医康护一体化模式在全膝关节置换患者临床路径中的应用  

The Application of Doctor-therapist-nurse Mode in the Clinical Pathway of Total Knee Arthroplasty

作　　者：李九群[1] 王凤卿[1] 肖银贵 胡会英[1] 高心灵 张洪雷[1] LI Jiu-qun;WANG Feng-qing;XIAO Yin-gui(Department of Sports Medicine and Rehabilitation,Peking University Shenzhen Hospital,Shenzhan 518036,Guangdong Province,China)

机构地区：[1]北京大学深圳医院运动医学与康复科,广东深圳518036

出　　处：《罕少疾病杂志》2018年第3期65-67,78,共4页Journal of Rare and Uncommon Diseases

基　　金：深圳市科技创新研发资金基础研究项目(JCYJ20140415162338793)

摘　　要：目的探讨医康护一体化模式在全膝关节置换患者临床路径中的应用效果。方法将150例患者按入院的先后顺序随机分为实验组、对照Ⅰ组和对照Ⅱ组。实验组在医康护一体化模式下通过整合疗理计划实施临床路径,对照Ⅰ组实施常规护理,对照Ⅱ组实施单纯临床护理路径。比较三组患者病人满意度、住院费用(除人工关节材料)、住院时间、膝关节功能评分(HSS)、术后并发症发生率。结果实验组术后并发症发生率明显低于对照Ⅰ组和对照Ⅱ组,而对照Ⅱ组明显低于对照Ⅰ组(P<0.05);术前膝关节功能评分无明显差异性(P>0.05),术后实验组膝关节功能评分明显高于其他两组,而对照Ⅱ组明显高于对照Ⅰ组(P<0.05);实验组与对照Ⅰ组、对照Ⅱ组比较,对照Ⅱ组与对照Ⅰ组比较,病人住院时间缩短,费用大幅降低,病人满意度提高(均P<0.05)。结论在全膝关节置换患者中应用医康护一体化模式,能缩短患者住院日、降低住院费用,有效预防术后并发症,促进患者的功能康复,提高患者满意度,是值得推广的一种工作模式。Objective The study was to discuss the effect of the application of doctor-therapist-nurse mode in the clinical pathway for total knee arthroplasty. Methods 150 patients were divided into the test group, the frst control group and the second control group. The test group was carried out clinical pathway by the integrated therapy process under doctor-therapist-nurse mode. While the frst and the second control group was practised the routine nursing and the clinical pathway nursing respectively. Then, the incidence of postoperative complication, the hospital for special surgery knee score （HSS）, the hospital stay, the hospital charge （except the artifcial prosthesis）, and the patient satisfaction were compared among the three groups. Results The second control group was lower than the frst control group but higher than the test group in the incidence of postoperative complication, the hospital stay and the hospital charge obviously （P〈0.05）. The HSS had no difference among the three groups preoperatively （P〉0.05）, however, it was evident that the second control group got a higher score than the frst control group but lower than the test group postoperatively （P〈0.05）. The second control group was higher than the first control group but lower than the test group in the patient satisfaction obviously （P〈0.05）. Conclusion The doctor-therapist-nurse mode could shorten the hospital stay, reduce the hospital charge, prevent the incidence of postoperative complication, promote the functional recovery and improve the satisfaction in total knee arthroplasty, which is a worth spreading mode.

关 键 词：医康护一体化模式 全膝关节置换 临床路径 

分 类 号：R658.3[医药卫生—外科学] R49[医药卫生—临床医学]