哈尔滨市某肿瘤专科医院非计划再次手术回顾性分析与质量评价  

Retrospective analysis and quality evaluation of unplanned reoperation in a cancer hospital in Harbin

作　　者：许馨元 闫存玲[2] 高汉[1] XU Xin-yuan;YAN Cun-ling;GAO Han(Department of Medical Affairs,Harbin Medical University CancerHospital,Harbin150081,China;Office of Complaints Management,Harbin Medical University CancerHospital,Harbin150081,China)

机构地区：[1]哈尔滨医科大学附属肿瘤医院医务部,黑龙江哈尔滨150081 [2]哈尔滨医科大学附属肿瘤医院投诉管理办公室,黑龙江哈尔滨150081

出　　处：《哈尔滨医科大学学报》2022年第4期402-405,共4页Journal of Harbin Medical University

基　　金：“互联网+”医疗对临床决策转型的重大影响研究(JJMS2020-07)。

摘　　要：目的分析某肿瘤专科医院非计划再次手术发生的情况,研究其对医疗质量的影响。方法收集哈尔滨市某肿瘤专科医院2016~2020年发生的非计划再次手术病例数据资料和同时期正常手术病例的指标数据,分析发生原因并进行质量评价。结果2016~2020年,该肿瘤专科医院共实施手术137656例,其中非计划再次手术429例,发生率0.31%。重返原因分别为术后出血(62.70%)、吻合口瘘(11.19%)、切口裂开(7.23%)、术后感染(3.96%)和肠梗阻(3.96%),且半数以上发生在术后5天内(65.73%)。与同时期正常手术患者相比,重返手术室将延长患者平均住院日,增加平均住院费用、药费、耗材费,提升药占比(P<0.05)。结论医院应完善落实医疗质量安全核心制度,加强对非计划再次手术的管理,针对发生的原因进行改进,进一步提升医疗服务质量。Objective To analyze the occurrence of unplanned reoperations in a tumor specialist hospital,and to study its impact on medical quality.Methods The data of patients with unplanned reoperations from 2016 to 2020 in a cancer hospital in Harbin,and the patients undergoing normal surgery during the same period were collected,the reasons for the occurrence were summarized,and the quality was evaluated.Results From 2016 to 2020,a total of 137656 inpatient surgeries were performed in an oncology hospital,including 429 unplanned reoperations,with an incidence rate of 0.31%.Among the main reasons for unplanned reoperation,the most common ones were postoperative bleeding(62.70%),anastomotic leakage(11.19%),incision dehiscence(7.23%),postoperative infection(3.96%)and intestinal obstruction(3.96%),and most of them occurred within 5 days after operation(65.73%).Compared with patients undergoing normal surgery in the same period,unplanned reoperation prolonged the average hospital stay,and increased the average hospitalization cost,drug cost,consumable cost,and drug ratio(P<0.05).Conclusion Hospitals should improve the implementation of the core system of medical quality and safety,strengthen the management of unplanned reoperations,and make improvements based on the causes to further improve the quality of medical services.

关 键 词：非计划再次手术 医疗质量 肿瘤专科医院 

分 类 号：R197.323.4[医药卫生—卫生事业管理]