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比较日间护理与过夜腹腔镜胆囊切除术的随机对照试验

Randomized Controlled Trial Comparing Daycare and Overnight Stay Laparoscopic Cholecystectomy.

作者信息

Salleh A A M, Affirul C A, Hairol O, Zamri Z, Azlanudin A, Hilmi M A, Razman J

机构信息

Departments of Surgery, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia.

Department of Surgery, Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia.

出版信息

Clin Ter. 2015;166(3):e165-8. doi: 10.7417/CT.2015.1848.

Abstract

BACKGROUND

This present study sought to review the feasibility and patients' satisfaction of laparoscopic cholecystectomy to be perform as daycare procedure.

MATERIAL AND METHODS

Sixty-two patients with symptomatic gallstones were recruited within a year. They were randomized into overnight stay and daycare groups. The outcomes and post-operative complications were analyzed.

RESULTS

Fifty-eight patients were eligible for analysis and four patients were excluded because of conversion to open cholecystectomy. All patients in daycare group reported no fever but two patients in the overnight stay group complaint of post-operative fever (p=0.150). The mean pain score using Visual Analogue Score (VAS) in daycare group was 2.93 but in the overnight stay was recorded as 3.59 (p=0.98). Five patients had post-operative nausea and vomiting (PONV) in daycare group compared to 2 patients in the overnight stay group (p=0.227). Patient's satisfaction were higher in the daycare group (p=0.160). All patients in daycare group were back at work within a week but in overnight stay, 11 patients had to stay off work for more than one week (p=0.01).

CONCLUSIONS

Daycare laparoscopic cholecystectomy is safe and feasible. The satisfaction of daycare surgery is higher than overnight stay group. Patients' selection is an important aspect of its success.

摘要

背景

本研究旨在探讨腹腔镜胆囊切除术作为日间手术的可行性及患者满意度。

材料与方法

一年内招募了62例有症状胆结石患者。他们被随机分为过夜住院组和日间手术组。分析了手术结果及术后并发症。

结果

58例患者符合分析条件,4例因转为开腹胆囊切除术被排除。日间手术组所有患者均无发热,但过夜住院组有2例患者术后发热(p = 0.150)。日间手术组使用视觉模拟评分法(VAS)的平均疼痛评分为2.93,过夜住院组为3.59(p = 0.98)。日间手术组有5例患者发生术后恶心呕吐(PONV),过夜住院组为2例(p = 0.227)。日间手术组患者满意度更高(p = 0.160)。日间手术组所有患者在一周内恢复工作,但过夜住院组有11例患者不得不休假超过一周(p = 0.01)。

结论

日间腹腔镜胆囊切除术安全可行。日间手术的满意度高于过夜住院组。患者选择是其成功的重要方面。

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