溃疡性结肠炎中医临床路径的实施评价研究

Implementation and evaluation research of TCM clinical pathway for ulcerative colitis

目的通过对溃疡性结肠炎(UC)活动期的住院患者进行临床路径的实施、管理及评价研究,进一步完善临床路径,促进临床疗效及医疗卫生经济学成本效益的提高,使患者获得症状疗效及经济疗效,寻求治疗与经济的平衡点,提高患者的满意率。方法采用路径组与非路径组(历史对照)研究,其中路径组采用前瞻性研究,按照临床路径实施并管理。结果路径组临床疗效总有效率92.2%,非路径组88.9%,差异无统计学意义(P﹥0.05);路径组平均住院日(23.61±9.63)天,非路径组(31.24±18.58)天,2组比较差异有统计学意义(P﹤0.01)。路径组患者平均住院费(12 851.97±5 370.17)元,非路径组(12 999.84±6 951.86)元,2组比较差异无统计学意义(P﹥0.05);路径组日均费用(610.66±308.11)元,非路径组(459.05±195.68)元,2组比较差异有统计学意义(P﹤0.05)。结论以中医临床路径为指导治疗UC,在规范诊治流程、提高医疗质量、发挥中医特色、降低平均住院时间,同时降低医疗费用方面有重要的作用和意义。

Objective With implementation,management and evaluation research of clinical pathway for inpatients with active ulcerative colitis（UC）,to optimize the clinical pathway further and promote the improvement of clinical efficacy and cost-benefit of health economics,to get the efficacy of symptoms and economy for patients,to seek balance between treatment and economy,to enhance patients’satisfaction rate.Methods A study was conducted with a pathway group（Group P） and a historical control group（Group C）,the prospective study was adopted in the Group P that was implemented and administrated according to the clinical pathway.Results The total effective rate of clinical efficacy in the Group P was 92.2% and in the Group C was 88.9%,with insignificant difference（P 0.05）;the average length of stay in the Group P was（23.61±9.63） days and in the Group C was（31.24±18.58） days,with significant difference（P 0.01）.The average hospitalization expenses in the Group P were（12 851.97±5 370.17） yuan and in the Group C were（12 999.84±6 951.86） yuan,with insignificantdifference（P 0.05）;the averagedaily costin theGroup Pwas（610.66±308.11） yuan and in the Group C was（459.05±195.68） yuan,with significant difference（P 0.05）.Conclusion Under the guide of TCM clinical pathway in the treatment of UC,it plays an important and significant role in standardizing process of diagnosis and treatment,improving medical quality,exerting TCM characteristics,reducing the average length of stay,as well as bringing down the medical expenses.