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目的分析外科及妇产科医疗不良事件的危险因素,保障医疗安全。方法收集笔者所在3家医院1981—2011年发生的22例外科及妇产科医疗不良事件,回顾性分析临床资料。结果本组22例,误诊6例,漏诊、误治及沟通缺陷各3例,并发症7例;发生在外科(含麻醉科)17例、妇产科5例。死亡9例,生存13例,其中5例遗留后遗症。17例发生医疗争议,其中诉至法院3例,经医患双方或第三方协调解决14例。结论因临床思维缺陷造成诊疗决策失误是外科和妇产科医疗不良事件的最常见因素,医院管理者要重视核心制度环节管理,切实提高患者医疗安全性。
Objective To analyze the risk factors of surgical and obstetrics and gynecology medical adverse events to ensure the medical safety. Methods Twenty-two surgical and obstetrics and gynecological medical emergencies occurred in three hospitals of our hospital from 1981 to 2011 were retrospectively analyzed. Results The group of 22 cases, misdiagnosed 6 cases, missed diagnosis, misdiagnosis and communication defects in 3 cases, 7 cases of complications; occurred in 17 cases of surgery (including anesthesiology), obstetrics and gynecology in 5 cases. 9 died, 13 survived, of which 5 left sequelae. 17 cases of medical disputes, which prosecuted to the court in 3 cases, coordinated by both doctors and patients or third parties to solve 14 cases. Conclusions The errors of diagnosis and treatment decision-making caused by clinical thinking defects are the most common factors of surgical and obstetrics and gynecological medical adverse events. Hospital administrators should pay attention to the management of the core system and effectively improve the medical safety of patients.