Surgical Complications Perioperative Management Quality of Medical Care
目的：分析我院近四年择期手术并发症的分布情况，为预防择期手术并发症的发生提供依据。方法：从医院病案工作站中检索2018年1月1日-2021年12月31日期间医院择期手术患者的住院病案首页信息，共40 134份，根据《国家三级公立医院绩效考核操作手册（2020版）》中有关择期手术的定义，筛选出择期手术并发症159例。按照年份、科室、性别分析择期手术并发症的分布，以及各类手术并发症在各科室的分布情况。结果：2018年~2021年医院择期手术并发症总发生率为0.40%。2018年至2021年，年度择期手术并发症发生率总体呈下降趋势。择期手术并发症构成比排名前三的科室分别为胸心外科、胃肠外科及耳鼻喉科。排名前三的择期手术并发症分别为肺部感染、出血或血肿及吻合口瘘。所有择期手术并发症中，男性总发生率为0.53%，女性总发生率为0.25%，差异有统计学意义（P < 0.05）。结论：医院择期手术并发症的管理重点应放在重点并发症、多发科室、重点手术上，针对存在的问题及时进行分析，不断提高医疗质量，逐步减少手术并发症的发生，保障患者安全。
Objective：To investigate the distribution of complications of elective surgeryof our hospital in recent four years，so as to provide a theoretical basis for preventing the occurrence of the complications of elective surgery. Methods：40，134 inpatient medical records of our hospital from January 1，2018 to December 31，2021 were retrieved from the hospital medical record workstation. According to the definition of elective surgery in the “National Tertiary Public Hospital Performance Evaluation Manual（2020 Edition）”，159 cases of elective surgery complications were selected. The distribution and analysis of surgical complications were carried out according to year，department and gender，and the distribution of various surgical complications in each department. Results：The total incidence of elective surgical complications from 2018 to 2021 was 0.40%. And the annual incidence of elective surgical complications showed a decreasing trend. The top three departments of elective surgical complications were thoracic surgery，gastrointestinal surgery and otorhinolaryngology. The top three elective surgical complications were pulmonary infection，hemorrhage or hematoma，and anastomotic fistula.Among all the elective surgical complications，the total incidence was 0.53% in males and 0.25% in females，and there was a statistically significant difference between different genders（P < 0.05）. Conclusions：The management of elective surgical complications should focus on key complications，frequent departments and key operations，analyze and improve the problems and causes of perioperative medical quality，continuously improve the medical quality，gradually reduce the occurrence of surgical complications，to ensure patient safety.