142例非计划再次手术回顾性分析及重点监控对策

Retrospective Analysis and Key Monitoring Countermeasures on 142 Cases of Unplanned Reoperation

目的:通过回顾性分析非计划再次手术的发生情况,探讨非计划再次手术重点监控对策,保证围手术期患者安全。方法:收集某三甲医院2016年～2017年142例非计划再次手术的患者信息、手术信息,以及各专科非计划再次手术原因分布和两次手术间隔时间等进行统计分析。结果:比较非计划再次手术与一般手术患者性别比、年龄、预后、住院费用、住院天数和手术级别差异均有统计学意义(p<0.001);普外科和心胸外科术后15小时预防术后出血,骨科术后15天预防切口液化、感染和妇产科术后4天预防管道、吻合口瘘等是各专科防控非计划再次手术的重点。结论:加强重点患者、重点级别手术、重点时段的安全监管,才能有效减少非计划再次手术发生,降低医疗风险。

Objective ： By analyzing the occurrence of unplanned reoperation, the objective of the study was to discuss the key monitoring measures of unplanned reoperation, in order to ensure the safety of perioperative patients. Methods ： Surgeries conducted from 2016 to 2017 year, 142 patients with unplanned reoperation in hospital were retrospectively analyzed ; the patient information, surgical information, the causes of unplanned reoperation and the interval between two operations were statistically analyzed. Results： There were significant differences in sex ratio, age, prognosis, hospitalization cost, length of hospital stay and operation grade between nonplanned reoperation and general stu-geiy （p 〈 0.001） , general stu-geiy and cardiothoracic surgery prevention of postoperative hemorrhage after operation 0.65 days, prevention of incision liquefaction/infection 15 days after orthopedic operation, and prevention of piping/anastomotic fistula 4 days after obstetrics and gynecology operation. This is the focus prevention and control of unplanned reoperation. Conclusion ： In order to effectively reduce unplanned reoperation and reduce medical risk, it is necessary to strengthen the safety supervision of key patients, key-level operations and key periods.