腭咽成形术临床路径设计中影响因素的分析

Analysis of the influencing factors in formulating clinical pathways for patients with uvulopalatopharyngoplasty

目的探讨影响腭咽成形术临床路径的主要因素，为制定相应临床路径提出理论依据和对策。方法采用回顾性研究，选择腭咽成形手术病历161份，对患者的年龄、术前合并症、术前注射抗生素、术后并发症、住院天数、住院费用等信息进行统计学分析。结果年龄、术前合并症、术前注射抗生素对住院天数的影响差异有统计学意义，住院天数、术前合并症、术前注射抗生素可对住院费用产生影响。结论设计腭咽成形术临床路径时要早期干预、处理影响住院天数和住院费用的因素，严格筛选患者，以减少变异；对术前有2种及以上合并症的患者，根据个体差异制定相应的路径流程。

Objective To discuss the main factors influencing the clinical pathway for Uvulopalatopharyngoplasty, and to provide the corresponding measures and theories in the formulation of clinical pathway. Methods 161 patients undergoing uvulopalatopharyngoplasty from January 2006 to December 2007 were selected. The clinical data of age, preoperative accompanying diseases, preoperative used antibiotics, postoperative complications, hospital stay, hospital charges were statistically analyzed using the retrospective study. Results Hospital stay was influenced by age, preoperative accompanying diseases and preoperative used antibiotics. The days of hospital stay, preoperative accompanying disease, antibiotics of preoperative used influenced hospital charge. Conclusions It is essential to early intervene and handle the influencing factors that incluence hosptal stay and hospital charge, and strictly choose the patients, to reduce the occurrence of variance, in formulating a uvulopalatopharyngoplasty clinical pathway. It is better to formulate different clinical paths separately for the various operations of uvulopalatopharyngoplasty and for the patients with two and more types of accompanying diseases.