山东省某医院急性脑梗死患者临床路径管理的应用评价

Application Research of a Clinical Pathway for Acute Cerebral Infarction in a Haspital,Shandong

目的:探讨临床路径管理在急性脑梗死治疗中的应用价值。方法:选择山东省某医院神经内科2010年5月至2011年11月收治的急性脑梗死患者180例,随机分为临床路径组和传统治疗组,每组90例,采用前瞻性队列研究比较两组患者的主要指标。结果:临床路径组的平均住院日、西药费、成药费、总药费、住院总费用明显少于传统治疗组(P<0.01);临床路径组各指标不受患者是否有合并症的影响,而传统组的住院时间与是否有合并症的影响显著(P<0.05),单纯脑梗死患者住院时间相对较短,单纯脑梗死合并高血压和糖尿病患者住院时间较长。临床路径组患者的满意度优于传统治疗组(χ2=8.922,P<0.05);实行临床路径管理对HINSS评分的改善和患者转归情况与传统治疗组相比,没有统计学差异(P>0.05)。结论:急性脑梗死临床路径能够显著缩短患者平均住院日,减轻患者经济负担,提高患者满意度。

Objective：The paper aims at evaluating the application value of the clinical pathway for acute cerebral infarction. Methods： 180 cases of acute cerebral infarction admitted to the Department of Neurology of our hospital from May 2010 to November 2011,were randomly divided into the clinical pathway group and the conventional therapy group, 90 cases in each group. A prospective cohort study was used to compare some indicators. Results：Average length of stay, costs of western medicine, proprietary Chinese medicine, total medicine and hospitalization in clinical pathway group were significantly less than traditional treatment group.The above indicators in clinical pathway group were not influenced with the complication affects.The hospitalization lengths of the conventional therapy group was statistically different（P〈0.05） in patients with different complication. Patients with simple cerebral infarction had a shorter hospital stay, and patients of cerebral infarction with hypertension and diabetes had a longer hospital stay. The satisfaction of the clinical pathway group was better than conventional therapy groul~：g.922,P〈O.05）. The improvement of HINSS scores and outcomes had no significant difference（P〉.05） within two groups. Conclusion： Acute cerebral infarction under the clinical pathway can significantly shorten the average length of stay,reduce the economic burden of patients and improve patients＇ satisfaction.This clinical pathway should be worth drawing.