经皮内镜下腰椎间盘切除术临床路径实施现状调查研究  

Status survey of the clinical pathway implementation of percutaneous endoscopic lumbar discectomy

作　　者：陈佳丽[1] 宁宁[1] 叶霞[1] 王雅琴[1] 李玲利[1] 

机构地区：[1]四川大学华西医院骨科,四川成都610041

出　　处：《现代预防医学》2015年第15期2851-2854,共4页Modern Preventive Medicine

基　　金：四川省科技厅科技支撑项目-临床路径变异管理信息系统的研制(2011SZ0208)

摘　　要：目的了解经皮内镜下腰椎间盘切除术临床路径实施现状,为此临床路径的实施提供反馈。方法采用自行设计腰椎间盘突出症临床路径变异记录表,收集2011年1月-2012年12月符合条件的研究对象资料进行分析,共计117例。结果 117例患者中,正性变异62例,占53.0%;负性变异32例,占27.4%;未变异23例,占19.6%。住院天数平均为(7.35±2.34)d;术前NRS疼痛评分平均为(5.11±1.04)分,术后24 h平均为(1.35±0.96)分;19例发生早期并发症;均为好转或治愈出院;平均住院费用为20 475.72元,其中手术费用占72.2%。变异组间术后疼痛及住院费用的差异有统计学意义。结论经皮内镜下腰椎间盘切除术临床路径以正性变异为主,有进一步优化和推广的价值和意义。Objective To investigate and analyze the clinical pathway of percutaneous endoscopic lumbar discectomy（PELD） and to provide feedback for further treatment. Methods A self-designed record chart was used to the patients who underwent PELD through the clinical pathway during January 2012 to December 2012, and 117 patients＇ records were analyzed. Results The rates of the positive variant group, negative variant group and non-variant group were 53.0%, 27.4% and 9.6%, respectively. The average number of days of hospitalization was（7.35±2.34） days, The average of preoperative pain NRS score was（5.11±1.04） points, and after 24 h average was（1.35±0.96） points. 19 cases were happened early complications. All patients were improved or cured. The average hospital cost was 20, 475.72 Yuan, and the cost of surgery accounted for 72.2%. There was a significant difference between the postoperative pain and hospital groups. Conclusion The main variance in clinical pathway of PELD was a positive variant group,and the further optimization and promotion of the clinical pathway was valuable and meaningful.

关 键 词：临床路径 变异 腰椎间突出症 经皮内镜 现状调查 

分 类 号：R68[医药卫生—骨科学]