摘要
目的探讨北京安贞医院通州院区麻醉手术中心在运行初期完成的前1000例心脏外科手术中的麻醉质控管理经验与运行成效,为新建医院及各级医疗机构提供可复制、可推广的麻醉质量管理模式。方法采用回顾性研究方法,纳入2024年10月14日至2024年12月18日在通州院区完成的前1000例心脏外科手术患者,65岁以上占比40.9%,美国麻醉医师协会(ASA)分级≥Ⅲ级占85.7%,手术分级≥Ⅲ级占93.1%。通过麻醉信息平台采集围手术期数据,统计分析关键质控指标并与国内外平均水平比较。结果该1000例患者围手术期死亡率为0.10%,明显低于国际平均水平(3.29%);二次开胸率为1.50%,非计划插管率为0.90%,术后新发脑梗率为1.40%,均优于文献报道。术中及围手术期重大并发症(如严重过敏反应、拔管后声音嘶哑)发生率为0.00%。在人力资源紧张条件下,仍高效完成高强度手术任务,麻醉医师日均工作时间9.94 h,麻醉助手8.55 h。结论北京安贞麻醉手术中心构建的麻醉质控体系,涵盖术前风险评估、术中标准化监测、术后快速康复及持续质量改进。在运行初期阶段实现了医疗质控管理高质量平稳推进,死亡率及各重大并发症发生率远低于国际平均水平。
Objective To explore the anesthesia quality control management experience and operational outcomes from the first 1,000 cardiac surgeries performed during the initial operation period of the Department of Anesthesiology of Beijing Anzhen Hospital(Tongzhou),providing a replicable and scalable anesthesia quality management model for newly established hospitals and medical institutions at various levels.Methods A retrospective study was conducted on 1,000 patients who underwent cardiac surgery at Beijing Anzhen Hospital(Tongzhou)from October 14th to December 18th,2024.Among them,40.9%were aged over 65 years,85.7% were classified as American Society of Anesthesiologists(ASA)physical status≥Ⅲ,and 93.1% underwent surgeries with a classification≥Ⅲ.Perioperative data were collected through an anesthesia information platform,and key quality control indicators were statistically analyzed and compared with domestic and international benchmarks.Results The perioperative mortality rate of these patients was 0.10%,significantly lower than the international average of 3.29%.Rates of reoperation for bleeding(1.50%),unplanned intubation(0.90%),and newonset postoperative stroke(1.40%)were all better than those reported in the literature.The incidence of major intraoperative and perioperative complications,such as severe allergic reactions and postoperative hoarseness due to extubation,was 0.00%.Despite limited human resources,the center efficiently handled high-intensity surgical workloads,with anesthesiologists working an average of 9.94 h per day and anesthesia assistants 8.55 h per day.Conclusion The anaesthesia quality control system established by the Department of Anesthesiology of Beijing Anzhen Hospital encompasses preoperative risk assessment,standardized intraoperative monitoring,postoperative enhanced recovery,and continuous quality improvement.During the initial operation phase,this system ensured the high-quality and steady advancement of medical quality control management,with mortality and the incidence of major complications far below the international averages.
作者
王嘉瑞
张岩松
李书闻
赵文度
林培容
金沐
王晟
WANG Jiarui;ZHANG Yansong;LI Shuwen;ZHAO Wendu;LIN Peirong;JIN Mu;WANG Sheng(Department of Anesthesiology,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)
出处
《麻醉安全与质控》
2026年第1期17-21,共5页
Perioperative Safety and Quality Assurance
基金
四大慢病重大专项(2023ZD0504404)。
关键词
麻醉
心脏外科手术
质控管理
围手术期
anesthesia
cardiac surgery
quality control management
perioperative
