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    Please use this identifier to cite or link to this item: https://ir.csmu.edu.tw:8080/ir/handle/310902500/2468


    Title: 開刀房手術延期或取消之原因探討
    Analysis for the Reasons of Postponement or Cancellation of Surgery in the Operating Room
    Authors: 劉漢傑
    Hon-Kit,Lau
    Contributors: 中山醫學大學:醫學院;醫學研究所;周明智
    Keywords: 手術室;手術取消;手術延期;醫療品質。
    Health care quality;Operating room management;Surgical cancellation;Surgical postponement
    Date: 2010
    Issue Date: 2010-10-18T08:02:25Z (UTC)
    Abstract: 背 景: 現代醫學追求醫療品質。其中,手術或麻醉安全,最為大眾關心。在眾多議題中,本文以手術被延遲或取消原因為題,探討及追蹤病患的結果。
    研究目的:在手術室,手術因許多不同原因延期或取消。通過使用資料庫的數據,我們追蹤並探討病患的各種結果,以期改進醫療品質。
    設 計:回溯性分析。
    設 置:醫學中心,大學附設醫院。
    方 法:本文從資料庫中(麻醉發病率和死亡率紀錄),回顧並收集5年期手術室之資料。從手術被延期或取消的資料,分析延期或取消發生原因,並透過病歷或電話追蹤最長6個月,以瞭解每位病患最後結果。
    結 果:5年期間,共計45,663次手術需麻醉。其中,在手術室內延期或取消之手術患者共有67名(0.15%)。33名(49.3%)延期,延期時間分別從1天到6個月(中間數=8天)。取消預定手術患者21名(31.3%)。9名(13.4%)患者住院治療中死亡(平均數=12.7天;範圍:1-20天)。2名(3.0%)患者改以局部麻醉進行手術。2名(3.0%)患者失聯無法追蹤。
    結 論:延期或取消手術之主要原因為醫療狀況改變共47次(70.2%);延期手術(中位數8天)共33次(49.3%)未執行手術共21次(31.3%)。
    未執行手術主要原因:
    1、該計劃手術尚未充分完成術前之評估;
    2、醫療風險大或另有替代手術之治療方法。
    Topic: Analysis for the Reasons of Postponement or Cancellation of Surgery in the Operating Room
    Study Object: To analyze the reasons for postponement or cancellation of surgery in the operating room (OR), and to determine the effect on patient outcomes.
    Design: Retrospective analysis.
    Setting: University-affiliated hospital.
    Measurements: Over a 5-year period, 45,663 surgeries requiring anesthesia occurred. Surgery was postponed or cancelled in the OR for 67 patients (0.15%). Airway problems, change in medical condition, and change in surgical condition were the reasons recorded. Each patient's surgical result was audited using medical charts and telephone calls for at least 6 months.
    Main Results: 33 cases (49.3%) were postponed from one day to 6 months (range, one to 165 days; median, 8 days). The scheduled surgeries for 21 (31.3%) patients were never performed; and 9 patients (13.4%) died during their hospitalization (range, one to 20 days; mean, 12.7 days).
    Conclusions: Surgery was postponed or cancelled in the OR mainly for changes in medical condition (70.2%); either medical risk outweighed the benefits of surgery, or alternative treatments were used.
    URI: https://ir.csmu.edu.tw:8080/handle/310902500/2468
    Appears in Collections:[Institute of Medicine] Electronic Theses of Dissertations

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