我院2010～2013围手术期死亡患者危险因素及术前治疗分析

Analysis of Risk Factors and Treatment before Operation for Patients Died in the perioperative Period in Our Hospital during 2010～2013

目的：分析某院一段时间内围手术期死亡患者危险因素及术前治疗。方法：检索某院电子病历管理系统,回顾分析2010年6月1日-2013年12月31日在某院外科接受手术治疗患者资料,以美国心脏病协会《非心脏手术的围手术期心血管评估与治疗指南》为依据并检索相关文献,分析围手术期死亡患者危险因素及治疗措施。结果：共调查手术病人431例次,术前合并内科疾病者181例次,术前无合并内科疾病者250例次。死亡患者8例。单因素分析影响围手术期死亡因素为：高龄、贫血、低蛋白血症、既往合并冠心病、脑梗死。围手术期评估欠充分,治疗以中成药为主。结论：高龄、贫血、低蛋白血症、既往合并冠心病、脑梗死是我院围手术期死亡的主要因素,围手术期评估与治疗需进一步完善。

Objective To analyze risk factors and the treatment before operation for patients that died in the perioperative period in our hospital in one period. Methods： Search the electronic medical record （EMR） system of a hospital to find out the patients underwent operation in our surgery department during June 2010 till December 2013. Comply with the ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery： a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and search relative documents to analyze the risk factors of the death cases and their treatment. Results： 431 cases were analyzed, 181 cases had other diseases before the operation while 250 cases were healthy before operation, 8 patients died in the perioperative period. Single factor analysis finds out that the risk factors are： aged, anemia, hypoproteinemia, coronary heart disease（CHD） and stroke in the past history. The perioperative assess and treatment needed further exam and treat as the guideline suggests, Chinese patent medicine was used mostly. Conclusion： High age, anemia, hypoproteinemia, CHD and stroke in the past history are the risk factors of perioperative death of our hospital, and perioperative assess and treatment needs to enhanced.