night, compared to patients with lip repair, p value = 0.011. Four patients (1%), all of whom had undergone cleft palate surgery, were readmitted within 4 weeks of the operation due to respiratory obstruction or haemorrhage. Using logistic regression, evidence showed that these readmissions were related to a longer original postoperative LOS. This study shows that length of stay for primary cleft lip, palate and alveolus surgery can in most cases be limited to one night postoperatively, provided that adequate support can be provided at home.
本回顾性研究评估了 2007 年 1 月至 2009 年 4 月 406 例初次唇腭裂及牙槽裂手术患者住院时间(LOS)的相关变量。3 例患者为日间手术,343 例(84%)住院 1 晚,48 例(12%)住院 2 晚,12 例(3%)住院>2 晚。泊松回归分析显示,术后 LOS 与年龄、旅行距离、诊断和手术类型之间无相关性,所有变量的 p 值均>0.2。60/406 例患者术后 2 晚或以上主要因疼痛控制不佳和口腔摄入不足而住院。与唇裂修复患者相比,行腭裂修复的患者术后 LOS>1 晚的可能性更高,p 值=0.011。4 例(1%)患者因呼吸阻塞或出血在术后 4 周内再次入院,均接受过腭裂手术。使用逻辑回归,证据表明这些再入院与较长的原始术后 LOS 有关。本研究表明,在大多数情况下,初次唇裂、腭裂和牙槽裂手术的住院时间可以限制在术后 1 晚,前提是可以在家中提供足够的支持。