158例非计划再次手术临床分析及对策研究

Clinical characteristics and counter measures of 158 cases of unplanned reoperation

目的探讨非计划再次手术的临床特点及原因分析,为降低非计划再次手术的发生率提出监管对策。方法提取本院2014年至2017年的手术资料,对非计划再次手术发生率、临床特点、发生原因进行分析。结果四年中,本院共发生158例非计划再次手术,发生率为0.24%,疑难危重病例占比65.9%,三四级手术占比65.8%;术后出血、伤口愈合不良、肠黏连梗阻穿孔是主要原因,分别占21.5%、20.9%、20.9%。结论医院应当严格落实手术分级管理等相关医疗制度,提高手术操作水平,加强高危手术的围手术期管理,完善非计划再次手术的上报制度与监管模式,减少非计划再次手术的发生。

Objective To analyze clinical characteristics and causes of unplanned reoperation so as to put forward the counter measures of decreasing the incidence of unplanned reoperation.Method We analyzed the incidence,clinical characteristics,and causes of the cases of unplanned reoperation extracted from Hospital Information System from 2014 to 2017.Results There were 158 cases of unplanned reoperation in our hospital in the four years,with the incidence of 0.24%,in which difficult and critical illness accounted for 65.9%,level three and four surgery accounted for 65.8%.Postoperative hemorrhage,poor wound healing,intestinal adhesion,obstruction,and perforation were the main causes,respectively accounting for 21.5%,20.9%,20.9%.Conclusion To decrease the incidence of unplanned reoperation,we should strictly implement medical rules of operative classification,improve surgical technique,enhance the perioperative management of high-risk surgery,and strengthen the reporting system and supervision model of unplanned reoperation.