Blomgren K, Aaltonen L-M, Lehtonen L, Helmiö P
Department of Otorhinolaryngology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Department of Public Health, University of Helsinki and Administration Centre, Helsinki University Hospital, Helsinki, Finland.
Clin Otolaryngol. 2018 Feb;43(1):7-12. doi: 10.1111/coa.12894. Epub 2017 May 25.
To assess factors contributing to patient injuries in operative rhinology.
Data of the accepted patient injury claims involving operative rhinology, between the years 2001 and 2011, were obtained from the Finnish Patient Insurance Centre registry. Two senior otolaryngologists analysed and evaluated the injury mechanisms.
Analysis and classification of factors contributing to patient injuries.
During the ten-year study period, there were 67 patient injuries in operative rhinology, comprising 36% of all patient injuries in otorhinolaryngologic surgery. The majority (78%) of patients were treated in university or central hospitals and almost all (90%) by fully trained otolaryngology specialists. The factors contributing to the injuries were errors in surgical technique, like lesions to the orbit, skull base and meninges, and adjacent nerves, as well as mistakes with removable packings left in situ. Nearly half of the patients had undergone endoscopic sinus surgery. One patient died because of bleeding from the intracranial artery. Fourteen patients (21%) needed a re-operation due to the injury.
Patient injuries in rhinology were caused by typical complications of common operations performed by otorhinolaryngology specialists. The increased volume of endoscopic sinus surgery was evident also in patient injuries.
评估鼻科手术中导致患者受伤的因素。
从芬兰患者保险中心登记处获取2001年至2011年间接受的涉及鼻科手术的患者受伤索赔数据。两位资深耳鼻喉科医生分析并评估了损伤机制。
分析并分类导致患者受伤的因素。
在为期十年的研究期间，鼻科手术中有67例患者受伤，占耳鼻喉科手术中所有患者受伤的36%。大多数（78%）患者在大学医院或中心医院接受治疗，几乎所有患者（90%）由训练有素的耳鼻喉科专家治疗。导致受伤的因素包括手术技术失误，如眼眶、颅底和脑膜以及相邻神经的损伤，以及留在原位的可移除填充物的错误使用。近一半的患者接受了鼻内镜鼻窦手术。一名患者因颅内动脉出血死亡。14名患者（21%）因损伤需要再次手术。
鼻科患者受伤是由耳鼻喉科专家进行的常见手术的典型并发症引起的。鼻内镜鼻窦手术量的增加在患者受伤情况中也很明显。
