围手术期安全指标:手术取消及术后即刻并发症

S. D. Silva, Bruna Kruczewski, S. F. Cetolin, Andreia Dalla Vecchia, V. Beltrame
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摘要

围手术期包括手术前、手术中和手术后的时间。基于对这一过程中患者的护理和安全的关注,本研究试图评估医院环境下外科手术的质量。这是一项流行病学、描述性和回顾性研究,在圣卡塔琳娜州joa巴市Santa Terezinha大学医院[医院Universitário Santa Terezinha]进行。该调查旨在确定手术取消的原因,以及发生在麻醉后护理单位的即时术后并发症。分析了456份手术取消日图记录和361份术后护理患者病历。结果显示,手术取消的主要原因是转移或计划外手术(23.1%),计划外手术中有27%没有报告取消的原因。取消手术和术后并发症以成人(80%以上)和女性居多。术后最常见的并发症是低血压。在已进行的手术中,取消最多的是胸部手术(41.8%),而取消最多的是腹部/骨盆手术(49%)。结果显示,被取消的手术中,与临床状况有关的手术只占6.8%,因此大部分手术本来是可以避免的。
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Perioperative safety indicators: surgery cancellation and immediate postoperative complications
The perioperative period comprises the moments before, during and after surgery. Based on the concern about the care for and safety of patients in this process, this study sought to assess the quality of surgical procedures in a hospital environment. It is an epidemiological, descriptive and retrospective research conducted at Santa Terezinha University Hospital [Hospital Universitário Santa Terezinha], in the municipality of Joaçaba, Santa Catarina (SC). The investigation aimed to identify the reasons for surgical cancellation, as well as immediate postoperative complications that occur in the postanesthesia care unit. A total of 456 records from surgery cancellation daily maps and 361 medical records of patients in postoperative care were analyzed. Results show that the main cause for cancellation of surgeries was transfer or unscheduled procedure (23.1%), but 27% of the unscheduled surgeries did not have the reason for cancellation reported. Adult (over 80%) and female individuals were the majority for both cancelled surgeries and postoperative complications. The most frequent postoperative complication was hypotension. Among performed surgeries, thoracic ones (41.8%) were most prevalent, while abdominal/pelvic (49%) surgeries were the most cancelled. It is concluded that a big portion of the cancelled surgical procedures could have been prevented, since only 6.8% of them were related to clinical conditions.
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