207例非计划再次手术调查分析

Investigation and Analysis of 207 Cases of Unplanned Reoperation

目的分析某院非计划再次手术的基本情况,探讨有针对性的管理措施,促进医疗质量持续改进。方法回顾性分析某三级综合医院2020年1月1日-2022年12月31日的非计划再次手术的病例信息,从影响因素、分级授权、发生原因、再次手术间隔时间等方面对非计划再次手术情况进行描述和比较。结果2020年1月1日-2022年12月31日发生非计划再次手术207例,总发生率0.24%,呈下降趋势(χ^(2)=13.289,P=0.001)。4级手术的非计划再次手术率(0.61%)高于1~3级手术(0.08%)(χ^(2)=201.810,P<0.001)。急诊入院手术中有2例越级手术。非计划再次手术的主要原因是术后出血或血肿(50.24%)。非计划再次手术主要发生在术后0~7天内(70.5%)。结论应加强对四级手术、急诊手术的管理,优化排班制度,进一步降低非计划再次手术率。

Objectives This study aims to analyze the basic situation of unplanned reoperation in a hospital and explore targeted management measures to promote continuous improvement of medical quality.Methods The case information of unplanned reoperation in a tertiary general hospital from January 1,2020 to December 31,2022 was retrospectively analyzed.The unplanned reoperation was described and compared from the aspects of influencing factors,graded authorization,causes,and interval time of reoperation.Results From January 1,2020 to December 31,2022,207 cases of unplanned reoperation occurred,with a total incidence of 0.24%,showing a downward trend(χ^(2)=13.289,P=0.001).The unplanned reoperation rate of grade 4 surgery(0.61%)was higher than that of grade 1-3 surgery(0.08%)(χ^(2)=201.810,P<0.001).There were 2 cases of skip-grade surgery in emergency admission surgery.The main reason for unplanned reoperation was postoperative hemorrhage or hematoma(50.24%).Unplanned reoperation mainly occurred within 0 to 7 days after surgery(70.5%).Conclusions The management of grade 4 surgery and emergency surgery should be strengthened,and the scheduling system should be optimized to further reduce the unplanned reoperation rate.