2026 年第 2 期 第 21 卷

门诊与住院模式下儿童口腔手术全身麻醉安全性和恢复质量及经济负担的队列研究

A cohort study on the safety, recovery quality, and economic burden of general anesthesia for pediatric oral surgery in outpatient and inpatient settings

作者：陈登超修冬莲魏娟邵君刘欢欢

英文作者：Chen Dengchao Xiu Donglian Wei Juan Shao Jun Liu Huanhuan

单位：福建医科大学附属口腔医院口腔颌面外科，福州350002

英文单位：Department of Oral and Maxillofacial Surgery Hospital of Stomatology Fujian Medical University Fuzhou 350002 China

关键词：口腔手术；日间全身麻醉；医疗干预率；疼痛管理；医保政策

英文关键词：Oralsurgery;Ambulatorygeneralanesthesia;Medicalinterventionrate;Painmanagement; Medicalinsurancepolicy

• 摘要：

• 目的 比较门诊与住院模式下儿童口腔手术气管插管全身麻醉的术后安全性、恢复质量及经济负担。方法 回顾性纳入2022年11月至2025年8月福建医科大学附属口腔医院426例患儿（门诊组与住院组各213例）。门诊组为符合日间手术标准当日离院者，住院组留院观察≥24 h。主要终点为术后24 h意外医疗干预率（门诊组：非计划再就诊率；住院组：非计划干预升级率），次要终点包括围术期并发症、疼痛评分、家长满意度及经济成本，行组间比较；同时采用多因素回归校正手术类型等混杂因素。结果2组术后24 h均未出现意外医疗干预。2组术中低氧血症、气道痉挛发生率、术后并发症发生率、家长疼痛控制满意度、整体满意度差异均无统计学意义（均P＞0.05）；门诊组自费麻醉费用显著高于住院组［（1 668±224）元比(837±79)元］(P＜0.001）。结论 门诊模式在儿童口腔手术气管插管全身麻醉中安全性等同于住院模式，且疼痛管理可获得同等家庭满意度，但因医保政策限制，门诊模式自费比例显著增加，可能制约其临床推广。

• Objective To compare the postoperative safety, recovery quality, and economic burden of tracheal intubation general anesthesia for pediatric oral surgery between outpatient and inpatient settings. Methods A total of 426 children (213 cases in the outpatient group and 213 cases in the inpatient group) admitted to Hospital of Stomatology, Fujian Medical University from November 2022 to August 2025 were retrospectively enrolled. The outpatient group consisted of children who met the ambulatory surgery criteria and were discharged on the same day, while the inpatient group was observed for ≥24 h. The primary endpoint was the unplanned medical intervention rate within 24 h after surgery (unplanned revisit rate in the outpatient group; unplanned intervention escalation rate in the inpatient group). Secondary endpoints included perioperative complications, pain scores, parental satisfaction, and economic costs, compared between groups; while, multivariate regression analysis was used to adjust for confounding factors such as surgical type. Results No unplanned medical interventions occurred within 24 h after surgery in either group. There were no statistically significant differences between the two groups in the incidence of intraoperative hypoxemia, airway spasm, postoperative complications, parental satisfaction with pain control, or overall satisfaction (all P＞0.05). The out-of-pocket anesthesia cost in the outpatient group was significantly higher than that in the inpatient group ［(1 668±224)yuan vs (837±79)yuan］(P＜0.001). Conclusion The outpatient setting is comparable to the inpatient setting in terms of safety for tracheal intubation general anesthesia in pediatric oral surgery, and equivalent family satisfaction with pain management can be achieved. However, due to restrictions in medical insurance policies, the proportion of out-of-pocket expenses in the outpatient setting is significantly higher, which may restrict its clinical promotion.