广西某三甲妇幼保健院19例非计划再次手术回顾性分析

Retrospective Analysis of 19 Cases of Unplanned Reoperation in a Three A and Tertiary Maternal and Child Health Hospital in Guangxi

目的分析广西某三级甲等妇幼保健院非计划再次手术原因,为提高医疗质量安全、降低非计划再次手术发生率提供依据。方法回顾性分析某妇幼保健院2019年1月1日-2019年12月31日的19例非计划再次手术患者的临床资料,分析患者再手术的科室分布、发生率和发生原因。结果非计划再次手术发生率为0.12%;非计划再次手术主要发生在外科(6例,占0.58%)、小儿外科(6例,占0.32%)、妇科(5例,占0.08%)和产科(2例,占0.06%);切口愈合不良或裂开、术后出血或血肿、吻合口瘘、病理相关问题、术后感染、内固定位置不良是发生非计划再次手术的主要原因。结论低龄、恶性肿瘤和高级别手术增加非计划再次手术发生率,医院应加强围手术期管理,纳入科室质量与安全管理,应用现代化管理工具进行监管,有效降低非计划再次手术的发生,保障患者安全。

Objective To analyze the causes of unplanned reoperation in a Three A and Tertiary Maternal and Child Health hospital in Guangxi,in order to provide evidence for improving the quality of medical care and reducing the incidence of unplanned reoperation.Methods The clinical data of 19 patients with unplanned reoperation in a maternal and child health hospital from January 1 st,2019 to December 31 st,2019 were retrospectively analyzed,and the distribution,incidence and causes of patient reoperation were analyzed.Results The rate of unplanned reoperation was 0.12%.Unplanned reoperations mainly occurred in surgery(6 cases,0.58%),pediatric surgery(6 cases,0.32%),gynecology(5 cases,0.08%)and obstetrics(2 cases,0.06%).Poor wound healing or dehiscence,postoperative bleeding or hematoma,anastomotic fistula,pathology-related problems,postoperative infection,and poor internal fixation position are the main reasons for unplanned reoperation.Conclusions Young age,malignant tumor and high-level surgery could increase the incidence of unplanned reoperation.The hospital should strengthen perioperative management,bring the quality and safety management into the department,and apply modern management tools for supervision,so as to effectively reduce the occurrence of unplanned reoperation and ensure patient safety.