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目的探讨非计划再次手术原因及影响因素,寻找提高手术质量的持续改进方法。方法对样本医院2015年7月至2016年6月期间101例非计划再次手术进行回顾性分析,数值变量应用T检验、分类变量使用卡方检验进行统计分析。结果非计划再次手术原因以未达到效果手术再调整和术后出血/血肿为主。老年患者(≥65岁)、三四级手术、Ⅲ类切口、急诊手术、高级职称医师非计划再次手术发生率分别为0.85%,1.80%,0.97%和0.97%,显著高于其他患者。结论高龄、高级别手术、污染切口、急诊手术增加了非计划再次手术风险,降低非计划再次手术发生率应当加强围手术期管理,提高医疗技术水平,并规范进行非计划再次手术管理。
Objective To explore the causes and influencing factors of unplanned reoperation and to find a continuous improvement method to improve the quality of operation. Methods A retrospective analysis was performed on 101 unplanned reoperations in the sample hospital from July 2015 to June 2016. T-tests were used for the numerical variables and the categorical variables were analyzed using the chi-square test. The results of unplanned reoperation reasons not to achieve the effect of surgical readjustment and postoperative bleeding / hematoma based. The incidence of unplanned reoperation in elderly patients (≥65 years), 34th and 34th grade surgery, type Ⅲ incision, emergency operation and senior professional physician were 0.85%, 1.80%, 0.97% and 0.97% respectively, which were significantly higher than those in other patients. CONCLUSIONS: Elderly, high-level surgery, incisional wound incision and emergency surgery increase the risk of unplanned reoperation. To reduce the incidence of unplanned reoperation, perioperative management should be strengthened to improve the level of medical skills and standardize the management of unplanned reoperation.