临床路径指导先天性心脏病室间隔缺损介入治疗应用研究  

Clinical pathway-guided interventional therapy for ventricular septal defect in congenital heart disease

作　　者：李子林 张静隆 梁宏亮 陈佳 李超 左健 LI Zilin;ZHANG Jinglong;LIANG Hongliang;CHEN Jia;LI Chao;ZUO Jian(Department of Cardiovascular Surgery,Xijing Hospital,Air Force Medical University,Xi'an 710032,China)

机构地区：[1]空军军医大学西京医院心血管外科,陕西西安710032

出　　处：《空军军医大学学报》2022年第8期1010-1012,1017,共4页Journal of Air Force Medical University

基　　金：国家自然科学基金(81400276);国家重点研发计划项目(2016YFC1301900,2016YFC1301901)。

摘　　要：目的回顾性探讨临床路径指导先天性心脏病室间隔缺损介入治疗的安全性、有效性和经济性。方法本研究纳入2016年2月至2021年2月患有先天性心脏病室间隔缺损并成功给予介入治疗的517例患者,按照实行临床路径情况分为两组:临床路径组(n=359)和非临床路径组(n=158)。对患者相关临床数据、住院天数、住院相关费用等给予评估。结果两组患者室间隔缺损类型均以膜周型室缺为主,均成功接受手术,且治愈率均在99%以上,在患者部分基本信息、治疗效果和术后并发症等方面两组无显著差异(P>0.05)。临床路径组室间隔缺损大小明显小于非临床路径组(P<0.01),而手术时间长于非临床路径组(P<0.01),同时,临床路径组较非临床路径组明显增加了日间手术占比率,减少了住院天数及药费,差异具有统计学意义(P<0.05)。结论在确保临床治疗安全的前提下,临床路径可有效缩短先天性心脏病室间隔缺损介入治疗患者平均住院天数并降低药费,明显增加日间手术比例。Objective To retrospectively explore the safety,effectiveness and economy of interventional therapy for ventricular septal defect in congenital heart disease guided by clinical pathway.Methods From February 2016 to February 2021,517 patients with ventricular septal defect in congenital heart disease who were successfully treated with interventional therapy were included in this study.According to the implementation of clinical pathway,they were divided into two groups:clinical pathway group(n=359)and non-clinical pathway group(n=158).The clinical data,hospital stay and hospitalization-related expenses of patients were evaluated.Results The type of ventricular septal defect in the two groups was mainly perimembranous ventricular septal defect.Both groups were successfully operated,and the cure rate was more than 99%.There was no significant difference in the basic information,treatment effect and the incidence of postoperative complications between the two groups(P>0.05).The size of ventricular septal defect in the clinical pathway group was significantly smaller than that in the non-clinical pathway group(P<0.01),and the operation time was longer than that in the non-clinical pathway group(P<0.01).At the same time,the clinical pathway group significantly increased the proportion of daytime surgery and reduced the hospital stay and drug costs,and the differences were statistically significant(P<0.05).Conclusion On the premise of ensuring the safety of clinical treatment,clinical pathway can effectively shorten the average hospital stay and reduce drug costs of patients with ventricular septal defect in congenital heart disease,and significantly increase the proportion of daytime surgery.

关 键 词：临床路径 先天性心脏病 介入治疗 药费 住院天数 日间手术 

分 类 号：R285[医药卫生—中药学] R541.1[医药卫生—中医学]