根管内器械分离的医方责任和纠纷防范

Legal liability and prevention of medical disputes about endodontic instruments separation

根管内器械分离是根管治疗过程中的常见并发症之一,与根管的复杂解剖形态、器械本身的性能以及操作者因素密切相关,在现有医学科技条件下无法避免其发生。根管内的分离器械除了可能导致根管治疗的失败,还会造成医患双方的心理负担,极易引发医疗纠纷。虽然器械分离不属于医疗事故,但是并不意味着医方不需要承担责任。准确的术前评估和规范操作可以最大程度地降低器械分离的发生。术前告知、详尽的病历书写、在出现器械分离后做出最佳的临床决策以减少不良后果,有利于减少医疗纠纷的发生。

Instrument separation is one of the common complications in the process of root canal therapy,which is closely related to the complex anatomical morphology of the root canal,the performance of instrument and the factors of the operator,and cannot be avoided under the existing medical technology conditions.In addition to the failure of root canal treatment,instrument separation can also cause psychological burden to both doctors and patients,and easily lead to medical disputes.Although the instrument separation is not a medical accident,the doctor should also take some responsibility.Comprehensive preoperative evaluation and standardized operation can reduce the occurrence of instrument separation.Preoperative notification,detailed medical records and making the best clinical decision after instrument separation to reduce adverse consequences are beneficial to reduce medical disputes.