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[目的]探讨肿瘤专科医院非计划再次手术的原因,加强非计划再次手术的监督与管理,提高手术质量,保障医疗质量安全。[方法]回顾性分析某三级甲等肿瘤专科医院2013~2015年163例非计划再次手术病例,对非计划再次手术的发生原因进行调查分析。[结果 ]肿瘤手术患者非计划再次手术发生率为0.35%,主要集中在胃肠外科、胸外科及神经外科,发生的主要原因为术区出血(53例,占32.52%),其次为术中损伤(25例,占15.34%)、术后切口裂开(22例,占13.50%)、吻合口瘘(9例,占5.52%)、术后切口感染(9例,占5.52%)等问题。[结论]加强重点科室、重点环节、重点病例和重点人群的监管,做好手术医师分级准入与再考核再授权制度是降低非计划再次手术发生率的重要保障。同时,加强手术医师对非计划手术发生原因的认识,加强围手术期管理,可降低非计划再次手术的发生率。
[Objective] To investigate the reason of unplanned reoperation in cancer specialist hospitals, strengthen the supervision and management of unplanned reoperation, improve the quality of operation and ensure the quality and safety of medical treatment. [Methods] A retrospective analysis of 163 cases of unplanned reoperation cases in a tertiary tumor hospital from 2013 to 2015 was conducted to investigate the causes of unplanned reoperation. [Results] The incidence of unplanned reoperation was 0.35% in patients undergoing neoplasm surgery, mainly in gastrointestinal surgery, thoracic surgery and neurosurgery. The main cause of this was surgical bleeding (53 cases, 32.52%), followed by intraoperative (25 cases, accounting for 15.34%), postoperative incision (22 cases, accounting for 13.50%), anastomotic fistula (9 cases, accounting for 5.52%) and incision infection (9 cases, accounting for 5.52%) . [Conclusion] To strengthen the supervision of key departments and departments, key links, key cases and key populations, and to make graduation admittance and reevaluation reauthorization system of surgeons an important guarantee to reduce the incidence of unplanned reoperation. At the same time, surgeons’ awareness of the causes of unplanned surgery and their perioperative management should be strengthened to reduce the incidence of unplanned reoperation.