临床路径管理在结节性甲状腺肿治疗中的效果评价

Effect of clinical pathway on nodular goiter

  • 摘要: 目的 探讨临床路径在我院普通外科结节性甲状腺肿治疗中的实施效果。 方法 调查2009年11月-2010年8月临床路径实施前后我院普通外科结节性甲状腺肿治疗情况。将165份病例按是否实施临床路径分为非路径组87例和路径组78例,根据手术方式不同,又将两组各分为单侧甲状腺手术组和双侧甲状腺手术组,评价临床路径的实施效果。 结果 路径组单侧手术患者的住院时间较非路径组由(7.79±2.69) d下降到(6.55±1.36) d;术前住院时间由(4.04±2.69) d下降到(3.03±1.11) d。双侧手术患者住院时间由(8.00±2.62) d下降到(7.17±1.61) d,术前住院时间由(3.84±2.19) d下降到(3.33±1.48) d。路径组单侧手术患者较路径组药品费用由(4 965.8±1 796.7)元下降到(3 716.6±1 668.1)元;住院费用由(10 366.1±3 509.7)元下降到(10 080.1±3 436.3)元;双侧手术患者药品费用由(5 149.7±2 174.14)元下降到(4 428.2±1 558.2)元,住院费用由(11 533.7±4 006.1)元下降到(11 283.5±2 716.9)元。术后不良反应和并发症发生率也从14.94%下降到6.41%。 结论 实施临床路径可有效缩短患者住院日,减少患者住院费用,降低术后不良反应和并发症发生率,可在临床上推广应用。

     

    Abstract: Objective To study the effect of clinical pathway on nodular goiter. Methods Clinical data of nodular goiter treated in our department from November 2009 to August 2010 were investigated.One hundred and sixty-five patients with nodular goiter were divided into non-clinical pathway group(n=87) and clinical pathway group(n=78) and further divided into unilateral operation group and bilateral operation group according to different surgical procedures.Effect of different clinical pathways was assessed. Results The hospital stay time of unilateral surgery group was longer than that of bilateral operation group((7.79±2.69)d vs(6.55±1.36d)) and before admission to hospital than after admission to hospital((4.04±2.69)d vs(3.03±1.11d)).The hospital stay time of bilateral operation group decreased to(7.17±1.61)d from(8.00±2.62)d after operation and from(3.84±2.19)d before operation.The drug cost of unilateral operation group decreased to(3 716.6±1 668.1) yuan from(4 965.8±1 796.7) and the hospitalization fee decreased to(10 080.1±3 436.3) yuan from(10 366.1±3 509.7) yuan.The drug cost of bilateral operation group decreased to(4 428.2±1 558.2) yuan from(5 149.7±2 174.14) yuan and the hospitalization fee decreased to(11 283.5±2 716.9) yuan from(11 533.7±4 006.1) yuan.The incidence of adverse reactions and complications decreased to 6.41% from 14.94%,respectively,after surgery. Conclusion The implementation of clinical pathway can effectively shorten the hospital stay time of patients,decrease their hospitalization cost,reduce the incidence of adverse reactions and complications after surgery,and can thus be popularized in clinical practice.

     

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