急性早幼粒细胞白血病应用临床护理路径效果分析

Analyse Effects of the Application of Clinical Care Pathway in Acute Promyelocytic Leukemia

目的对比分析急性早幼粒细胞白血病患者应用临床护理路径与未应用临床护理路径对患者各方面的影响。方法随机选取内蒙古医科大学附属医院血液科2011年7月～2013年4月入院患者,复诊一次以上、年龄>14岁、都符合进入临床路径[依据《急性早幼粒细胞白血病APL治疗的专家共识》(中华医学会,白血病学组)]患者48例,实验组24例,对照组24例。两组均采用DA方案(柔红霉素+阿糖胞苷)予以巩固治疗,实验组应用临床护理路径,对照组未应用临床护理路径。所得数据在单因素分析的基础上,又作Logistic多元回归分析。结果单因素分析,实验组病人感染、出血相对减少,恶心呕吐、贫血,实验组明显低于对照组,差异有统计学意义(P<0.05)。患者满意度、知晓率明显提高。Logistic多元回归分析,实验组恶心呕吐发生率12.5%明显少于对照组37.5%(P﹤0.05,exp﹤1,其95%可信区间内不含1)。结论急性早幼粒细胞白血病应用临床护理路径后,患者满意知晓率明显提高,并发症明显减少。

Objective comparative the acute promyeloeytic leukemia patients applying clinical care pathway and without applying clinical care pathway the effects for patients in all aspects. Methods By random sampling method, selected from Aitiliated first hospital, Inner Mongolia Medical College in July 2011 in April 2013, admitted to hospital and visit more than once, 14 years old or older, all meet the clinical pathway, experimental group of 24 patients and control group of 24 patients. Two groups all use DA scheme （soft erythromycin plus cytarabine） consolidated therapy, experimental group applied clinical care pathway, and the control group without applying clinical care pathway. The data on the basis of single factor analysis, and Logistic multivariate regression analysis. Resul~ single factor analysis, experimental group infection and bleeding less, nausea, anemia, the experimental group is lower than the control group obviously, the significant difference was statistically （P〈0.05）. Patient satisfaction, awareness has improved significantly. Logistic multivariate regression analysis, experimental group nausea and vomiting was 12.5% less than the control group obviously37.5% （P 〈 0.05, exp〉 1, the 95% confidence interval does not include 1）. Conclusion acute promyelocytic leukemia, after application of clinical care pathway, patients satisfaction awareness improved obviously, Complications were significantly reduced.