摘要
目的:构建三维(3D)成像手术腹腔镜系统的设备及配套部件术前安全检查体系,保障设备正常使用。方法:对3D腹腔镜成像系统使用中出现的问题进行根因分析,制定相应的解决策略;梳理组成3D腹腔镜成像系统的各部件的功能和原理,绘制故障原因鱼骨图,制定相应的解决策略并评估其改进效果。将改进措施实施前40台手术的数据纳入对照组,将改进措施实施后40台手术的数据纳入观察组,分析对比两组数据的差异,评价改进措施的效果。结果:利用根因分析法在总结手术前3D腹腔镜成像系统的设备及配套部件的检查要点的基础上,找出了导致临床不良反馈的原因,通过实施3D腹腔镜及其附件损伤较小的消毒和灭菌方法,临床术者的不良反馈总数下降了60%。结论:建立涵盖术前、术中及术后3个阶段的3D腹腔镜成像系统安全使用管理体系,能够减少因设备故障或不当操作导致的手术风险以及临床不良反馈,可为3D腹腔镜成像系统安全使用和管理提供参考依据。
Objective To construct the preoperative examination system about equipment and its matching annex of 3D laparoscope imaging system so as to ensure normal application of equipment. Methods： The root cause analysis（RCA） was applied to solve problems that existed in the use of 3D laparoscope imaging system and to formulate the corresponding solving strategies. The functions and principles of all components of 3D laparoscopic imaging system were reviewed comprehensively. And the fishbone diagram of the cause of default was drawn to formulate solving strategies and evaluate the improvement effect. The data of 40 operations before improved measurement was implemented were divided into control group, and those after improved measurement was implemented were divided into observation group. The difference of the two group was analyzed so as to evaluate the improved effect. Results： On the basis of summarized key points of equipment and matching annex of preoperative 3D laparoscope imaging system, the RCA was applied to find the reason that lead to adverse feedback of clinical practice. Through implemented the disinfection and sterilization method with lesser damage, 3D laparoscope and its annex, the total number of adverse feedback of patients has decreased 60%. Conclusion： The established management system for safe use of 3D laparoscope imaging system which covers preoperative, intraoperative and postoperative stages can reduce the surgical risk and clinical adverse feedbacks comes from the equipment failure and inappropriate operation. Moreover, it can provide reference for the safe use and management of 3D laparoscopic imaging system.
出处
《中国医学装备》
2018年第1期36-39,共4页
China Medical Equipment
关键词
三维成像手术腹腔镜系统
根因分析
临床不良反馈
消毒灭菌
手术风险
安全管理
3D imaging operating laparoscope system
Root cause analysis
Clinical adverse feedback
Disinfection and sterilization
Surgical risk
Safe management
