世界最新医学信息文摘(电子版)
世界最新醫學信息文摘(電子版)
세계최신의학신식문적(전자판)
World Latest Medicine Information
2013年
22期
35-36
,共2页
消化内科%变异情况%临床路径%控制原因%主导因素
消化內科%變異情況%臨床路徑%控製原因%主導因素
소화내과%변이정황%림상로경%공제원인%주도인소
the digestive internal medicine%Variation%Clinical pathway%Control%The dominant factor
目的:分析总结消化内科中6种疾病临床路径变异原因以及具体应对措施,以便于在临床中推广使用。方法选取我院消化内科2012年1月至2013年7月收治的130临床路径患者,其中78例患者出现变异情况,分析患者变异的原因,在分析之后进行归类和总结,并在分析讨论之后制定出有效控制变异的措施。结果在路径的实施过程中,出现不同程度变异的患者例数78例,总变异率为60.0%,若按照变异类型对比进行分类,其中由患者自身疾病因素而导致的变异比例为37.0%,34%为患者主观因素,21.0%由医生导致,另外由医院引起的变异占8.0%。若按照对变异的管理产生的困难程度进行分类,患者自身病因导致的变异属于不可控制,比例为37%。存在于患者和医生中的主观因素引起的变异能够得到控制,其比例为55.0%。其中51例大肠肉息摘除术患者中,患者平均出院时间为(4.15±0.15)天,和临床路径所规定的时间之前差异明显(P<0.05),具有统计学意义。结论若变异情况由患者以及医生等主观因素所导致,则能够良好的控制。用药的不合理以及过度检查是变异情况出现的主要原因,在今后加强用药控制和检查频率能够有效的控制变异情况。
目的:分析總結消化內科中6種疾病臨床路徑變異原因以及具體應對措施,以便于在臨床中推廣使用。方法選取我院消化內科2012年1月至2013年7月收治的130臨床路徑患者,其中78例患者齣現變異情況,分析患者變異的原因,在分析之後進行歸類和總結,併在分析討論之後製定齣有效控製變異的措施。結果在路徑的實施過程中,齣現不同程度變異的患者例數78例,總變異率為60.0%,若按照變異類型對比進行分類,其中由患者自身疾病因素而導緻的變異比例為37.0%,34%為患者主觀因素,21.0%由醫生導緻,另外由醫院引起的變異佔8.0%。若按照對變異的管理產生的睏難程度進行分類,患者自身病因導緻的變異屬于不可控製,比例為37%。存在于患者和醫生中的主觀因素引起的變異能夠得到控製,其比例為55.0%。其中51例大腸肉息摘除術患者中,患者平均齣院時間為(4.15±0.15)天,和臨床路徑所規定的時間之前差異明顯(P<0.05),具有統計學意義。結論若變異情況由患者以及醫生等主觀因素所導緻,則能夠良好的控製。用藥的不閤理以及過度檢查是變異情況齣現的主要原因,在今後加彊用藥控製和檢查頻率能夠有效的控製變異情況。
목적:분석총결소화내과중6충질병림상로경변이원인이급구체응대조시,이편우재림상중추엄사용。방법선취아원소화내과2012년1월지2013년7월수치적130림상로경환자,기중78례환자출현변이정황,분석환자변이적원인,재분석지후진행귀류화총결,병재분석토론지후제정출유효공제변이적조시。결과재로경적실시과정중,출현불동정도변이적환자례수78례,총변이솔위60.0%,약안조변이류형대비진행분류,기중유환자자신질병인소이도치적변이비례위37.0%,34%위환자주관인소,21.0%유의생도치,령외유의원인기적변이점8.0%。약안조대변이적관리산생적곤난정도진행분류,환자자신병인도치적변이속우불가공제,비례위37%。존재우환자화의생중적주관인소인기적변이능구득도공제,기비례위55.0%。기중51례대장육식적제술환자중,환자평균출원시간위(4.15±0.15)천,화림상로경소규정적시간지전차이명현(P<0.05),구유통계학의의。결론약변이정황유환자이급의생등주관인소소도치,칙능구량호적공제。용약적불합리이급과도검사시변이정황출현적주요원인,재금후가강용약공제화검사빈솔능구유효적공제변이정황。
Objective To analysis the digestive internal medicine clinical path variation reasons and 6 kinds of diseases in the speciifc countermeasures, so as to be used widely in clinical. Methods Our hospital between January 2012 and 2012 of digestive diseases at the records of 130 patients with clinical pathway, 8 of which 78 cases of patients with a mutation situation, analysis the reason that patients with variations are classified and summarized after the analysis, and based on the analysis discussion to develop effective control measures of variation. Results In the process of the implementation of the path, and 78 cases of patients with different degree of variation of the number of cases, the total variation rate was 60.0%, if the variable type classifying despised, which caused by the patient's own illness factors variation ratio was 37.0%, 34%of patients with subjective factors, lead to 21.0%by a doctor, the other variation caused by hospitals accounted for 8.0%. If according to the management of the traverse on the dififculty of classiifcation, the patient's own causes variation are uncontrollable, at 37%. Present in the patients and doctors to subjective factors of variation can be controlled, the proportion of 55.0%. 51 cases e. meat rate in patients with excision, average discharge time was (4.15+0.15) in patients with day, and before the time stipulated in the clinical path difference obviously, (P<0.05) with statistical signiifcance. Conclusion If the variation is caused by subjective factors, such as patients and doctors, can good control. Drug use unreasonable and excessive examination is the main reason for the variation occurs, in the future to strengthen drug control and inspection frequency can effectively control the variation.