某综合医院非计划再次手术原因分析及对策.pdfVIP

·348 · 中华临床医师杂志( 电子版)2015 年1 月第9 卷第2 期 Chin J Clinicians(Electronic Edition),January 15,2015,Vol.9,No.2 ·临床医疗管理· 某综合医院非计划再次手术原因分析 及对策 狄杰斌 戚丽娜 【摘要】 目的 通过对非计划再次手术的原因分析，加强非计划再次手术的监管，提高医疗 质量。方法 对某三级甲等综合医院2013 年度发生的40 例非计划再次手术患者的临床资料进行回 顾性分析。结果 40 例非计划再次手术中发生最多的科室是神经外科（8 例），其次为肿瘤外科（5 例），普外科、心外科（各 4 例）。非计划再次手术主要发生在三级以上手术，占 75.0% 。发生非计 划再次手术最多的月份是3 月份（7 例），其次为 1 月份（5 例）、10 月份（5 例）。非计划再次手术 的主要原因是首次手术的主要并发症（术后出血或渗血、刀口裂开或不愈合、术后感染等），占全部 原因的 75.0% 。结论 医院应将非计划再次手术作为医疗质量管理的重点，严格手术分级管理与手 术医师分级授权制度，不断加强围手术期管理，加强非计划再次手术监测与绩效考核，降低非计划 再次手术的发生率。 【关键词】 再手术； 原因分析； 疾病管理 Analysis and countermeasure on the cause of unplanned reoperation of a general hospital Di Jiebin, Qi Lina. Department of Medical Quality Management, Taian City Central Hospital, Taian 271000, China Corresponding author: Di Jiebin, Email: dlfjb@163.com 【Abstract 】 Objective To analyze the reason of unplanned reoperation and to strengthen it’s supervision and improve the quality of medical care. Methods The clinical data of 40 cases who had experienced unplanned reoperation in a tertiary hospital in 2013 were studied retrospectively . Results Among the 40 cases, most patients came from department of neurosurgery (8 cases), department of surgical oncology (5 cases), department of general surgery and department of cardiac surgery (4 cases in each department). Most of the unplanned reoperations happened in three-level and higher surgery, accounting for 75%. Most of the unplanned reoperations occurred in March (7 cases), January and October (5 cases in each season). The main reason for unplanned reoperation was the main complications of the first surgery, such as postoperative bleeding or errhysis, edge crack or not healing, postoperative infection, accounting for 75.0% of all causes. Conclusion The hospital should take unplanned reo