术后日间护理作为二次牙槽骨植骨术（SABG）的安全且具成本效益的选择：一项回顾性对比队列研究。
Postoperative Daycare as a Safe and Cost-Effective Option for Secondary Alveolar Bone Graft (SABG) Surgery: A Retrospective Comparative Cohort Study.
机构信息
Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.
Department of Biochemistry, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
出版信息
Cleft Palate Craniofac J. 2024 Sep;61(9):1421-1428. doi: 10.1177/10556656231171210. Epub 2023 Apr 25.
OBJECTIVE
To evaluate the outcomes of Secondary Alveolar Bone Grafting (SABG) in patients treated either in daycare or with multiple day hospitalization (MDH) in relation to costs and complication rates.
DESIGN
Retrospective comparative cohort study.
SETTING
The data was collected from two settings: Postoperative daycare or MDH after oral cleft surgery in an Academic Medical Center in The Netherlands.
PATIENTS
Data of 137 patients with unilateral Cleft lip, alveolus, and palate (CLAP) treated between 2006-2018 were evaluated. Registered clinical variables: age, gender, cleft subtype, bone donor site, type of hospitalization, length of stay, additional surgery, complications, surgeons, and costs.
INTERVENTIONS
Closure of the alveolar cleft with/without closure of the anterior palate.
MAIN OUTCOME MEASURES
Univariate analyses.
RESULTS
Of the 137 patients, 46.7% were treated in MDH, and 53.3% in daycare. Total costs for daycare were significantly lower ( < .001). All patients treated in daycare received mandibular symphysis bone, whereas in MDH, 46.9% received iliac crest bone instead. Bone donor site was associated with postoperative care type. Complication rates were slightly but not significantly higher in daycare (26%) vs. MDH (14.1%) ( = .09). Most were Grade I (minor) according to Clavien Dindo classification.
CONCLUSIONS
Daycare after alveolar cleft surgery is about as safe as MDH, but significantly cheaper.
目的
评估日间手术（daycare）和多日住院（multiple day hospitalization，MDH）两种治疗方案在二次牙槽骨移植（secondary alveolar bone grafting，SABG）中的效果，比较两种方案的成本和并发症发生率。
设计
回顾性比较队列研究。
设置
数据来自荷兰某学术医疗中心两种治疗方案下的资料：腭裂术后日间手术或多日住院。
患者
评估了 2006 年至 2018 年间接受单侧唇裂、牙槽裂和腭裂（cleft lip，alveolus，and palate，CLAP）治疗的 137 例患者的数据。记录的临床变量包括：年龄、性别、裂隙类型、骨供区、住院类型、住院时间、是否需附加手术、并发症、手术医生和治疗费用。
干预
采用牙槽裂植骨术或牙槽裂植骨联合前腭裂修复术。
主要观察指标
单变量分析。
结果
137 例患者中，46.7%接受 MDH，53.3%接受 daycare。 daycare 治疗的总费用明显更低（ < .001）。所有在 daycare 接受治疗的患者均接受下颌颏部骨移植，而在 MDH 中，46.9%接受了髂嵴骨移植。骨供区与术后护理类型有关。daycare 的并发症发生率（26%）略高于 MDH（14.1%），但差异无统计学意义（ = .09）。大多数并发症根据 Clavien Dindo 分级为Ⅰ级（轻微）。
结论
日间手术治疗牙槽裂的效果与 MDH 相当，但费用显著更低。
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