择期手术患者围手术期死亡原因及影响因素分析  

Influencing factors of perioperative death of patients with elective surgery

作　　者：胡春兰[1] 毛莉颖[1] 牟勇[1] HU Chunlan;MAO Liying;MOU Yong(Guangdong Second Provincial Hospital,Guangzhou,Guangdong,510317,China)

机构地区：[1]广东省第二人民医院,广东广州510317

出　　处：《现代医院》2020年第5期675-678,共4页Modern Hospitals

基　　金：广东省医学科学技术研究基金(A2018479)。

摘　　要：目的探讨择期手术患者围手术期死亡的原因及影响因素,为降低围手术期死亡率提供管理依据。方法回顾性分析某院2016年1月-2019年9月择期手术术后死亡患者的临床资料,并进行统计分析。结果70 517例择期手术患者,术后死亡53例,死亡率为0. 08%;主要发生科室为心血管外科、心胸外科、关节骨科、普外一科、普外二科;主要的手术类型为心脏瓣膜置换术、冠状动脉旁路移植术、人工股骨头置换术、食管癌根治术,主要的手术部位为心脏/心脏大血管、四肢、胃肠、胸肺、肾及输尿管,导致死亡的主要原因为感染性休克、可疑肺栓塞、吻合口瘘、术后低心排综合征等。结论术后严重并发症是择期手术围手术期死亡的主要原因,加强手术围手术期管理,及时预防和处理并发症,对降低围手术期死亡率有重要意义。Objective To investigate the influencing factors of perioperative death of patients with elective surgery so as to provide management basis for reducing perioperative mortality. Methods The clinical data of the patients who died after selective surgery from January 2016 to September 2019 were retrospectively analyzed. Results Among the 70 517 patients who underwent elective surgery,53 patients died with a mortality rate of 0. 08%. The perioperative death mainly occurred in the following departments: cardiovascular surgery,cardiothoracic surgery,joint orthopedics,the first department of general surgery and the second department of general surgery. The death mainly occurred from the following types of surgery:heart valve replacement,coronary artery bypass grafting,artificial femoral head replacement and radical esophageal cancer surgery. The main surgical sites were the heart or great vessels of the heart,limbs,gastrointestinal tract,lung-thorax,kidney and ureter. The common death causes were septic shock,suspected pulmonary embolism,anastomotic leakage and postoperative low cardiac output syndrome. Conclusion Severe postoperative complications are the main cause of perioperative death in selective surgery. Strengthening the perioperative management of surgery by preventing and treating complications timely are important for the reduction of perioperative mortality in elective surgery.

关 键 词：择期手术 围手术期死亡 并发症 

分 类 号：R197.323.2[医药卫生—卫生事业管理] R6[医药卫生—公共卫生与预防医学]