CAJ | 학술논문

目的分析行非急诊手术合并2型糖尿病患者住院费用的影响因素.方法回顾性调查2013年1月1日至2013年12月31日本院行非急诊手术患者的住院病历资料,糖尿病组109例,条件匹配的162例非糖尿病患者为对照组.比较两组住院费用等指标,对糖尿病组住院费用影响因素进行多重线性回归分析.结果糖尿病组中位住院费用为12 014.74元,是对照组9698.54元的1.24倍(P=0.001).与对照组相比,糖尿病组麻醉分级、伤口愈合时间、术后感染率、住院时间均明显升高(P＜0.01);麻醉分级(β=0.442,P=0.000)、术后1周空腹血糖(β=0.204,P=0.020)、术后感染(β=0.204,P=0.019)是糖尿病组住院费用的主要影响因素;在微创手术情况下,糖尿病组与对照组术后感染率、住院费用差异无统计学意义(P＞0.05).结论非急诊手术合并2型糖尿病患者的住院费用高,麻醉分级、术后1周空腹血糖、术后感染是其主要影响因素.优先选择微创手术、规范围手术期血糖管理将有助于减少糖尿病患者住院费用.
목적 분석행비급진수술합병2형당뇨병환자주원비용적영향인소.방법 회고성조사2013년1월1일지2013년12월31일본원행비급진수술환자적주원병력자료,당뇨병조109례,조건필배적162례비당뇨병환자위대조조.비교량조주원비용등지표,대당뇨병조주원비용영향인소진행다중선성회귀분석.결과 당뇨병조중위주원비용위12 014.74원,시대조조9698.54원적1.24배(P=0.001).여대조조상비,당뇨병조마취분급、상구유합시간、술후감염솔、주원시간균명현승고(P＜0.01);마취분급(β=0.442,P=0.000)、술후1주공복혈당(β=0.204,P=0.020)、술후감염(β=0.204,P=0.019)시당뇨병조주원비용적주요영향인소;재미창수술정황하,당뇨병조여대조조술후감염솔、주원비용차이무통계학의의(P＞0.05).결론 비급진수술합병2형당뇨병환자적주원비용고,마취분급、술후1주공복혈당、술후감염시기주요영향인소.우선선택미창수술、규범위수술기혈당관리장유조우감소당뇨병환자주원비용.
Objective To investigate the factors of hospitalization expense in patients with type 2 diabetes mellitus undergoing non-emergency surgery.Methods A retrospective study included diabetic (109 cases) and control (162 cases) groups.Hospitalization expense and other observation indices were compared between two groups and subgroups.The factors that contribute to hospitalization expense were analyzed with multifactor regression analysis model.Results The median hospitalization expense was 12 014.74 yuan in the diabetic group,1.24 times than that in the control group (P =0.001).Diabetic group has higher American Society of Anesthesiologists (ASA) classification,longer wound healing time,higher postoperative infection rate,and longer hospital stay (P ＜ 0.01).Multifactor analysis revealed that the significant factors that influence the hospitalization expense were ASA classification (β =0.442,P =0.000),postoperative fasting plasma glucose (β =0.204,P =0.020),and postoperative infection (β =0.204,P =0.019).No significant difference was found in postoperative infection rate and hospitalization expense between two groups,when patients had received minimally invasive surgeries (P ＞ 0.05).Conclusions Type 2 diabetes patients have higher hospitalization expense;ASA classification,postoperative fasting plasma glucose,and postoperative infection are the main influence factors.Giving priority to minimally invasive surgeries and enhancing perioperative glucose control can help to reduce hospitalization expense in patients with type 2 diabetes mellitus.