日间鼻科手术后不良事件发生现状分析  

Analysis of adverse events after daytime rhinology surgery

作　　者：李文静 王月 奚春花[1] 李铭[1] Li Wenjing;Wang Yue;Xi Chunhua;Li Ming(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,100730

出　　处：《北京医学》2024年第9期779-782,共4页Beijing Medical Journal

摘　　要：目的分析日间鼻科手术后不良事件发生现状。方法选取2022年8月1日至2023年7月30日首都医科大学附属北京同仁医院行日间鼻科手术的患者,收集患者一般情况、手术方式、麻醉方式及非计划病房术后监护和非查房呼叫护理等不良事件等资料。分析术后非计划病房术后监护和非查房呼叫护理不良事件发生率及原因。结果共纳入日间鼻科手术患者693例,其中男422例、女271例;平均年龄(32.5±19.5)岁。693例患者中,发生术后不良事件265例(38.2%),其中非计划病房术后监护25例(3.6%),主要原因为患者相关因素(72.0%);非查房呼叫护理257例(37.1%),主要原因为术后疼痛(78.6%)。不同患者日间鼻科手术后不良事件发生率的比较,男性高于女性,小儿组(0~6岁)高于其他年龄组,鼻中隔手术高于其他手术方式,全身麻醉高于局部麻醉,差异均有统计学意义(P<0.05)。结论日间鼻科手术后不良事件发生率较高,非计划病房术后监护不良事件主要原因为患者病情变化,非查房呼叫护理不良事件主要原因为患者术后疼痛。建议加大患者病情管理力度,并对疼痛进行预处理,减少日间鼻科手术不良事件发生率。Objective To analyze the current situation of adverse events after daytime rhinology surgery.Methods The patients who underwent daytime rhinology surgery in Beijing Tongren Hospital,Capital Medical University from August 1st,2022 to July 1st,2023 were selected,the data of patients'general situation,operation mode,anesthesia mode,adverse events such as unplanned in-ward postoperative monitoring and non-rounds call nursing were collected.The incidence and causes of unplanned in-ward postoperative monitoring and non-rounds call nursing were analyzed.Results A total of 693 patients with daytime rhinology surgery were selected,included 422 males and 271 females,and the average age was(32.5±19.5)years.Among the 693 patients,265 cases(38.2%)had postoperative adverse events which including 25 cases(3.6%)with unplanned in-ward postoperative monitoring events mainly due to patient-related factors(72.0%)and 257 cases(37.1%)with non-rounds call nursing events mainly due to postoperative pain(78.6%).The incidence of adverse events in different patients after daytime rhinology surgery was higher in males than that in females,higher in children of 0-6 years old than in other age groups,higher in nasal septum surgery than in other surgical methods,and higher in general anesthesia than in local anesthesia,the differences were statistically significant(all P<0.05).Conclusions The incidence of adverse events after daytime rhinology surgery is relatively high,the main reason for unplanned in-ward postoperative monitoring adverse events is the change of patient's condition,and the main reason for non-rounds call nursing adverse events is patient's postoperative pain.It is suggested that the management of patients'condition should be strengthened and the pain should be pretreated to reduce the incidence of adverse events in daytime rhinology surgery.

关 键 词：日间手术 鼻科手术 不良事件 疼痛 医疗质量 

分 类 号：R614[医药卫生—麻醉学]