CAJ | 학술논문

目的：探讨临床路径管理对首发抑郁障碍和复发抑郁障碍患者的效果。方法采用临床随机对照试验的方式，将2012年11月至2013年12月山西医科大学第一医院收治的首发抑郁障碍患者98例和复发抑郁障碍患者124例随机分为试验组（临床路径管理组）和对照组（常规管理组），进行临床观察。结果首发抑郁障碍患者实施临床路径管理的住院费用和住院天数均低于常规管理的患者（t=3.441，P=0.001；t=2.959，P=0.004），其实施临床路径管理的总有效率91.84%高于常规管理组的总有效率75.51%（χ2=4.781，P=0.029）；复发抑郁障碍实施临床路径管理的患者住院费用和住院天数也低于常规管理组（t=2.149，P=0.033；t=2.424，P=0.017），其实施临床路径管理的总有效率88.71%高于常规管理组的总有效率74.19%（χ2=4.324，P=0.038）；实施临床路径管理的首发抑郁患者住院费用低于复发抑郁患者的住院费用（t=7.897，P<0.01），而住院天数和临床疗效两组差异无统计学意义（P>0.05）。结论临床路径管理无论对首发抑郁障碍还是复发抑郁障碍患者均可降低其住院费用，缩短住院天数，提高临床疗效。
목적：탐토림상로경관리대수발억욱장애화복발억욱장애환자적효과。방법채용림상수궤대조시험적방식，장2012년11월지2013년12월산서의과대학제일의원수치적수발억욱장애환자98례화복발억욱장애환자124례수궤분위시험조（림상로경관리조）화대조조（상규관리조），진행림상관찰。결과수발억욱장애환자실시림상로경관리적주원비용화주원천수균저우상규관리적환자（t=3.441，P=0.001；t=2.959，P=0.004），기실시림상로경관리적총유효솔91.84%고우상규관리조적총유효솔75.51%（χ2=4.781，P=0.029）；복발억욱장애실시림상로경관리적환자주원비용화주원천수야저우상규관리조（t=2.149，P=0.033；t=2.424，P=0.017），기실시림상로경관리적총유효솔88.71%고우상규관리조적총유효솔74.19%（χ2=4.324，P=0.038）；실시림상로경관리적수발억욱환자주원비용저우복발억욱환자적주원비용（t=7.897，P<0.01），이주원천수화림상료효량조차이무통계학의의（P>0.05）。결론림상로경관리무론대수발억욱장애환시복발억욱장애환자균가강저기주원비용，축단주원천수，제고림상료효。
Objective Toinvestigatetheeffectofclinicalpathwaymanagementinfirstepisodedepressive disorder and recurrent depressive disorder. Methods Using the clinical randomized controlled trial mode, From November 2012 to December 2013, There were 98 patients with first episode depressive disorder and 124 patients with recurrent depressive disorder in the First Hospital of Shanxi Medical University. Those patients were respectively randomly divided into the experimental group (clinical pathway management) and the control group (conventional management). The clinical effect was observed. Results Hospitalization expenses and hospitalization days of first episode depressive disorder patients using clinical pathway management were lower than patients using conventional management(t=3.441, P=0.001;t=2.959, P=0.004).The total effective rate of first episode depressive disorder patients using clinical pathway management was 91.84%, higher than the conventional management group that was 75.51%(χ2=4.781, P=0.029). Hospitalization expenses and hospitalization days of recurrent depressive disorder patients using clinical pathway management were lower than patients using conventional management too(t=2.149, P=0.033;t=2.424, P<0.017). Its' clinical effect was higher than the conventional management group(χ2=4.324, P=0.038). Hospitalization expenses of first episode patients using clinical pathway management were lower than patients with recurrent depression disorder(t=7.897, P<0.01),hospitalization days and total effective rate had no significant difference (P>0.05). Conclusion Clinical pathway management can reduce the hospitalization days and expenses, then improve the clinical effect in both of the patients with first episode depressive disorder and recurrent depressive disorder.