[基于标准手术流程（SOP）的肺癌手术质量监测与持续改进：单一手术团队的经验]
[Surgical Quality Surveillance and Sustaining Improvement of Lung Cancer Surgery Based on Standard Operation Procedure (SOP): Experience of Single Surgical Team].
作者信息
Wang Xing, Yan Shi, Wang Yaqi, Wu Nan
机构信息
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Surgery II, Peking University Cancer Hospital & Institute, Beijing 100142, China.
出版信息
Zhongguo Fei Ai Za Zhi. 2017 Apr 20;20(4):253-258. doi: 10.3779/j.issn.1009-3419.2017.04.05.
BACKGROUND
Standard operation procedure (SOP) could standardize treatment procedure and reduce medical expenses, but SOP drawn by the government may not suit all medical institutions, so individual adjustment made by surgical team is necessary.
METHODS
We recorded the information of patients undergoing lung resection, including postoperative hospital stay, medical expenses and ratio of video-assisted thoracoscopic surgery (VATS) rate to evaluate surgical quality sustaining improvement in terms of structure indicator, process indicator and outcome indicator, aiming at exploring the ideal postoperative hospital stay and the best indicators to evaluate surgical quality improvement.
RESULTS
The average postoperative hospital stay reduced significantly between 2016 and 2013 [(4.08±1.8) d vs (6.13±3.6) d, P<0.001)]. VATS rate increased from 2013-2016 (17%→48%→68%→73%), as well as single port VATS rate (0%→2%→52%→66%).
CONCLUSIONS
Surgical quality surveillance and sustaining improvement by surgical team could further reduce postoperative hospital stay and perioperative complications.
背景
标准操作流程（SOP）可规范治疗流程并降低医疗费用，但政府制定的SOP可能并不适用于所有医疗机构，因此手术团队进行个体化调整很有必要。
方法
我们记录了接受肺切除术患者的信息，包括术后住院时间、医疗费用以及电视辅助胸腔镜手术（VATS）率，以从结构指标、过程指标和结果指标方面评估手术质量的持续改进情况，旨在探索理想的术后住院时间以及评估手术质量改进的最佳指标。
结果
2016年与2013年相比，术后平均住院时间显著缩短[（4.08±1.8）天对（6.13±3.6）天，P<0.001]。VATS率从2013年至2016年有所上升（17%→48%→68%→73%），单孔VATS率也如此（0%→2%→52%→66%）。
结论
手术团队进行手术质量监测和持续改进可进一步缩短术后住院时间并减少围手术期并发症。
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