临床路径在胸痛患者急救中的应用

Clinical Pathway in Emergency Treatment for Patients with Thoracodynia

目的探讨临床路径在胸痛患者急救中的应用。方法选择2012年6月至2013年8月收治的胸痛患者180例,随机分为治疗组88例和对照组92例,治疗组按照临床路径实施急救,对照组给予传统治疗与护理。比较两组患者初步确诊时间、急诊滞留时间、胸痛缓解时间、急诊期间医疗费用、患者及家属满意度。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果初步确诊时间、急诊滞留时间、胸痛缓解时间治疗组分别为(39.13±15.47)min,(50.19±19.15)min,(45.35±19.22)min,对照组分别为(67.35±23.68)min,(82.26±22.40)min,(62.32±26.16)min,两组比较差异均有统计学意义(均P<0.05);急诊期间医疗费用治疗组(834.32±116.49)元,对照组(827.35±114.37)元,两组比较差异无统计学意义(P>0.05);急诊诊断符合率治疗组96.59%(85/88),对照组80.43%(74/92),两组比较差异有统计学意义(P<0.05);患者及家属满意度治疗组92.05%(81/88),对照组83.69%(77/92),两组比较差异有统计学意义(P<0.05)。结论在胸痛患者急救中应用临床路径可缩短急救时间,提高抢救成功率,提高患者及家属满意度,值得临床推广使用。

Objective To discuss the clinical pathway in the application of emergency treatment for patients with thoracodynia. Methods 180 cases of patients with thoracodynia treated from June 2012 to August 2013 were randomly divided into treatment group （n = 88） and control group （n = 92）. Clinical path was given to treatment group and conventional interventions to the control group. The time for initial diagnosis, emergency stay and thoracodynia relief, emergency medical expenses, the satisfaction rate of patients and their families were compared in both groups. T-test was used for estimate data and X2 test for count data, the result of P 〈0.05 was statistically significant. Results The time for initial diagnosis, emergency stay and thoracodynia relief was （39.13 ± 15.47） min, （50.19 ± 19.15） min and （45.35 ± 19.22） min respectively in the treatment group, and was （67.35 ± 23.68） min, （82.26 ± 22.40） min and （62.32 ± 26.16） min respectively in the control group, which showed a statistically significant difference （all P 〈0.05）. The cost of emergency treatment was （834.32 ± 116.49） Yuan in the treatment group and （827.35 ± 114.37） Yuan in the control group, and no significant difference was found between the two groups （P 〉0.05）. The rate of emergency diagnosis accuracy was 96.59.83% （85/88） and 80.43% （74/92） in the treatment group and the control group respectively, which showed a statistically significant difference （P 〈0.05）. The satisfaction rate of patients and their families was 92.05% （81/88） and 83.69% （77/92） in the treatment group and the control group respectively, which showed a statistically significant difference （P 〈0.05）. Conclusions Clinical pathway can shorten the rescue time, improve the success rate of emergency treatment and the satisfaction rate of patients and their families, and it can be widely used in clinical practice.