非白内障眼科日间手术当日取消率及原因分析  

Analysis of the incidence and reasons of the same-day cancellation of non-cataract ophthalmic ambulatory surgery

作　　者：奚春花[1] 施东婧 李芸慧 张伊 岳建英[1] 李铭[1] 王古岩 Xi Chunhua;Shi Dongjing;Li Yunhui;Zhang Yi;Yue Jianying;Li Ming;Wang Guyan(Department of Anesthesiology,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院麻醉科,北京100730

出　　处：《中华医学杂志》2022年第21期1608-1613,共6页National Medical Journal of China

基　　金：北京市医院管理中心临床医学发展专项(ZYLX202103)。

摘　　要：目的分析非白内障眼科日间手术当日取消率及原因,为进一步提高眼科日间手术医疗质量提供依据。方法通过电子病案管理系统,收集首都医科大学附属北京同仁医院2020年12月1日至2021年11月30日预约行眼科日间手术的病例资料,包括患者一般状况、疾病诊断、拟安排术式、麻醉方式以及是否完成手术等信息。分析手术中心登记的取消手术的总体数量及取消率,以及不同年龄、性别、亚专科手术类型、麻醉方式、患者来源的手术取消率,并进一步分析手术取消原因。结果共申请非白内障眼科日间手术10595台,其中827台于手术当日被临时取消,取消率为7.8%。不同年龄段患者的当日手术取消率差异有统计学意义(P<0.001),其中1~2岁患儿手术取消率最低(2.1%,23/1110),其次为0~11个月患儿(3.4%,2/59),而75岁以上老年患者手术取消率最高,为10.4%(48/462)。不同亚专科手术类型之间手术取消率差异有统计学意义(P<0.001),其中肿瘤组手术取消率最低,为4.5%(33/732),而角膜组手术取消率最高,为14.3%(40/280),其次为整形组11.8%(153/1297)。不同性别、不同麻醉方式及不同患者来源之间手术取消率差异无统计学意义(均P>0.05)。最常见的当日手术取消原因为患者手术当日未出现(49.7%,479/827)、患者全身情况有变化(18.4%,152/827)以及术前准备不足(6.0%,50/827)。64.3%(532/827)的当日手术取消是可以通过术前加强沟通、会诊及管理从而避免的。结论非白内障眼科日间手术当日取消率为7.8%,其中高龄患者、创伤较小的眼科手术当日取消率较高。患者当日未出现及患者病情变化是当日取消手术的主要原因,且多数是可避免的。Objective To investigate the incidence and reasons of the same-day cancellation of non-cataract ophthalmic ambulatory surgery,and to provide a basis for further improvement of the medical quality of ophthalmic ambulatory surgery.Methods The data of the appointment for ophthalmic ambulatory surgeries from December 1,2020 to November 30,2021,including the patient′s general condition,disease diagnosis,proposed surgical arrangement,anesthesia method and the completion of the surgeries,were collected through the electronic medical record management system in Beijing Tongren Hospital,Capital Medical University.The total number and incidence of cancelled surgeries registered in the surgical center were analyzed,the incidence of cancelled surgeries of different ages,sexes,subspecialty surgical types,anesthesia methods,patient sources were analyzed,and the reasons for surgical cancellation were further analyzed.Results A total of 10,595 non-cataract ophthalmic day surgeries were applied,of which 827 were temporarily cancelled on the day of surgery,with a cancellation rate of 7.8%.The difference in the same-day surgery cancellation rate at different ages was statistically significant(P<0.001),of which the surgery cancellation rate in toddler and infants was the lowest,which was 2.1%(23/1110)and 3.4%(2/59),respectively,while the surgery cancellation rate was the highest in elderly patients over 75 years old,at 10.4%(48/462).There was a statistically significant difference in surgical cancellation rates among different sub-specialties(P<0.001),with the lowest surgical cancellation rate in the tumor sub-specialty at 4.5%(33/732),while the corneal sub-specialty had the highest surgical cancellation rate at 14.3%(40/280),followed by the plastic sub-specialty with 11.8%(153/1297).There were no statistically significant differences in the rate of surgical cancellation between different sexes,anesthesia methods or patients′home address(all P>0.05).The most common reason for same-day surgery cancellation was the absence of the

关 键 词：眼科 日间手术 当日 取消 医疗质量 

分 类 号：R614[医药卫生—麻醉学]