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如何避免与手术相关的损伤?围手术期神经损伤可能报告不足。

[How to avoid injuries in connection with surgery? Perioperative nerve injuries are probably underreported].

作者信息

Räf L, Netz P

机构信息

Landstingens Omsesidiga Försäkringsbolag (LOF), Stockholm.

出版信息

Lakartidningen. 1999 Apr 21;96(16):1951-8.

Abstract

The occurrence of mechanical nerve injury in connection with anaesthesia and surgery is probably more common than generally believed, and by no means all cases are reported to the patient injury claims department. Both incorrect positioning of the patient on the operating table and pressure from retractors and other instruments can contribute to the occurrence of such injuries. Both neurological and neurophysiological procedures should be used to localise the injury, particularly for the purpose of insurance assessment. Most important of all, however, is prevention of injury. Risk minimisation is dependent on the observation of meticulous routines in surgery units, and clear division of staff responsibilities. The surgical injury rate can be monitored by means of a register of general complications.

摘要

与麻醉和手术相关的机械性神经损伤的发生率可能比普遍认为的更为常见,而且绝非所有病例都会上报给患者损伤索赔部门。患者在手术台上的不当体位以及牵开器和其他器械产生的压力都可能导致此类损伤的发生。应同时采用神经学和神经生理学方法来确定损伤的位置,尤其是为了保险评估的目的。然而,最重要的是预防损伤。将风险降至最低取决于手术科室严格遵守细致的常规操作,以及明确划分工作人员的职责。手术损伤率可以通过一份一般并发症登记册来进行监测。

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