疾病诊断相关分组背景下眼科多学科团队术前血糖管理模式研究  

Study on preoperative blood glucose management model of ophthalmology Multidisciplinary team under the background of disease diagnosis related groups

作　　者：叶慎菊 叶华[1] 朱彩霞 Ye Shenju;Ye Hua;Zhu Caixia(Ophthalmology of First Affiliated Hospital of Gannan Medical University,Ganzhou 341000,China)

机构地区：[1]赣南医学院第一附属医院眼科,江西赣州341000

出　　处：《中国实用护理杂志》2020年第2期130-135,共6页Chinese Journal of Practical Nursing

基　　金：赣州市2018年指导性科技计划(社会发展)项目(GZ2018ZSF022)。

摘　　要：目的研究疾病诊断相关分组(DRGs)背景下眼科多学科团队术前血糖管理模式及其实施效果。方法选择2018年1月1日至12月31日收治的CS03Z、CS09A(上海联众DRGs系统诊断编码)病组中行玻璃体切割术、玻璃体注药术、白内障摘除术的病例170例。将2018年1月1日至6月31日的76例分为对照组,实施常规术前会诊制血糖管理;将2018年7月1日至12月31日的94例分为观察组,实施多学科团队术前血糖管理模式。对2组住院时间、均次住院费用、术前血糖管理质量及住院满意度进行比较。结果对照组玻璃体切割术、玻璃体注药术、白内障摘除术均次住院费用分别为(13949.71±2099.36)、(4933.22±2269.33)、(6521.16±1006.40)元,观察组分别为(12937.37±1447.33)、(2649.53±1105.92)、(5315.76±1037.02)元,2组比较差异有统计学意义(t=2.266、3.818、4.074,P<0.05或0.01);对照组玻璃体切割术、玻璃体注药术、白内障摘除术住院时间分别为(9.98±3.91)、(9.63±5.46)、(7.65±3.88)d,观察组分别为(6.37±3.54)、(3.97±2.29)、(4.17±2.23)d,2组比较差异有统计学意义(t=3.980、3.979、3.632,均P<0.01);对照组血糖意外事件发生率为14.47%(11/76),观察组为2.13%(2/94),2组比较差异有统计学意义(χ^(2)=11.642,P<0.01);对照组手术延迟率为2.63%(2/76),观察组为0(0/94),2组比较差异有统计学意义(χ^(2)=7.045,P<0.01);对照组护士血糖管理合格率为66.67%(24/36),观察组为97.22%(35/36),2组比较差异有统计学意义(χ^(2)=9.005,P<0.01);对照组患者满意率为82.89%(63/76),观察组为94.68%(89/94),2组比较差异有统计学意义(χ^(2)=6.166,P<0.05)。结论DRGs背景下构建以临床路径为核心的眼科多学科团队术前血糖管理模式能有效降低患者的均次住院费用和住院时间,改善血糖管理质量,提高患者住院满意度。Objective To study the preoperative blood glucose management model and its implementation effect in the multidisciplinary team of ophthalmology under the background of diagnosis related groups(DRGs).Methods A total of 170 patients underwent vitrectomy,vitreous injection,and cataract extraction surgery were enrolled in the CS03Z and CS09A groups from January 1,2018 to December 31,2018.The cases from January 1,2018 to June 31,2018 were in the control group,accounting for 76 cases,and routine blood glucose management was performed.The cases from July 1,2018 to December 31,2018 were observed in the observation group,and 94 cases were implemented.The multidisciplinary blood glucose management model was implemented.The average hospitalization days,average hospitalization costs,preoperative blood glucose management quality,and hospitalization satisfaction were compared between the two groups.Results In the control group,the average hospitalization cost of the three operations(PPV/IV/Phaco group)was(13949.71±2099.36)yuan,(4933.22±2269.33)yuan,(6521.16±1006.40)yuan,the average hospitalization cost of the three operations of the observasion group was(12937.37±1447.33)yuan,(2649.53±1105.92)yuan,(5315.76±1037.02)yuan,the difference between the two groups was statistically significant(t=2.266,3.818,4.074,all P<0.05 or 0.01).The average hospitalization day of the 3 operation group was(9.98±3.91)d,(9.63±5.46)d,(7.65±3.88)d,and the observation group was(6.37±3.54)d,(3.97±2.29)d,(4.17±2.23)d,the difference between the two groups was statistically significant(t=3.980,3.979,3.632,all P<0.01).The preoperative blood glucose accident rate in the control group was 14.47%(11/76),The observation group was 2.13%(2/94),the difference between the two groups was statistically significant(χ^(2)=11.642,P<0.01).The surgical delay rate of the control group was 2.63%(2/76);the surgical delay rate of the observation group was 0(0/94),the difference between the two groups was statistically significant(χ^(2)=7.045,P<0.01).The nurse blo

关 键 词：疾病诊断相关分组 多学科团队 眼科 血糖管理 

分 类 号：R77[医药卫生—眼科]