二次手术监管措施的探讨

目的为提高手术质量,从系统入手,采取三项措施,确保手术安全。方法提取本院2008～2010年的手术统计资料,对非计划二次手术发生的比例、专业及科室情况、成因、二次手术转归等进行分析。结果从2008年开始,二次手术率逐渐下降。发生二次手术率较高的科室为心胸外科及神经外科,术后出血、感染、切口问题、吻合口瘘是发生非计划二次手术的主要原因。结论非计划二次手术的发生与手术者专业水平、操作技术、术前准备情况及手术病种因素有关,从手术医师分级、信息监管、落实二次手术上报制度等三方面加强监管,可有效降低二次手术的发生率。

PROBE ON THE SUPERVISION MEASURES IN DECREASING INCIDENCE OF UNPLANNED SECONDARY OPERATION

ObjectiveFor improving the quality of operative technique and ensuring the safety of patients,a supervision measures was enforced in our clinical operative departments starting from 2008. Methods The authors analyzed the data of incidence of unplanned Secondary operations(uso) occurred in different operative departments & specialities in our hospital from 2008-2010.The causes of this operative complication were investigated and its final result of the patients were followed and deliberated. Results The incidence of USO was gradually decreased from 2008 since the supervision measures was executed in our hospital.The authors found that the highest incidence of USO were occurred in Chest & Heart Surgical Department and Neurosurgical Department.The main causes of USO were postoperative bleeding,infection,skin incision problems and fistula of anastomosis,etc. Conclusion The USO were investigated in our series due to the following factors: Low technical level of the operators;unqualified preoperative preparation;problems of surgical methodology and the pathology of the diseases itself.The incidence of USO was effectively decreased since the supervision measures put into effect and take it as a quality auditing system.This measures includes: Classification of various operators;supervision information;Report to the high leadership in case of USO occur.