Rode H, Millar A J, McCormack D, Prescott C A, O'Leary P, Cywes S
Department of Paediatric Surgery, University of Cape Town.
S Afr Med J. 1994 Dec;84(12):829-33.
Ambulatory surgery has become an important component in the provision of surgical care. In 1987 a day-case surgical unit was established at Red Cross War Memorial Children's Hospital, Cape Town. Experience over a 6-year period (1987-1992) is reviewed in relation to the nature and total number of surgical procedures, pre-operative preparation, daily utilisation of the facility, postoperative care and complications. During this period 16,538 patients (mean age 3 years) were operated on in the unit. Nine surgical disciplines participated. Pre-operative assessment and preparation reduced the rate of cancellations on the day of surgery to less than 6%, with a 90% effective use of schedules operating time. Scarce nursing resources were also maximally utilised. Most procedures took less than 30 minutes and only 0.8% exceeded 1 hour. The average ward stay was 6 hours. No major complications were encountered and acceptance by patients and parents was excellent. Only 16 children who were not scheduled to do so needed to stay in hospital overnight. Recommendations to establish and improve day-stay surgical services are presented. It is concluded that a practical, efficient service can be established and that the authorities should be encouraged to expand appropriate facilities.
门诊手术已成为外科护理服务的一个重要组成部分。1987年，开普敦红十字战争纪念儿童医院设立了一个日间手术科室。本文回顾了该科室在1987年至1992年这6年期间的手术性质、手术总数、术前准备、科室的每日使用情况、术后护理及并发症情况。在此期间，该科室共为16538名患者（平均年龄3岁）实施了手术。九个外科专业参与其中。术前评估和准备将手术当日的取消率降至6%以下，手术排班时间的有效利用率达到90%。同时，也最大限度地利用了稀缺的护理资源。大多数手术耗时不到30分钟，只有0.8%的手术超过1小时。患者平均住院时间为6小时。未出现重大并发症，患者及家长的接受度很高。只有16名未安排过夜住院的儿童需要留院过夜。本文还提出了建立和改进日间手术服务的建议。结论是，可以建立一个实用、高效的服务体系，应鼓励相关部门扩大合适的设施。
