围术期管理对手术相关危险因素影响研究  

Procedure Related Risk Factors Study of Perioperative Period Management

作　　者：樊宏[1] 胡剑超[1] 张彦[1] 阳红[1] 王乃俊[1] 陈燕[1] 

机构地区：[1]成都军区昆明总医院质量管理科,云南昆明650032

出　　处：《中国医院管理》2012年第4期28-31,共4页Chinese Hospital Management

摘　　要：目的探讨手术并发症、死亡相关危险因素和改进围术期安全质量管理对其的影响及意义。方法对可能引发术后并发症及死亡的危险因素进行单元性分析和多元性回归分析,并对实施新的管理制度和改进管理模式前、后手术并发症及死亡率作对照分析。结果单元性与多元性回归分析显示,肥胖、吸烟史、麻醉风险评估≥2级、切口类型≥Ⅱ和手术时间>3 h与发生术后并发症及死亡有显著相关性(P在0.000～0.019以内),而且均为诱发的高危因素(OR在2.860～9.710以内)。改进管理制度和管理模式后手术并发症发生率分别下降1.40%(P=0.002)、1.30%(P=0.000)、1.62%(P=0.000),实施手术安全质量信息化管理系统之后手术死亡率降低了0.16%(P=0.002)。结论加强和改进围术期安全质量管理能够有效预防和控制术后并发症及死亡,对持续改进手术质量、保障病人安全具有重要的现实意义。Objective To evaluate the surgical complications and death associated risk factors and improve perioperative safety and quality management of their impact and significance. Methods Matters leading to postoperative complications and risk factors of death unit and plurality of regression analysis, and implementation of new management systems and management improvement before and after surgery for complications and mortality were analyzed. Results Diversity of the results of unit regression analysis showed that obesity, smoking history, anesthesia risk assessment≥2 level, the type of ≥ Ⅱ and surgical incision time 〉3 h and the occurrence of postoperative complications and death were signifi- cantly correlated （with P in 0.000N0.019）, and are induced by high-risk factor （with OR in 2.860-9.710）. After manage- ment system improvement and management of complications, the incidence decreased 1.40% （P=0.002）, 1.30% （P= 0.000）, 1.62% （P=0.000）; implementation of the quality of surgical information management system security operative mortality after reduced by 0.16% （P=0.002）. Conclusion Strengthening and improving the quality of perioperative manage- ment can secure the effective prevention and control of postoperative complications and death, and have important practical significance for patients＇ safety continuous improvement of quality.

关 键 词：手术 围术期 危险因素患者安全质量控制 

分 类 号：R619[医药卫生—外科学]