首页|江苏省基层医院围麻醉期不良事件的调查分析

江苏省基层医院围麻醉期不良事件的调查分析

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目的:调查分析江苏省基层医院围麻醉期不良事件发生情况及其特点,为减少基层医院手术患者不良事件提供参考,为提高基层医院麻醉质量提供依据。方法:调查采取多阶段分层整群随机抽样方法,从54家基层医院抽取81例围麻醉期不良事件,采集资料方式以查阅病例记录与询问主治医生相结合,调查指标包括围麻醉期不良事件的具体内容、归属类别、发生时间、诱发因素和患者转归。结果:从不良事件发生时间看,麻醉诱导期12例(14.8%,6类),主要与循环系统相关;手术中36例(44.4%,15类),特点是种类繁多且重现率高低不等;手术后15例(18.5%,13类),特点是种类繁多且重现率较低;麻醉苏醒期14例(17.3%,8类),主要与呼吸系统相关。从不良事件诱发因素看,涉及患者因素64例(79.0%),涉及手术因素28例(34.6%),涉及麻醉因素28例(34.6%),单纯麻醉管理不当引起不良事件3例(3.7%)。从临床转归看,结局良好66例(81.5%),不幸死亡12例(14.8%)和预后不佳3例(3.7%)。结论:麻醉医师需要重视预防手术患者循环系统和呼吸系统潜在风险,妥善处理围麻醉期急危重症或各时间段突发情况,以提高围手术期患者安全和减少围麻醉期不良事件。
Investigation of 81 cases of adverse events during perianesthesia period in primary hospitals in Jiangsu province
Objective:To investigate adverse events during the perianesthesia period in primary hospitals in Jiangsu, in order to help anesthetists avoid anesthesia-related adverse events and provide suggestions for anesthesia quality and safety in primary hospitals.Methods:This study employed multi-stage stratified cluster random sampling method, and 81 cases of adverse events were selected from 54 primary hospitals. Data were collected by means of reviewing medical records and inquiring attending physicians. The contents, attributions, occurrence times, and predisposing factors of adverse events were analyzed, and the final outcomes of patients were analyzed.Results:Thirty-six cases (44.4%, 15 types) of adverse events occurred during surgery, which were characterized by a diversity in category and predominance in the circulatory and respiratory systems. Fifteen cases (18.5%, 13 types) occurred after surgery, with a wide variety and low recurrence rate. Twelve cases (14.8%, 6 types) occurred during the induction and intubation period, mainly circulatory problems. Fourteen cases (17.3%, 8 types) occurred during the resuscitation and extubation period, mainly respiratory troubles. All adverse events were derived from three factors: patients, surgery, and anesthesia, either individually or mutually. In general, there were 64 cases (79.0%) involving patient conditions, 28 cases (34.6%) related to surgical factors, and 28 cases (34.6%) involving anesthetic factors. Only three adverse events were reasonably attributed to anesthesia itself. Sixty-six patients (81.5%) were successfully recovered, 12 (14.8%) died, and 3 (3.7%) had a poor prognosis.Conclusion:Anesthetists should not only focus on avoiding diverse risks in the circulatory and respiratory system, but also specialize in dealing with various critical illness or emergencies, in order to reduce the incidence of adverse events and improve the life safety of patients.

杨国旺、边震、季雨萌、李艺轩、陈诗雯、高建瓴、金鑫

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215006 江苏苏州,苏州大学附属第一医院麻醉科

215123 江苏苏州,苏州大学医学院临床医学系

215125 江苏苏州,苏州大学附属独墅湖医院麻醉、危重症和疼痛医学科

基层医院 不良事件 麻醉 循环系统 呼吸系统

麻醉学卓越人才教育培养计划的研究与实践&&

2021JGYJKT015FYX202104

2023

中华临床医师杂志(电子版)
中华医学会

中华临床医师杂志(电子版)

CSTPCD
影响因子:0.99
ISSN:1674-0785
年,卷(期):2023.17(2)
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