涡阳县人民医院实施胆囊结石腹腔镜胆囊切除术临床路径效果分析

Analysis of clinical pathway effectiveness of laparoscopic cholecystectomy for gallstones in a county hospital

目的评价胆囊结石腹腔镜胆囊切除术临床路径的临床应用效果。方法将涡阳县人民医院2013年3月至2014年11月实施临床路径管理的259例胆囊结石腹腔镜胆囊切除术患者纳为路径组,未实施临床路径管理的256例胆囊结石腹腔镜胆囊切除术患者纳为对照组,对两组患者的平均住院天数、手术前住院天数、住院费用、药品费用、检查费用、药品费用比例、术后并发症率和患者满意度等指标进行比较评价。结果路径组平均住院天数为(5.3±1.6)d,手术前住院天数为(1.2±0.4)d,与对照组比较,差异有统计学意义(P<0.05);路径组较对照组的住院费用和检查费增加,药品费用减少,差异有统计学意义(P<0.05)。术后随访,路径组患者满意度高于对照组,差异有统计学意义(P<0.05);两组术后并发症差异无统计学意义(P>0.05)。结论胆囊结石腹腔镜胆囊切除术临床路径的实施可以有效缩短住院时间,降低治疗费用,减轻患者经济负担,提高患者满意度,对提升医院社会和经济效益有着积极意义。

Objective To evaluate the effect of clinical application of gallbladder stones clinical pathway of laparoscopic cholecystec-tomy(CP). Methods Path group:259 patients who received CP of laparoscopic cholecystectomy from March 2013 to November 2014 in our hospital. Control group:256 patients who received the traditional pathway of laparoscopic cholecystectomy. Clinical indexes,such as the hospitalization of two groups of patients before operation,hospitalization days,cost of hospitalization,drug cost,inspection cost,the propor-tion of drug costs,complication rate and satisfactory degree of patients after operation,were compared and evaluated. Results The path groupˊs hospitalization days,average hospitalization days before the operation were shorter than those of control group,and the difference had statistical significance;hospitalization expenses and inspection cost were increased,but drug costs were reduced in path group,and the difference had statistical significance. Patients satisfaction increased during the postoperative follow - up in path group with statistical signifi-cance,but there was no significant increase in postoperative complications between the two groups. Conclusion The implementation of gall-stone undergoing laparoscopic cholecystectomy clinical pathway can shorten the time of hospitalization,reduce the cost of treatment,reduce the economic burden of patients,and improve patient satisfaction.