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中华口腔医学研究杂志(电子版) ›› 2016, Vol. 10 ›› Issue (01) : 60 -63. doi: 10.3877/cma.j.issn.1674-1366.2016.01.011

所属专题: 文献

口腔医院管理

口腔专科住院患者非计划再次手术原因分析
邓润智1,(), 闫翔1, 任红润1, 邵辰杰1, 周扬1   
  1. 1. 210008 南京大学医学院附属口腔医院(南京市口腔医院)口腔颌面外科
  • 收稿日期:2016-01-03 出版日期:2016-02-01
  • 通信作者: 邓润智
  • 基金资助:
    南京市卫生青年人才项目(QRX11260); 南京市医学科技发展项目(YKK15114)

Analysis on causes of unplanned return to surgery in a stomatological hospital

Runzhi Deng1,(), Xiang Yan1, Hongrun Ren1, Chenjie Shao1, Yang Zhou1   

  1. 1. Department of Oral & Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China
  • Received:2016-01-03 Published:2016-02-01
  • Corresponding author: Runzhi Deng
  • About author:
    Corresponding author: Deng Runzhi, Email:
引用本文:

邓润智, 闫翔, 任红润, 邵辰杰, 周扬. 口腔专科住院患者非计划再次手术原因分析[J]. 中华口腔医学研究杂志(电子版), 2016, 10(01): 60-63.

Runzhi Deng, Xiang Yan, Hongrun Ren, Chenjie Shao, Yang Zhou. Analysis on causes of unplanned return to surgery in a stomatological hospital[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2016, 10(01): 60-63.

目的

探讨口腔专科住院患者非计划再次手术的特点及原因。

方法

通过回顾研究2012年1月至2014年12月期间,南京大学医学院附属口腔医院住院患者的临床资料,统计了所有非计划再次手术的发生率及其原因。

结果

三年间手术共8135例,非计划再次手术136例,发生率为1.67%。非计划再次手术男女比例为2.32∶1,平均年龄52.4岁。非计划再次手术的主要原因为血管危象(32.35%)、出血(30.15%)和诊断困难(29.41%)。

结论

导致口腔专科住院患者非计划再次手术的主要原因为血管危象、术后出血和诊断困难,强化围手术期处理水平和提高临床与病理诊断准确率可以减少非计划再次手术的发生。

Objective

To determine the clinical characteristics and causes of unplanned return to surgery in a stomatological hospital.

Methods

All 136 patients undergoing unplanned return to operating room from January 2012 to December 2014 were reviewed to analyze the clinical characteristics and causes.

Results

There were 8135 cases undergoing surgery and the rate of unplanned return to surgery was 1.67%. The patients undergoing return to surgery comprised 95 men and 41 women (the male∶female ratio of 2.32∶1) . The mean age was 52.4 years. Among the common causes of unplanned return to operating room, the proportion of vascular crisis, postoperative bleeding and diagnostic issues were 32.35%, 30.15% and 29.41% respectively.

Conclusions

The main causes of unplanned return to surgery in the stomatological hospital were flap vascular crisis, postoperative bleeding and diagnostic issues. Improving perioperative management and diagnostic capability could reduce the incidence of unplanned return to surgery.

表1 2012年1月至2014年12月非计划再次手术原因
表2 血管危象的原因
表3 诊断困难的原因
[1]
McLaughlin N, Jin P, Martin NA. Assessing early unplanned reoperations in neurosurgery:opportunities for quality improvement[J]. J Neurosurg,2015,123(1):198-205.
[2]
de Vries EN, Ramrattan MA, Smorenburg SM,et al. The incidence and nature of in-hospital adverse events:a systematic review[J]. Qual Saf Health Care,2008,17(3):216-223.
[3]
Halfon P, Eggli Y, Matter M,et al. Risk-adjusted rates for potentially avoidable reoperations were computed from routine hospital data[J]. J Clin Epidemiol,2007,60(1):56-67.
[4]
Dierks MM, Huang ZS, Siracuse JJ,et al. Diagnostic,surgical judgment,and systems issues leading to reoperation:mining administrative databases[J]. Am J Surg,2010,199(3):324-329,329-330.
[5]
Henneman D, Dekker JW, Wouters MW,et al. Benchmarking clinical outcomes in elective colorectal cancer surgery:The interplay between institutional reoperation- and mortality rates[J]. Eur J Surg Oncol,2014,40(11):1429-1435.
[6]
郭阿娟,雷韦,潘梁军,等. 224例非计划再次手术发生原因分析[J].中华医院管理杂志,2014,30(2):120-122.
[7]
姚敏,王晓颖,罗奕.口腔医院非计划再次手术发生情况统计与分析[J].中国病案,2015,16(3):48-51.
[8]
Kroon HM, Breslau PJ, Lardenoye JW. Can the incidence of unplanned reoperations be used as an indicator of quality of care in surgery?[J]. Am J Med Qual,2007,22(3):198-202.
[9]
Zheng XR, Chen T, Yang YF,et al. Unplanned reoperations in neurosurgical patients due to postoperative bleeding:a single-center experience and literature review[J]. Medicine(Baltimore),2015,94(23):e739.
[10]
张陈平,张志愿,邱蔚六,等.口腔颌面部缺损的修复重建——1973例临床分析[J].中国修复重建外科杂志,2005,19(10):773-776.
[11]
卢明星,杨旭东,王育新,等.头颈部游离组织瓣血管危象的预防和处理[J].口腔医学研究,2010,26(2):243-245.
[12]
Ahmadi I, Herle P, Rozen WM,et al. One versus two venous anastomoses in microsurgical free flaps:a meta-analysis[J]. J Reconstr Microsurg,2014,30(6):413-418.
[13]
石荣华,赵云富,刘渊,等.浅静脉及深浅静脉回流对183例前臂皮瓣存活率的影响[J].口腔颌面外科杂志,2012,22(4):252-256.
[14]
Futran ND, Stack BC Jr. Single versus dual venous drainage of the radial forearm free flap[J]. American Journal of Otolaryngology,1996,17(2):112-117.
[15]
Scher KS. Unplanned reoperation for bleeding[J]. Am Surg,1996,62(1):52-55.
[16]
狄杰斌,戚丽娜.某综合医院非计划再次手术原因分析及对策[J/CD].中华临床医师杂志:电子版,2015,9(2):348-351.
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