中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2015年
5期
369-373
,共5页
王浩%周岩冰%张佃良%牛兆建%王东升%陈栋%吕亮%李宇%曹守根
王浩%週巖冰%張佃良%牛兆建%王東升%陳棟%呂亮%李宇%曹守根
왕호%주암빙%장전량%우조건%왕동승%진동%려량%리우%조수근
直肠肿瘤%安全%核查制度%结果评价
直腸腫瘤%安全%覈查製度%結果評價
직장종류%안전%핵사제도%결과평개
Rectal neoplasms%Safety%Checklist%Outcome assessment
目的 探讨手术安全核查对直肠癌患者术后临床结局的影响.方法 收集青岛大学附属医院2007年4月至2013年3月手术的2 157例直肠癌患者的临床资料,按手术安全核查的实施时间将资料分为核查前组(2007年4月至2010年3月)和核查后组(2010年4月至2013年3月),应用x2检验、独立样本t检验及非参数检验对两组患者的临床资料进行比较,用多因素Logistic回归分析手术安全核查与术后并发症的关系.结果 核查后组术后并发症的发生率为15.98％(195/1 220),明显低于核查前组的20.38％ (191/937)(x2=6.985,P=0.008),核对后组的中位住院时间和术后住院时间分别为13 d和8d,均较核查前组缩短1d(Z=-4.066,P＜0.01;Z=-5.878,P＜0.01),多因素Logistic分析显示手术安全核查为影响直肠癌患者术后并发症的独立危险因素(OR =0.761,95％ CI:0.605 ～0.958).结论 手术安全核查可明显降低直肠癌患者的手术并发症发生率,缩短住院时间,改善患者短期临床结局.
目的 探討手術安全覈查對直腸癌患者術後臨床結跼的影響.方法 收集青島大學附屬醫院2007年4月至2013年3月手術的2 157例直腸癌患者的臨床資料,按手術安全覈查的實施時間將資料分為覈查前組(2007年4月至2010年3月)和覈查後組(2010年4月至2013年3月),應用x2檢驗、獨立樣本t檢驗及非參數檢驗對兩組患者的臨床資料進行比較,用多因素Logistic迴歸分析手術安全覈查與術後併髮癥的關繫.結果 覈查後組術後併髮癥的髮生率為15.98％(195/1 220),明顯低于覈查前組的20.38％ (191/937)(x2=6.985,P=0.008),覈對後組的中位住院時間和術後住院時間分彆為13 d和8d,均較覈查前組縮短1d(Z=-4.066,P＜0.01;Z=-5.878,P＜0.01),多因素Logistic分析顯示手術安全覈查為影響直腸癌患者術後併髮癥的獨立危險因素(OR =0.761,95％ CI:0.605 ～0.958).結論 手術安全覈查可明顯降低直腸癌患者的手術併髮癥髮生率,縮短住院時間,改善患者短期臨床結跼.
목적 탐토수술안전핵사대직장암환자술후림상결국적영향.방법 수집청도대학부속의원2007년4월지2013년3월수술적2 157례직장암환자적림상자료,안수술안전핵사적실시시간장자료분위핵사전조(2007년4월지2010년3월)화핵사후조(2010년4월지2013년3월),응용x2검험、독립양본t검험급비삼수검험대량조환자적림상자료진행비교,용다인소Logistic회귀분석수술안전핵사여술후병발증적관계.결과 핵사후조술후병발증적발생솔위15.98％(195/1 220),명현저우핵사전조적20.38％ (191/937)(x2=6.985,P=0.008),핵대후조적중위주원시간화술후주원시간분별위13 d화8d,균교핵사전조축단1d(Z=-4.066,P＜0.01;Z=-5.878,P＜0.01),다인소Logistic분석현시수술안전핵사위영향직장암환자술후병발증적독립위험인소(OR =0.761,95％ CI:0.605 ～0.958).결론 수술안전핵사가명현강저직장암환자적수술병발증발생솔,축단주원시간,개선환자단기림상결국.
Objective To explore the impact of the surgical safety checklist on postoperative clinical outcomes in rectal cancer patients.Methods Data of 2 157 rectal cancer patients undergoing surgery between April 2007 and March 2013 was studied.Patients were divided into two groups according to before or after the time point of April 1,2010,on which the Surgical Safety Checklist was implemented.The clinical outcomes occurring within 30 days after operation were compared between the two groups by chi-square test,independent-samples t test or non-parametric test.Multivariate Logistic regression analysis was performed to identify independent factors.Results The rate of morbidity was 20.38％ (191/937) in the pre-implementation group,which was significantly higher than that in the post-implementation one 15.98％ (195/1 220) (x2 =6.985,P =0.008).Median hospital stay and postoperative hospital stay were 13 and 8 days after checklist,which were one day shorter than those observed prior to the checklist (Z =-4.066,P ＜ 0.01;Z =-5.878,P ＜ 0.01).Multi-Logistic analysis showed that the Surgical Safety Checklist was an independent factor influencing postoperative complications (OR =0.761,95％ CI:0.605-0.958).Conclusions Implementation of the Surgical Safety Checklist reduces postoperative morbidity and hospital stay and improves clinical outcomes in rectal cancer patients undergoing resection.
