肺癌患者日间手术后延迟出院的危险因素研究

doi:10.3761/j.issn.2096-7446.2022.03.002

摘要/Abstract

摘要： 目的分析肺癌患者日间手术后延迟出院的危险因素,为减少日间手术患者延迟出院提供参考。方法回顾性收集浙江省某三级甲等医院2020年4月1日—2021年11月30日接受日间手术的肺癌患者临床资料。将患者分为正常出院组（住院时间≤48 h）和延迟出院组（住院时间>48 h）,采用单因素分析和Logistic回归分析其延迟出院的危险因素。结果本研究共纳入1 363例肺癌患者,其中延迟出院患者223例,延迟出院发生率为16.4%。单因素分析结果显示,两组在年龄、是否为本地就医、手术方式、手术时间、术中出血量、恶心呕吐、使用抗凝药物、物理预防措施方面,差异具有统计学意义（P<0.05）。Logistic回归分析显示,年龄[OR=1.020,95%CI（1.007,1.036）]、手术时间[OR=1.014,95%CI（1.010,1.017）],恶心呕吐[OR=1.567,95%CI（1.052,2.332）]是患者术后延迟出院的独立危险因素（P<0.05）;使用抗凝药物[OR=0.113,95%CI（0.081,0.158）]、物理预防措施[OR=0.504,95%CI（0.270,0.943）]是患者术后延迟出院的保护因素（P<0.05）。结论护理人员应关注肺癌患者日间手术后延迟出院的危险因素,加强围术期风险评估与宣教,主动了解肺癌患者术中情况,并及早进行个性化干预以降低其延迟出院的风险。

关键词: 肺肿瘤, 延迟出院, 日间手术, 外科护理

Abstract: Objective To analyze the risk factors of delayed discharge among lung cancer patients undergoing day surgery to provide reference for reducing the delayed discharge of patients. Methods The data of lung cancer patients who accepted the day surgery were retrospectively collected during April 1st 2020 to November 30th 2021. The patients were divided into two groups,normal discharge group（stayed less than 48 h） and delayed discharge group（stayed over 48 h）. Univariate analysis and logistic regression were used to analyze the risk factor of delayed discharge. Results 1 363 patients were collected,223 patients were delayed and the incidence of delayed discharge was 16.4%. Univariate analysis showed that age,the local resident,the surgery type,surgery length,amount of bleeding,nausea and vomiting,anticoagulant therapy,mechanical prophylaxis were different between delayed discharge patients and normal discharge patients（P<0.05）. Logistic regression showed that age[OR=1.020,95%CI（1.007,1.036）],surgery length[OR=1.014,95%CI（1.010,1.017）],nausea and vomiting[OR=1.567,95%CI（1.052,2.332）] were independent risk factors（P<0.05）. Anticoagulant therapy[OR=0.113,95%CI（0.081,0.158）],mechanical prophylaxis[OR=0.504,95%CI（0.270,0.943）] were protective factors（P<0.05）. Conclusion It suggests that nurses need to focus on these risk factors for lung cancer patients who undergo day surgery,enhance their risk assessment and education during perioperative period,actively understand their intraoperative situation,and give an early individual intervention to reduce their risk of delayed discharge.

Key words: Lung Neoplasms, Delayed Discharge, Day Surgery, Medical-surgical Nursing

贺红, 庹汪阳, 袁华娣, 韩娜菲, 金尧娟. 肺癌患者日间手术后延迟出院的危险因素研究[J]. 中华急危重症护理杂志, 2022, 3(3): 203-207.

HE Hong, TUO Wangyang, YUAN Huadi, HAN Nafei, JIN Yaojuan. Analysis of risk factors of delayed discharge among lung cancer patients after day surgery[J]. Chinese Journal of Emergency and Critical Care Nursing, 2022, 3(3): 203-207.

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