某三甲综合医院心脏外科非计划再手术现状分析

Status Analysis of Unplanned Reoperation in Cardiac Surgery Department of a Provincial Grade A Tertiary General Hospital

目的分析心脏外科非计划再手术发生现状,探讨非计划再手术管理措施。方法搜集某三甲综合医院2018—2022年心脏外科手术患者信息,分析非计划再手术发生率、主要原因、病种、手术方式以及并发症等。结果共3902例手术患者,其中非计划再手术73例(占1.87%)。非计划再手术的主要原因为出血(占50%)。非计划再手术构成比最多的病种是冠心病(占38.4%),发生率最高的病种是扩张型心肌病(占11.1%)。非计划再手术患者平均住院费用、平均住院日、死亡率、医疗纠纷发生率高于未发生非计划再手术患者,差异有统计学意义(P=0.001)。结论医院应加强心脏外科围手术期管理,重点监管非计划再手术发生率较高的病种和手术方式,严格执行手术分级管理制度与非计划再手术上报制度,保证患者手术质量。

Objective To analyze the current situation of unplanned reoperation in cardiac surgery and to discuss the management measures of unplanned reoperation.Methods The information of patients undergoing cardiac surgery in a class A tertiary comprehensive hospital during 2018-2022 was collected to analyze the incidence of unplanned reoperation,major causes,disease types,surgical modalities and Complications.Results A total of 3902 patients underwent surgery,of whom 73(1.87%)underwent unplanned reoperation.The main cause of unplanned reoperation was bleeding(50%).The disease types with the highest unplanned reoperation composition ratio were coronary heart disease(38.4%),and the disease types with the highest incidence were dilated cardiomyopathy(11.1%).The average hospitalization cost,the average length of hospitalization,mortality rate and medical dispute rate of patients who had unplanned reoperation were significantly higher than those who did not have unplanned reoperation,the difference was statistically significant(P=0.001).Conclusion The hospital should strengthen the perioperative management of cardiac surgery,focus on supervising disease types and surgical modalities with high incidence of unplanned reoperation,and strictly implement the system of operation classification and the system of reporting unplanned reoperation to ensure the quality of patient surgery.