河北某三级综合医院实施胃癌手术临床路径的效果评价  

Study on the Effects of Clinical Pathway Management of Gastric Cancer Operation on Physician-nursing Behavior

作　　者：张娟[1] 冯海红[1] 孙弟波 范露露[1] 武雪亮[1] 袁美锦[1] Zhang Juan Feng Haihong Sun Dibo Fan Lulu Wu Xueliang Yuan Meijin(The First Affiliated Hospital of Hebei North University, Zhang jiakou 075000, Hebei Province Chin)

机构地区：[1]河北北方学院附属第一医院,张家口市075000

出　　处：《中国病案》2017年第7期41-43,49,共4页Chinese Medical Record

基　　金：河北省卫生计生委指令性科研项目(NO.ZL20140325)

摘　　要：目的探讨实施胃癌手术临床路径的临床效果。方法收集河北某三级综合医院2014年1月-2016年6月胃癌住院患者信息35例(临床路径组)和40例(非临床路径组),观察实施临床路径管理对临床诊断、病历书写质量、临床用药、术前准备时间、住院时间、医疗费用、辅助检查项目选择、满意度的影响。结果两组患者入出院诊断、手术前后诊断符合率均为100%,无统计学意义;临床路径组患者出院病案甲级率明显高于非临床路径组、乙级率明显低于非临床路径组,差异均具有统计学意义P<0.05;临床路径组抗菌药物费用、药占比明显低于非临床路径组、目录内用药比例明显高于非临床路径组;临床路径组术前准备时间、平均住院天数明显低于非临床路径组;临床路径组总费用、中西药费、化验费、检查费均明显低于非临床路径组;临床路径组实验室、影像及其他检查项目数量少于非临床路径组;临床路径组患者对医护工作的满意度优于非临床路径组,差距均具有统计学差异P<0.05。结论对胃癌实施临床路径能够规范医护诊疗行为,提高患者满意度,真正实现医患共赢。Objective To investigate the clinical effect of the applic.ation of clinical pathway on gastric cancer operation. Methods 35 cases （clinical pathway group） and 40 cases （non-clinical pathway group） diagnosed as gastric cancer in a Three A and Tertiary General Hospital in Hebei Province from January 2014 to June 2016 were selected. Clinical diagnosis, medical record quality, clinical drug, preoperative preparation time, hospitalization time, medical expense, and auxiliary examination choose, and satisfaction were recorded. Results The coincidence rate of admission and discharge diagnosis with diagnosis before and after operation were 100%, there were no statistical significance. The grade A rate of medicals records in clinical pathway group was significantly higher than that in no-implementation group, and grade B rate was significantly lower than that in no-implementation group, the differences were statistically significant, P〈0. 05. The antibacterial drugs cost and drug proportion in the implementation group were lower than those in no-implementation group, and medicine proportion within the directory in the implementation group was significantly higher than that in no-implementation group, the differences were statistically significant, P〈0.05. Preoperative preparation time and average hospitalization days in the implementation group were lower than those in no-implementation group, the differences were statistically significant, P〈0. 05. Total cost, expenses for medicine, laboratory fees, examination tees in the implementation group were significantly lower than those in no-implementation group, the difference had statistical significance, P 〈0. 05. Laboratory, imaging and other tests in the implementation group were less than those in no-implementation group, the differences were statistically significant, P〈0. 05. The satisfaction degree in the implementation group was more superior than that in no-implementation group, P〈0. 05. Conclusions The application of clinical pathway on gastric

关 键 词：胃癌手术 临床路径 医护行为 

分 类 号：R197.323[医药卫生—卫生事业管理]