胆囊切除术临床路径的相关因素分析

Analysis on the related factors of clinical pathway for patients with cholecystectomy

目的分析胆囊切除术临床路径的相关因素。方法普外科胆囊切除术128例手术出院患者作为研究对象,以胆囊切除术住院天数和住院费用为考察指标,对胆囊切除术临床路径的相关因素进行多元逐步回归统计分析。结果影响住院天数的主要因素包括:术后并发症、术前合并症、手术方式、手术时机,其中术后并发症影响最大;影响住院费用的主要因素由大到小依次是手术方式、输液天数、术后并发症、住院天数,其中手术方式影响最大。结论针对胆囊切除术实施临床路径应尽早干预术后并发症、术式、术前合并症等因素;不同术式需设立不同的路径流程,有2种合并症的胆囊切除术患者也宜另设一条路径。

Objective To analyze the related factors of cholecystectomy clinical pathway. Methods 128 surgery patients discharged from hospital taken general surgery laparoscopic cholecystectomy were studied. Hospitalization days and fees of cholecystectomy were study indexes. Multiple stepwise regression of statistical analysis was taken on relevant factors of chol-ecystectomy clinical pathway. Results The main four factors to hospitalization days from big to small were postoperative complications, preoperative complications, surgical time and surgical methods, among which postoperative complications had big-gest influence. The main four factors to hospitalization fees from big to small were surgical methods, infusion days, postoperative complications and hospitalization days, among which surgical methods had biggest influence. Conclusion Implementation of clinical pathways cholecystectomy should intervene as soon as possible post - operative complications, surgical proce-dures, preoperative complications and other factors. To separate a pathway for cholecystcctomy patients with two complications, different pathway should be set up for different operation methods.