58例骨科非计划再手术原因分析  

Analysis of the Causes of Unplanned Reoperation in 58 Cases of Orthopedics

作　　者：张娟 张怡 鱼锋 侯佳 Zhang Juan;Zhang Yi;Yu Feng;Hou Jia(Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China;不详)

机构地区：[1]首都医科大学附属北京积水潭医院,北京市100035

出　　处：《中国病案》2025年第3期81-83,共3页Chinese Medical Record

基　　金：院级管理创新项目(GL202402)。

摘　　要：目的探讨骨科非计划再手术原因,提升骨科手术质量。方法分析2022年1月1日—2023年12月31日骨科58例非计划再手术病例的主要亚专科分布及再手术原因,对其影响因素进行单因素分析与二元Logistic回归分析。结果骨科非计划再手术病例主要分布在脊柱外科(55.17%)、创伤骨科(12.07%)、矫形骨科(12.07%)等;骨科非计划再手术的首要原因为术后血肿(46.55%);单因素分析结果显示6个影响因素的差异有统计学意义,二元Logistic回归分析显示入院方式(P=0.001,OR=5.646,95%CI:1.997~15.960)、手术级别(P=0.040,OR=2.745,95%CI:1.045~7.208;P=0.049,OR=2.850,95%CI:1.003~8.097)、手术时长(P<0.001,OR=4.200,95%CI:2.285~7.720)、糖尿病(P=0.037,OR=2.150,95%CI:1.048~4.411)、贫血(P<0.001,OR=5.594,95%CI:2.835~11.039)、高脂血症(P<0.001,OR=6.341,95%CI:2.848~14.118)为骨科非计划再手术的独立危险因素。结论术后并发症是引起骨科非计划再手术的主要原因,手术级别及合并慢性合并症是骨科非计划再手术的独立危险因素。通过严格落实医疗质量安全核心制度,建立完善的手术质量安全管理体系,从而促进骨科手术质量提升。Objectives This study aims to explore the causes of unplanned reoperation in orthopedics,so as to improve the quality of orthopedic surgery.Methods The main subspecialty distribution and causes of reoperation in 58 cases of unplanned reoperation in orthopedics from 2022 to 2023 were analyzed,and univariate analysis and binary logistic regression analysis were performed on the influencing factors.Results Unplanned reoperation cases in orthopedics were mainly distributed in spine surgery(55.17%),trauma orthopedics(12.07%),joint surgery(12.07%),etc.The primary reason for unplanned reoperation in orthopedics was postoperative hematoma(46.55%).The results of univariate analysis showed statistically significant differences in the six influencing factors.Further binary logistic regression analysis showed that the admission method(P=0.001,OR=5.646,95%CI:1.997-15.960),surgical grade(P=0.040,OR=2.745,95%CI:1.045-7.208;P=0.049,OR=2.850,95%CI:1.003-8.097),surgical duration(P<0.001,OR=4.200,95%CI:2.285-7.720),diabetes(P=0.037,OR=2.150,95%CI:1.048-4.411),anemia(P<0.001,OR=5.594,95%CI:2.835-11.039),Hyperlipidemia(P<0.001,OR=6.341,95%CI:2.848-14.118)were independent risk factors for unplanned reoperation in orthopedics.Conclusions Postoperative complications are the main cause of unplanned orthopedic reoperation,and surgical level and combined chronic complications are independent risk factors for unplanned orthopedic reoperation.Therefore,by strictly implementing the core system of medical quality and safety,establishing a sound surgical quality and safety management system,hospitals can promote the improvement of orthopedic surgical quality.

关 键 词：非计划再手术 骨科 危险因素 手术质量安全 

分 类 号：R687[医药卫生—骨科学]