| 摘要: |
| 目的
通过对非计划再次手术的发生率、科室来源、发生原因进行统计分析，探讨非计划再次手术的防范措施，提高全院的手术质量。方法 对某三级甲等综合医院2014年度所有手术患者的临床资料进行回顾性分析。结果 共回顾性分析62 179份手术患者的资料，其中发生重返手术室的有2411人次，发生非计划再次手术的有435人次，非计划再次手术发生率为6.94‰，非计划再次手术主要发生在男性、40～59岁年龄组患者中，非计划再次手术主要科室来源为神经外科（143例）、心胸外科（39例）及口腔颌面外科（27例），术后出血/血肿、未达到效果手术再调整、术后漏、切口问题及手术部位感染为非计划再次手术发生的主要原因，占总原因的78.85%。结论 加强围手术期质量管理，严格执行非计划再次手术的上报制度，对非计划再次手术发生率高的重点科室、重点手术进行监管，是降低非计划再次手术发生率的有效措施。 |
| 关键词: 非计划再次手术 重返类指标 围手术期 医疗质量管理 |
| DOI： |
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| Analysis of the Causes and Department Distribution of 435 cases Undergone Unplanned Reoperation |
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| Abstract: |
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Objective By analyzing the incidence, department sources and the causes of non-planned reoperation, to discuss the measures in order to prevent non-planned reoperation and improve the operation quality of the hospital. Method A retrospective analysis was conducted on the clinical data of all surgical patients of a tertiary hospital in 2014. Result Among the data of 62 179 surgical patients who were studied retrospectively, 2 411 patients returned to the operating room, and 435 patients experienced the non-planned reoperation. The incidence of non-planned reoperation was 6.96‰. Among the most of the non-planned reoperation happened among male patients between 40～59 years old, the reoperated patients are mainly distributed in the departments of neurosurgery(143 cases), cardiothoracic surgery(39 cases) and oral and maxillofacial surgery(27 cases). The main causes of non-planned reoperation include postoperative bleeding/haematoma, re-adjust of un-desired effect, postoperative leakage, postoperative incision problems and postoperative surgical site infection, accounting for 78.85% of all the causes. Conclusion Strengthening perioperative quality management, strictly implementing report system of unplanned reoperation and ensuring the management of the department with high unplanned reoperation incidence, are all key means to decrease the incidence of non-planned reoperation. |
| Key words: medical quality management, patients return indicators, perioperative period,medical quality management |
