脑出血患者实施临床路径管理的应用效果评价
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摘要
目的探讨临床路径管理在脑出血患者治疗过程中的应用效果和价值。方法收集某三甲医院神经内科主要诊断为脑出血的370例住院患者的病案资料,随机分成路径组和对照组,综合比较两组脑出血患者的相关评价指标。结果路径组患者的住院总费用、药费、药占比、住院日、神经功能缺损程度评分、住院并发症发生率以及院内感染率均低于对照组(P<0.05),日常生活能力评分和总体满意度均高于对照组(P<0.01),而两组患者间的出院转归及病死率差异无统计学意义(P>0.05)。结论脑出血患者实施临床路径管理可以降低住院费用、缩短平均住院日、促进肢体功能恢复、改善生活质量、提高满意度,值得临床推广应用。
Objective To analyze the practical effects and value of the clinical pathway management in patients with intracerebral hemorrhage during the therapy sessions. Methods The medical records of 370 patients with primary diagnosis of intracerebral hemorrhage in the department of neurology of certain tertiary hospital were obtained retrospectively,patients were split into clinical pathway group and control group,the relevant indicators between two groups were evaluated and analyzed comprehensively. Results The average total hospitalization expenditure,drugs fees,the ratio of medicine fee,the length of stay,the nerve function defect score,hospitalization incidence of complications and nosocomial infection in pathway group were less than those in the control group( P < 0. 05),activity of daily living score and the satisfaction degree of patients in pathway group were superior to those in the control group( P < 0. 05),however,patient outcomes and fatality rate between the two groups had no statistically significant difference( P > 0. 05). Conclusion Clinical pathway management in patients with intracerebral hemorrhage is helpful for reducing hospital costs,shortening the length of stay,promoting motor functional rehabilitation,improving the quality of life and elevating the satisfaction of patients,which is worthy of further promotion.
Objective To analyze the practical effects and value of the clinical pathway management in patients with intracerebral hemorrhage during the therapy sessions. Methods The medical records of 370 patients with primary diagnosis of intracerebral hemorrhage in the department of neurology of certain tertiary hospital were obtained retrospectively,patients were split into clinical pathway group and control group,the relevant indicators between two groups were evaluated and analyzed comprehensively. Results The average total hospitalization expenditure,drugs fees,the ratio of medicine fee,the length of stay,the nerve function defect score,hospitalization incidence of complications and nosocomial infection in pathway group were less than those in the control group( P < 0. 05),activity of daily living score and the satisfaction degree of patients in pathway group were superior to those in the control group( P < 0. 05),however,patient outcomes and fatality rate between the two groups had no statistically significant difference( P > 0. 05). Conclusion Clinical pathway management in patients with intracerebral hemorrhage is helpful for reducing hospital costs,shortening the length of stay,promoting motor functional rehabilitation,improving the quality of life and elevating the satisfaction of patients,which is worthy of further promotion.
引文
[1]李迪,王文志,孙海欣.脑出血继发性损害中炎性反应的分子生物学标记物[J].中华老年心脑血管病杂志,2016,18(2):215-217.
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[5]罗贻春,沈雪,叶青,等.临床路径管理对脑出血患者卒中相关性肺炎的干预作用[J].卒中与神经疾病,2014,21(6):337-339,349.
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[8]伍小英,谭守勇,罗少霞,等.临床路径管理在肺结核可疑患者中的应用[J].广东医学,2015,36(22):3523-3525.
[9]Huang YC,Hu CJ,Lee TH,et al.The impact factors on the cost and length of stay among acute ischemic stroke[J].Journal of stroke and cerebrovascular diseases:the official journal of National Stroke Association,2013,22(7):e152-e158.
[10]胡丹,董峻,朱靖,等.2007-2011年某三甲医院脑梗死住院费用构成及影响因素分析[J].中国卫生统计,2014,31(4):707-709.
[11]倪阳,王甦平,龚睿婕,等.带状疱疹患者对临床路径诊疗的满意度研究[J].上海交通大学学报:医学版,2015,35(6):892-895.
[2]曾儒欣,贺湘蛟,张健,等.脑出血肺部感染患者的病原菌分布与治疗效果研究[J].中华医院感染学杂志,2016,26(2):320-322.
[3]张海瑞,马莉,张莹,等.辽宁省临床路径管理试点工作实施现状及效果评价[J].中国卫生事业管理,2015,32(5):341-344.
[4]芦燕玲,潘伟琦.老年高血压患者幽门螺杆菌感染与新发心脑血管事件关系的研究[J].中华老年心脑血管病杂志,2015,17(2):130-132.
[5]罗贻春,沈雪,叶青,等.临床路径管理对脑出血患者卒中相关性肺炎的干预作用[J].卒中与神经疾病,2014,21(6):337-339,349.
[6]Cadilhac DA,Purvis T,Kilkenny MF,et al.Evaluation of rural stroke services:does implementation of coordinators and pathways improve care in rural hospitals?[J].Stroke;a journal of cerebral circulation,2013,44(10):2848-2853.
[7]陈佳丽,宁宁,叶霞,等.经皮内镜下腰椎间盘切除术临床路径实施现状调查研究[J].现代预防医学,2015,42(15):2851-2854.
[8]伍小英,谭守勇,罗少霞,等.临床路径管理在肺结核可疑患者中的应用[J].广东医学,2015,36(22):3523-3525.
[9]Huang YC,Hu CJ,Lee TH,et al.The impact factors on the cost and length of stay among acute ischemic stroke[J].Journal of stroke and cerebrovascular diseases:the official journal of National Stroke Association,2013,22(7):e152-e158.
[10]胡丹,董峻,朱靖,等.2007-2011年某三甲医院脑梗死住院费用构成及影响因素分析[J].中国卫生统计,2014,31(4):707-709.
[11]倪阳,王甦平,龚睿婕,等.带状疱疹患者对临床路径诊疗的满意度研究[J].上海交通大学学报:医学版,2015,35(6):892-895.