美國急救醫(yī)學(xué)研究所(ECRI)提醒醫(yī)療機構(gòu)重視外科吻合器的正確使用，減少對患者的傷害。

美國急救醫(yī)療研究所（ECRI）2016年11月發(fā)布“2017年醫(yī)療技術(shù)十大危害”，旨在提醒醫(yī)療機構(gòu)高層管理人員，注意醫(yī)療器械及醫(yī)療設(shè)備潛在不安全因素，并采取積極措施，正確使用醫(yī)療技術(shù)，減少對患者帶來的傷害。

操作不當和錯誤使用外科吻合器，是第九大造成病人傷害的醫(yī)療技術(shù)。錯誤使用或操作不當，造成吻合器功能失常，導(dǎo)致手術(shù)過程中出血、組織損傷、無法預(yù)料的術(shù)后出血、吻合口漏、吻合口瘺以及其他術(shù)后傷害，必須引起廣大外科醫(yī)生的高度關(guān)注和重視。

報道中指出，極其細心地操作外科吻合器，掌握必要的技能，通常在使用中不會出現(xiàn)問題。美國食品藥品監(jiān)督管理局（FDA）每年接到幾千個涉及外科吻合器的不良事件報告，ECRI同樣也接到不斷的吻合器使用問題的報告。雖然嚴重的傷害不是經(jīng)常發(fā)生，但是的確發(fā)生了。 ECRI調(diào)查了嚴重病人傷害事件的致命性以及其他因素。

常見的不良事件報告，包括誤擊發(fā)或難以擊發(fā)，錯誤地使用吻合器，擊發(fā)時有異常聲響（這些表明吻合器已經(jīng)損壞或錯誤操作造成）, 以及組織被卡在了器械結(jié)構(gòu)里。

為了預(yù)防病人傷害，使用吻合器的外科醫(yī)生必須熟悉器械的操作，根據(jù)病人和組織情況，小心地選擇合適的縫釘大小，必須具備識別吻合器出現(xiàn)各種故障的能力。

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Problems associated with the use and functioning of surgical staplers can lead to intraoperative hemorrhaging, tissue damage, unexpected postoperative bleeding, failed anastomoses, and other forms of patient harm.

Surgical staplers require meticulous technique to operate, and problems during use are not uncommon. The U.S. Food and Drug Administration receives thousands of adverse event reports related to surgical staplers each year, and ECRI Institute likewise consistently receives reports of surgical stapler problems. Although severe injuries are infrequent, they do occur: We have investigated fatalities and other cases of serious patient harm.

problems include: misfiring or difficulty in firing, misapplied staples, unusual sounds during firing (which can indicate a damaged or malfunctioning mechanism), and tissue becoming “jammed” in the mechanism.

To prevent patient harm,users must be familiar with device operation, they must carefully select the appropriate staple size for the patient and tissue type, and they must be alert  to the signs that the stapler may not be functioning as intended.