中西医结合临床护理路径标准化体系的建立及在急救绿色通道中的应用效果分析  

Establishment of standardized clinical nursing path system of integrated traditional Chinese and Western medicine and its application effect analysis in emergency green channel

作　　者：邓秋迎[1] 郭艳枫[1] 武健 凌传仁 黄秋萍[1] 李焕梅[1] 刘青艳[1] 李薇薇[1] 张晓春[1] Deng Qiuying;Guo Yanfeng;Wu Jian;Ling Chuanren;Huang Qiuping;Li Huanmei;Liu Qingyan;Li Weiwei;Zhang Xiaochun(Department of Emergency,Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou 510120,Guangdong,China;The Second Clinical Medical College,Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdog,China)

机构地区：[1]广东省中医院急诊科,广东广州510120 [2]广州中医药大学第二临床医学院,广东广州510405

出　　处：《中国中西医结合急救杂志》2021年第1期90-94,共5页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：广东省科技厅项目(2016ZC0123);广东省省级科技计划项目(2017B30314176)。

摘　　要：目的建立中西医结合临床护理路径(CNP)标准化体系,观察其在急救绿色通道中的应用效果.方法选择2016年10月至2019年3月于广东省中医院急诊科就诊并进入急性冠脉综合征、急性缺血性脑卒中、急性上消化道出血、急性阑尾炎4个病种急救绿色通道的722例患者作为研究对象.以2016年10月至2017年12月于急诊科就诊并进入4个病种急救绿色通道的患者作为对照组,采用常规绿色通道护理配合措施;以2018年1月至2019年3月于急诊科就诊并进入4个病种急救绿色通道的患者作为路径组,采用中西医结合CNP标准化方案.比较不同病种绿色通道的两组患者急诊停留时间和急诊医疗费用,分析实施前后的效果.结果与对照组比较,纳入4个病种的路径组患者急诊停留时间(min)均明显缩短〔急性冠脉综合征:39.00(34.00,49.00)比65.00(34.00,157.00),急性缺血性脑卒中:54.83±23.04比117.54±115.68,急性上消化道出血:52.00(45.00,59.00)比125.50(67.00,221.75),急性阑尾炎:53.02±25.41比197.00±132.30,均P<0.05〕.与对照组比较,急性冠脉综合征(元:1113.66±541.73比938.60±465.23)、急性缺血性脑卒中(元:1928.08±1672.81比1151.65±457.97)路径组的急诊医疗费用均明显上升(均P<0.05),急性阑尾炎路径组的急诊医疗费用明显降低(元:1492.78±513.03比1746.53±747.32,P<0.05),急性上消化道出血路径组和对照组的急诊医疗费用比较差异无统计学意义(P>0.05).结论急诊科采用中西医结合CNP,可显著缩短患者的急诊绿色通道停留时间,降低部分患者的急诊医疗费用,值得进一步深入研究.Objective To establish the standardized clinical nursing path(CNP)system of integrated traditional Chinese and Western medicine and observe its application efiect in emergency green channel.Methods The 722 patients with critical emergency diseases admitted into the department of emergency in Guangdong Provincial Hospital of Traditional Chinese Medicine(TCM)and entering 4 different emergency green channels corresponding to their own diseases respectively,as acute coronary syndrome,acute ischemic stroke,acute upper gastrointestinal hemorrhage and acute appendicitis from October 2016 to March 2019 were selected as research objects.The emergent patients who entered the 4 green rescue channels from October 2016 to December 2017 were in the control group and they adopted conventional green channel nursing measures.The patients who entered the 4 green channels from January 2018 to March 2019 were in the path group,applying the standardized CNP of integrated traditional Chinese and Western medicine.The length of stay and total cost in emergency department between the two groups via different green channels of disease types were compared,and the effects before and after implementation were analyzed.Results Compared with those in the control groups,the lengths of emergency stay(minutes)of patients in path groups of the 4 diseases were significantly shortened[acute coronaiy syndrome:39.00(34.00,49.00)vs.65.00(34.00,157.00),acute ischemic stroke:54.83±23.04 vs.117.54±115.68,acute upper gastrointestinal hemorrhage:52.00(45.00,59.00)vs.125.50(67.00,221.75),acute appendicitis:53.02±25.41 vs.197.00±132.30,all P<0.05].Compared with those of the control groups,the emergency treatment costs of path groups in acute coronary syndrome(Yuan:1113.66±541.73 vs.938.60±465.23)and acute ischemic stroke(Yuan:1928.08±1672.81 vs.1151.65±457.97)increased significantly(both P<0.05),the cost of the acute appendicitis path group was significantly reduced(Yuan:1492.78±513.03 vs.1746.53+747.32,P<0.05),and there was no significant difference

关 键 词：中西医结合 临床护理路径 标准化体系 绿色通道 

分 类 号：R47[医药卫生—护理学]