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目的分析肺癌患者围手术期不留置尿管的成本效益,以进一步确定不留置尿管的临床价值。方法前瞻性纳入2015年7~12月四川大学华西医院行肺癌肺叶切除术患者148例。按是否留置尿管将患者分为尿管留置组[74例,男45例、女29例,年龄(52.55±19.87)岁]和无尿管留置组[74例,男42例、女32例,年龄(54.03±16.66)岁],比较两组成本效益指标。结果无尿管留置组术后有5人次置尿管,尿管留置组81人次置尿管。两组患者尿管留置时间差异无统计学意义[(1.56±0.65)d vs.(1.68±0.91)d,P=0.077]。尿管留置组尿管材料费(4 811.48元vs.296.74元,P=0.045)、护理费用(7 413.32元vs.457.32元,P=0.013)及总费用(12 224.8元vs.754.06元,P=0.000)均高于无尿管留置组。尿管留置组护理总时间长于无尿管留置组(335.71 h vs.17.95 h,P=0.034)。尿管留置组人均材料费、护理费和总费用[(65.02±5.62)元/(次·人)vs.(4.01±0.00)元/(次·人),(100.18±7.19)元/(次·人)vs.(6.18±1.22)元/(次·人),(165.20±12.81)元/(次·人)vs.(10.19±1.22)元/(次·人),P值均为0.000]均高于无尿管留置组。结论选择合适的肺癌患者围手术期无尿管留置不但节约费用且减少护理工作量。
Objective To analyze the cost-benefit of perioperative non-placement of catheters in patients with lung cancer to further determine the clinical value of indwelling catheters. Methods Forty-eight patients with lung cancer who underwent lobectomy in West China Hospital of Sichuan University from July to December 2015 were prospectively included. Patients were divided into catheter indwelling group (74 cases, 45 males, 29 females, age 52.55 ± 19.87 years) and catheter-free group [74 cases, 42 males and 32 females , Age (54.03 ± 16.66) years old]. The two groups were compared for their cost-effectiveness. Results Urinary catheter indwelling group had a total of 5 catheterization and 81 catheterization catheterization. There was no significant difference in urinary indwelling time between the two groups [(1.56 ± 0.65) d vs. (1.68 ± 0.91) d, P = 0.077]. Catheterization of catheterization costs (4 811.48 vs.296.74 yuan, P = 0.045), nursing care costs (7 413.32 yuan vs.457.32 yuan, P = 0.013) and total costs (12 224.8 yuan vs. 754.06 yuan, P = 0.000) were higher than without catheter indwelling group. The total duration of catheterization in the catheterization group was longer than in the catheter-free group (335.71 h vs. 17.95 h, P = 0.034). Per capita material cost, nursing cost and total cost of catheter indwelling group were (65.02 ± 5.62) yuan / (times · person) vs. (4.01 ± 0.00) yuan / (times · person), (100.18 ± 7.19) yuan / times · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · ·) ] Were higher than without catheter indwelling group. Conclusion Choosing the right catheterization for perioperative patients with lung cancer not only saves money and reduces the workload of nursing care.