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目的分析某院非计划再次手术原因,为持续提高手术医疗质量和安全提供科学依据。方法收集某院2014年和2015年两年间发生的非计划再次手术病案资料,应用Excel和SPSS 13.0进行分类汇总及统计分析,结果两年间共发生非计划再次手术60例。主要原因为术后出血、术后感染、植入物移位或脱落,在非计划再次手术患者中急诊手术比择期手术的发生率显著高(P<0.05),ASA和NNIS分级与非计划再次手术发生率正相关、随着ASA分级和NNIS分级增高发生率明显增多(P<0.05)。结论急诊手术、ASA≥3级、NNIS≥2级是引起非计划再次手术的高危因素,医院应通过提高医护人员专业水平、遵循术前讨论,对高危对象进行追踪并有效监管,以降低重返率。
Objective To analyze the causes of unplanned reoperation in a hospital and provide a scientific basis for continuously improving the quality and safety of surgical operations. Methods The data of unplanned re-operation cases collected in a hospital from 2014 to 2015 were collected and classified by Excel and SPSS 13.0. Results There were 60 unplanned reoperations in two years. The main reason was postoperative bleeding, postoperative infection, implants displacement or shedding. The incidence of emergency surgery was significantly higher than that of elective surgery (P <0.05) in patients undergoing unplanned reoperation. ASA and NNIS classification and unplanned again The incidence of surgery was positively correlated with ASA classification and NNIS grade increased significantly (P <0.05). Conclusions Emergency surgery, ASA≥3, and NNIS≥2 are the risk factors causing unplanned reoperation. The hospital should improve the professional level of medical staff and follow the preoperative discussion to track and monitor the high-risk patients to reduce the return rate.