Archampong E Q, Darko R
Department of Surgery, University of Ghana Medical School, Ghana.
West Afr J Med. 1996 Jul-Sep;15(3):143-8.
Day surgery is not simply a matter of economics for the health institution or the individual patient, or improved utilization of scarce and dwindling resources, or even a matter of increasing access to health care, fundamental as this is to us in the developing world. The ultimate question is to what extent does it satisfy the true needs of the patient and meet the requirements of his care as a whole. To address this day surgery in a general surgical unit has been reviewed over a 6 year period. This covered a total of 1547 cases consisting of hernias, hydroceles, excision biopsies, varicose veins etc. Infiltrative local anaesthesia using lignocaine (4 mg/kg) mostly with 1 in 200,000 adrenaline added proved effective in 98 percent of cases; there were no deaths. For the institutions day surgery has proven cost effective, lowering cost of operative treatment and improving utilization of scarce resources. It has also proven eminently acceptable to patients and their families, enhancing access to care and significantly reducing the personal cost of treatment. To demonstrate enhanced health economics future studies should ideally show a parallel diminution of in-patient bed facilities with increasing load of day surgery.
日间手术对于医疗机构或个体患者而言，不只是一个经济问题，也不是关于更好地利用稀缺且日益减少的资源，甚至也不仅仅是增加医疗服务可及性的问题，尽管在发展中国家这对我们至关重要。最终的问题是，它在多大程度上满足了患者的真正需求，并符合其整体护理要求。为了解决这个问题，对一个普通外科病房的日间手术进行了为期6年的回顾。这涵盖了总共1547例病例，包括疝气、鞘膜积液、切除活检、静脉曲张等。使用利多卡因（4毫克/千克）进行浸润性局部麻醉，大多添加1:200000的肾上腺素，98%的病例证明有效；无死亡病例。对于医疗机构来说，日间手术已被证明具有成本效益，降低了手术治疗成本，提高了稀缺资源的利用率。它也已被证明非常为患者及其家属所接受，增加了医疗服务可及性，并显著降低了个人治疗成本。为了证明改善了卫生经济学状况，理想情况下，未来的研究应表明随着日间手术量的增加，住院床位设施会相应减少。
