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家长对单纯性阑尾炎腹腔镜阑尾切除术后当日出院的满意度。

Parental satisfaction with same-day discharge after laparoscopic appendectomy for uncomplicated appendicitis.

作者信息

Ngo Sandra, Gee Kristin, Burkhalter Lorrie, Beres Alana L

机构信息

Division of Pediatric Surgery, Department of Surgery, University of Texas Southwestern, Dallas, Texas, USA.

Children's Health, Dallas, Texas, USA.

出版信息

Paediatr Child Health. 2019 Aug;24(5):318-322. doi: 10.1093/pch/pxy177. Epub 2018 Dec 22.

Abstract

OBJECTIVES

Recent studies suggest that same-day discharge is safe for the paediatric population after various laparoscopic procedures. Same-day discharge is increasingly common after laparoscopic surgery for uncomplicated appendicitis although it is not standard practice. This prospective study aims to assess parental satisfaction with same-day discharge after laparoscopic appendectomy for uncomplicated appendicitis.

METHODS

At our institution, 849 patients with uncomplicated acute appendicitis underwent laparoscopic appendectomy in 2016; of which, 382 were discharged on the same calendar day. Postdischarge surveys assessing parental satisfaction were administered by telephone at the 2-week follow-up.

RESULTS

Approximately 65% of 185 total parental responses reported initial satisfaction with same-day discharge. About 30% were nervous at that time, and 5% did not feel ready to go home yet. Upon reflection, a higher proportion of parents (81.6%) felt same-day discharge was the appropriate course of action, 11.4% were unsure, and 7.0% would not do it again. Some parents cited concerns regarding pain control and incongruous expectations from conversations with staff or surgical experiences of their own.

CONCLUSIONS

The majority of parents recalled being happy at discharge, with an increase to 82% retrospectively. Only 7% of parents would not elect to go home on the same day again. Opportunities for improvement include a unified plan from all providers with expectations of same-day discharge if appendicitis is intraoperatively confirmed to be uncomplicated and better analgesic instructions at discharge.

摘要

目的

近期研究表明,对于接受各种腹腔镜手术的儿科患者,当日出院是安全的。尽管并非标准做法,但在腹腔镜手术治疗单纯性阑尾炎后,当日出院越来越普遍。这项前瞻性研究旨在评估家长对单纯性阑尾炎腹腔镜阑尾切除术后当日出院的满意度。

方法

2016年,在我们机构,849例单纯性急性阑尾炎患者接受了腹腔镜阑尾切除术;其中,382例在同一日历日出院。在出院后2周通过电话进行随访,开展评估家长满意度的出院后调查。

结果

在185份家长的总回复中,约65%报告最初对当日出院感到满意。当时约30%感到紧张,5%觉得还没准备好回家。经过反思,更高比例的家长(81.6%)认为当日出院是合适的做法,11.4%不确定,7.0%不会再选择当日出院。一些家长提到了对疼痛控制的担忧,以及与工作人员交谈或自身手术经历中产生的不一致期望。

结论

大多数家长回忆出院时很高兴,回顾时这一比例增至82%。只有7%的家长不会再选择当日回家。改进的机会包括所有医疗人员制定统一计划,若术中确认阑尾炎为单纯性则期望当日出院,以及在出院时提供更好的镇痛指导。

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