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目的探讨临床路径管理在基层医院骨科的应用。方法选择我院2011年1月至2012年1月完成临床路径管理的6个病种:腰椎间盘突出症、颈椎病、重度膝关节骨关节炎、股骨颈骨折、胫骨平台骨折、踝关节骨折共231例作为临床路径管理组,同样将另外一个病区的入院患者,患者第一诊断相同,并采用常规方法以及传统的管理方法进行治疗的256例患者作为对照组,对比2组患者资料。结果临床路径组患者例均医疗费、西药费以及其他费用显著低于对照组,差异有统计学意义(P<0.05)。临床路径组平均住院日、术前、术后住院日及使用抗生素天数均显著低于对照组,差异有统计学意义(P<0.05)。临床路径组患者满意率为93.5%,对照组为78.1%,2组患者满意度对比差异有统计学意义(P<0.05)。2组病人分别对医生护士满意度进行对比,临床路径组满意度为95%,对照组为70%,2组医生护士满意度对比差异有统计学意义(P<0.05)。临床路径组治愈率(96.1%)与对照组(95.3%)对比差异无统计学意义(P>0.05)。结论临床路径管理能减少住院费用、缩短住院时间及抗生素使用天数,提高患者满意度,值得临床大力推广。
Objective To explore the clinical path management in primary hospital orthopedic applications. Methods Six clinical cases of pathological management were completed in our hospital from January 2011 to January 2012: lumbar disc herniation, cervical spondylosis, severe knee osteoarthritis, femoral neck fracture, tibial plateau fracture, total ankle fracture 231 cases as the clinical path management group, the same ward will be the same patient in another ward, the first diagnosis of the same patients, and the use of conventional methods and traditional management methods for treatment of 256 patients as a control group, compared two groups of patients data. Results The patients in the clinical pathway group were significantly lower in medical expenses, western medicine expenses and other costs than the control group (P <0.05). The average length of hospital stay, preoperative, postoperative hospital days and antibiotic days in the clinical pathway group were significantly lower than those in the control group (P <0.05). The satisfaction rate of patients in the clinical pathway group was 93.5%, while the control group was 78.1%. There was significant difference in satisfaction between the two groups (P <0.05). Two groups of patients were compared to the satisfaction of doctors and nurses, clinical pathology group satisfaction was 95%, the control group was 70%, two groups of nurses satisfaction was statistically significant (P <0.05). There was no significant difference between the clinical pathological group (96.1%) and the control group (95.3%) (P> 0.05). Conclusion Clinical pathway management can reduce the cost of hospitalization, shorten the length of hospital stay and the number of days of antibiotic use, improve patient satisfaction, and it is worth clinical promotion.