农村老年胆囊结石患者双向转诊过程中单病种临床路径的应用  

Application of clinical pathway of single-disease in dual referral mechanism of rural elderly patients with gallstone

作　　者：孙金兵[1] 蒋建龙[1] 顾芯烨[1] 顾雪坤 

机构地区：[1]苏州大学附属常熟医院普外科,江苏常熟215500

出　　处：《中国医药导报》2015年第2期145-147,共3页China Medical Herald

基　　金：国家"十二五"科技支撑计划项目"农村基本医疗卫生关键技术研究与示范"项目(编号2012BAJ18B00);江苏省常熟市科技发展计划(社会发展)项目(编号CS201414)

摘　　要：目的探讨单病种临床路径在农村老年胆囊结石患者双向转诊中的应用效果。方法选取2013年10月~2014年10月在苏州大学附属常熟医院（以下简称＂我院＂）行腹腔镜下胆囊切除术60岁及以上患者46例,随机分为试验组（n=23）和对照组（n=23）。试验组患者从入院手术到出院转回常熟市辛庄镇卫生院后续治疗均按胆囊结石单病种临床路径模式管理实施连续医疗护理;对照组患者则按传统治疗方法处理,痊愈后从我院直接出院。对两组患者的医院平均住院时间、抗生素使用时间、总住院费用、患者满意度等指标进行对比分析。结果试验组患者在平均住院时间、抗生素使用时间、总住院费用、患者满意度等方面均明显优于对照组（P〈0.05或P〈0.01）。结论单病种临床路径在农村老年胆囊结石患者双向转诊中效果明显,值得推广。Objective To evaluate the application effect of clinical pathway of single-disease in dual referral mecha-nism of rural elderly patients with gallstone. Methods 46 patients （≥60 years old） who received laparoscopic cholecys-tectomy （LC） in Changshu Affiliated Hospital of Soochow University （＆quot;our hospital＆quot; for short） from October 2013 to Oc-tober 2014 were collected. The samples were randomly divided into the path group and the control group, each consist-ing of 23 cases. Patients in the path group received continuous medical care according to clinical pathway of single-disease in our hospital and were referred to Xinzhuang Health Center after operation. The whole treatment followed the clinical pathway of single-disease management. The patients in the control group were treated with traditional treating method and recovered directly in our hospital. The average days in hospital, time of antibiotic use, the hospitalization costs and patient＇s satisfaction were compared and analyzed in both groups. Results The average days in hospital, time of antibiotic use, the hospitalization costs and the patient＇s satisfaction in the path group were all better than those of control group （P〈0.05 or P〈0.01）. Conclusion The clinical pathway of single-disease has obviously positive effect in the dual referral of elderly patients with gallstone and is worth of promoting.

关 键 词：临床路径 胆囊结石 双向转诊 

分 类 号：R657.42[医药卫生—外科学]