循证个体化治疗在骨科临床中的应用

Evidence-based individualized treatment in orthopedics

目的比较循证医学在骨科个体化的应用,前瞻性、病例自身前后对照的临床研究。方法以临床、前瞻性、自身对照设计为基础,纳入患者的标准:50例骨科住院手术患者。治疗措施:调查、明确患者的要求;查询相应的资料(如:PUBMED数据库、OVID数据库、清华同方、万方数据库),术前医生病情讨论,制定治疗方案(提供多个治疗方案以供患者选择);制作幻灯,安排患者以及家属讲座,协商治疗方案,了解各个方案的优缺点,最终选定、落实手术方案,完成手术。结果患者的担心紧张、病情的认识差别以及获取的详细资料、满意度、告状的意愿、医生认真负责、医生的知识来源、讲座之前与讲座之后有明显的差异。住院费用下降,差异有统计学意义(P<0.000)。结论循证医学在骨科个体化的应用可提高医疗质量,减少患者的费用,提高医生的能力,是提高治疗效果的最好方法。

Objective To compare application of evidence-based medicine in orthopedic individualization and perform prospective clinical studies. Methods Clinical prospective self-controlled design was used, the orthopedic hospitalized patients were experimental subjects. Enrolled criteria for the patients： orthopedic inpatient surgical patients. All of 50 patients were included in this study, treatment measures： survey, clear the patient＇s request; query the appropriate information （such as： the PUBMED database, OVID database, Tsinghua Tong Fang, Wanfang Database）, pre-operative doctor discussion, development of treatment program （to provide more treatment options for patient choice）; production slide, arrange lectures of patients and their families, negotiation of treatment options, understand the advantages and disadvantages of various options, the final selection and implementation of the surgery program to complete the surgery. Results The patient＇s worry about tension, understanding of the disease difference, the details, satisfaction, serious and responsible, complaint, the source of knowledge of doctors before the surgery （before lectures） before surgery （after lectures）, there were significant differences in the rate, signitleant difference in Hospitalization costs （P 〈0.000）. Conclusion The application of evidence-based medicine in orthopedics individualized, with the obvious social and economic benefits, can improve the ability of doctors to provide patients with the best information, improve medical quality, efficacy, and reduce the cost of the patients, to promote the rehabilitation of patients, doctor＇s confidence increased significantly,and it is the best way to improve clinical treatment, and has a good, very wide range of promotion prospects.