基于FMEA和POSSUM评分的手术风险评估研究

??????? 目的 研究建立手术风险评估的架构，以正确决策手术时机。方法 采用用于计数死亡率和并发症发生率的生理学和手术严重性（POSSUM）评分原理进行分层计分，同时引用失效模式与效应分析方法对手术可能发生故障模式的严重度及发生可能性及风险因素的影响度3个维度进行评估。结果 建立了手术前风险预警机制及手术评估架构，利用评估架构对某综合医院2010年200例80岁高龄的手术病人进行了术前评估，结果手术后并发症的发生率较2009年同年龄的手术病人的并发症下降了10.45%。结论 在手术前对手术相关因素进行评估，可以为手术时机的选择提供参考。

FMEA and Possum Grading Based Framework of Surgical Risk Assessment

????? Objective To find out when to put surgeries into action by means of establishing an evaluation pathway of the risks. Methods Possum grading was used for layering and FMEA for 3 aspects assessment, including severity, possibility and influence of risks. Results The risks early-warning system of surgery safety and framework of surgical risk assessment was established. By using this framework, the complications declined by 10.45%, based on samples, including 200 elders over 80 years old in 2010 in a comprehensive hospital. Conclusion Combination of Tree FMEA and Possum grading can help to evaluate the possible failures of all parts before operation. It offers an objective preoperational evidence to support the right time of surgery.