少数民族地区某三甲医院77例急诊手术死亡患者分析  

Analysis of 77 Patients Dying from Emergency Surgery in a Three A and Tertiary Hospital in a Minority Area

作　　者：段先召 胡向阳 邓艳斌 谭金波 彭绪东 Duan Xianzhao;Hu Xiangyang;Deng Yanbin;Tan Jinbo;Peng Xudong(The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture,Enshi 445000,Hubei Province,China)

机构地区：[1]恩施土家族苗族自治州中心医院,湖北省恩施市445000

出　　处：《中国病案》2024年第4期65-67,共3页Chinese Medical Record

摘　　要：目的对某三甲医院急诊手术死亡患者进行分析,探讨急诊手术患者死亡风险及影响因素,降低急诊手术患者病死率。方法统计2019年1月1日-2021年12月31日某三甲医院手术科室急诊手术患者及急诊手术死亡例数,急诊手术共12099台,术后死亡77例。患者临床资料包括:性别、年龄、手术科室、麻醉分级、手术分级、死亡病因等指标。结果某三甲医院3年共进行了12099台急诊手术,术后死亡77例,男女比为1:2.2,其中18岁~39岁年龄段占61.69%,而40岁~64岁年龄段的病死率均高于其他年龄段(P<0.05);神经外科(5.56%)、心胸大血管外科(6.19%)的病死率均高于其他手术科室(P<0.05),产科(0.03%)、骨科(0.07%)病死率均低于其他手术科室(P<0.05);急诊四级手术患者病死率(3.81%)高于其他级别手术(P<0.05),麻醉分级V级(25.56%)的急诊手术病死率高于其他麻醉级别的手术(P<0.05);对急诊手术死亡原因进行分析发现,非创伤性颅内出血、严重创伤、消化系统疾病及主动脉夹层是急诊手术死亡的前四位的病因。结论非创伤性颅内出血、严重创伤、消化系统疾病及主动脉夹层为某少数民族地区急诊手术死亡的主要病因,高龄、病情严重程度是急诊手术死亡的高危因素,少数民族地区需进一步加强神经外科、心胸外科、血管外科及普通外科的建设。Objectives To analyze the death risk and influencing factors of emergency operation patients in a Three A and Tertiary Hospital,and reduce the mortality of emergency operation patients.Methods From January 1st,2019 to December 31st,2021,the number of emergency operation patients and emergency operation deaths in the operating department of a Three A and Tertiary Hospital was analyzed.A total of 12099 emergency operations were performed,and 77 postoperative deaths were reported.The clinical data of patients included:gender,age,surgical department,anesthesia grade,surgical grade,cause of death and other indicators.Results There were 12099 emergency operations in a Three A and Tertiary Hospital in 3 years,and 77 cases died after operation,the ratio of male to female was 1:2.2,among which 61.69%were in the age group of 18 to 39 years old,and the mortality in the age group of 40 to 64 years old was higher than that in other ages(P<0.05).The mortality rates of neurosurgery(5.56%)and cardiothoracic vascular surgery(6.19%)were higher than those of other surgical departments(P<0.05),obstetrics(0.03%)and orthopedics(0.07%)were lower than those of other surgical departments(P<0.05).The mortality rate of patients undergoing emergency grade IV surgery(3.81%)was higher than that of other surgeries(P<0.05),and that of patients undergoing anesthesia grade V(25.56%)was higher than that of other surgeries(P<0.05).Non-traumatic intracranial hemorrhage,severe trauma,digestive diseases and aortic dissection were the top four causes of death in emergency surgery.Conclusions Non-traumatic intracranial hemorrhage,severe trauma,digestive diseases and aortic dissection were the main causes of death in emergency surgery in ethnic minority areas,and old age and severity of the disease were high-risk factors for death in emergency surgery.In ethnic minority areas,the construction of neurosurgery,cardiothoracic surgery,vascular surgery and general surgery should be further strengthened.

关 键 词：手术科室 急诊手术 病死率 

分 类 号：R197.323[医药卫生—卫生事业管理]