中国医药科学
中國醫藥科學
중국의약과학
China Medicine and Pharmacy
2015年
18期
83-86
,共4页
临床路径%文本设计%应用效果
臨床路徑%文本設計%應用效果
림상로경%문본설계%응용효과
Clinical pathway%The context design%The effect of application
目的：探讨临床路径文本的设计方法及应用效果。方法依据循证医学、中位数法、帕雷托原理等理念和方法，设计阑尾炎、腹股沟疝、交通性鞘膜积液3个普外科病种的临床路径文本，并用设计好的文本对这3个病种实施临床路径治疗，对实施临床路径的效果进行分析评价。结果收集2013年1月～2014年10月3个病种实施临床路径治疗组（路径组）和传统治疗组（对照组）病历资料，所有进入路径的患者均能按设计的诊疗内容完成治疗并在设计的时间内出院；3个病种平均住院天数路径组比对照组减少3～4d，平均住院总费用路径组明显低于对照组，经统计分析路径组和对照组在平均住院天数和平均住院总费用方面差异有统计学意义（P＜0.05）；3个病种路径组和对照组患者满意度调查满意率均≥98％，术后3～6个月随访，均恢复良好，无并发症发生，路径组和对照组无明显差别。结论应用临床路径对3个病种进行治疗，切实能保证医疗安全、减少平均住院天数、降低平均住院总费用、提高患者满意度。
目的：探討臨床路徑文本的設計方法及應用效果。方法依據循證醫學、中位數法、帕雷託原理等理唸和方法，設計闌尾炎、腹股溝疝、交通性鞘膜積液3箇普外科病種的臨床路徑文本，併用設計好的文本對這3箇病種實施臨床路徑治療，對實施臨床路徑的效果進行分析評價。結果收集2013年1月～2014年10月3箇病種實施臨床路徑治療組（路徑組）和傳統治療組（對照組）病歷資料，所有進入路徑的患者均能按設計的診療內容完成治療併在設計的時間內齣院；3箇病種平均住院天數路徑組比對照組減少3～4d，平均住院總費用路徑組明顯低于對照組，經統計分析路徑組和對照組在平均住院天數和平均住院總費用方麵差異有統計學意義（P＜0.05）；3箇病種路徑組和對照組患者滿意度調查滿意率均≥98％，術後3～6箇月隨訪，均恢複良好，無併髮癥髮生，路徑組和對照組無明顯差彆。結論應用臨床路徑對3箇病種進行治療，切實能保證醫療安全、減少平均住院天數、降低平均住院總費用、提高患者滿意度。
목적：탐토림상로경문본적설계방법급응용효과。방법의거순증의학、중위수법、파뢰탁원리등이념화방법，설계란미염、복고구산、교통성초막적액3개보외과병충적림상로경문본，병용설계호적문본대저3개병충실시림상로경치료，대실시림상로경적효과진행분석평개。결과수집2013년1월～2014년10월3개병충실시림상로경치료조（로경조）화전통치료조（대조조）병력자료，소유진입로경적환자균능안설계적진료내용완성치료병재설계적시간내출원；3개병충평균주원천수로경조비대조조감소3～4d，평균주원총비용로경조명현저우대조조，경통계분석로경조화대조조재평균주원천수화평균주원총비용방면차이유통계학의의（P＜0.05）；3개병충로경조화대조조환자만의도조사만의솔균≥98％，술후3～6개월수방，균회복량호，무병발증발생，로경조화대조조무명현차별。결론응용림상로경대3개병충진행치료，절실능보증의료안전、감소평균주원천수、강저평균주원총비용、제고환자만의도。
Objective To investigate the method of context design and the application effect of clinical pathway. MethodsAccording to the theories of evidence-based medicine (EBM), Pareto Principle and Median Method, the project of clinical pathway of three types of diseases (appendicitis, Inguinal hernia, Communicating hydrocele) was designed and subsequently applied in practice. Finally, the effect of the project was accessed.Results From January 2013 to October 2014, the clinical datasets of the clinical pathway treatment group (intervention group) and conventional treatment group (control group) were collected and analyzed. The patients from the Intervention Group completed the treatment and discharged on schedule. The average days of hospitalization of the Intervention Group were 3 to 4 days more than the Control Group. And the average expense of hospitalization of Intervention Group was significantly lower than the Control Group (P<0.05). The degree of satisfaction of both groups was greater than 98% and does not show significant difference.ConclutionApplication of clinical pathway could reduce the expense and the length of hospitalization for the treatment of three types of diseases in general surgery.
