输尿管结石的临床路径实施与效果评价

Practice and efficacy assessment of clinical pathway for ureteral calculi

目的研究临床路径在输尿管结石治疗中的实施情况并评价其效果。方法将2010年11月至2011年10月期间我科室收治的285例第一诊断为输尿管结石(单侧)并适合行输尿管镜碎石取石术的患者利用简单随机分组的方法分为临床路径组和对照组。其中入临床路径组151例,对照组134例,对比分析两组患者平均住院时间、住院费用、临床疗效、患者认知度和满意度以及医护人员对临床路径实施效果调查。结果临床路径组在疗效上与对照组无显著差异,而在平均住院天数及住院费用显著低于对照组(P<0.05);临床路径组患者对疾病的认识程度和满意度调查亦显著高于对照组(P<0.05);多数医护人员认为临床路径可有效增进医患沟通、提高医疗质量。结论临床路径可有效规范输尿管结石的手术治疗,提高效率,值得深入实施和推广。

Objective To evaluate the impact of clinical pathway for ureteroscopic lithotripsy.Methods 285 patients with primary diagnosis of unilateral ureteral calculus who needed ureteroscopic operation were randomly divided into clinical pathway group（151 cases） and control group（134 cases）.Average hospital stay,hospital costs,clinical efficacy,patients＇ satisfaction and awareness of disease were comparative analyzed.Furthermore,clinical workers＇ assessment assay was conducted.Results Patients who received clinical pathway treatment had shorter mean hospital stay,lower mean hospital costs than non-pathway patients（P〈0.05）,but there were no significant differences in therapeutic efficacy（P〉0.05）.Most patients and health care workers agreed clinical pathway improved communication,efficacy and satisfaction.Conclusion Clinical pathway was associated with improved medical quality for patients with ureteral calculi.