临床路径模式下经鼻蝶窦入路切除垂体腺瘤患者的围术期护理

Experience in perioperative nursing of patients with pituitary adenoma who were treated via transsphenoidal tumor resection in standardized clinical pathway

目的：总结在临床路径模式下经鼻蝶窦入路切除垂体腺瘤临床护理经验和体会。方法回顾性分析某院2011年1月—2012年6月收治的62例经鼻蝶窦入路垂体腺瘤切除术患者,并采用随机数字表法分为临床路径组和对照组,分别采用临床护理路径和常规护理。比较两组患者的住院时间、费用、对健康教育知识掌握度和对医护人员的满意度。结果临床路径组患者平均住院时间为（12.41±1.12）d,平均住院费用（24568±158）元,均低于对照组的（14.56±1.56）d,（27431±287）元,差异有统计学意义（t值分别为6.25,48.65；P〈0.01）。临床路径组健康教育知识掌握度及对医护人员的满意度分别为48.4%,83.9%,均高于对照组的19.3%,54.8%,差异有统计学意义（P〈0.05）。结论通过临床路径制定的标准化治疗方案,可提高经鼻蝶窦入路切除垂体腺瘤患者的健康教育知识掌握度和对医护工作的满意度,并提高医疗护理质量。

Objective To review and summarize our experiences in nursing of patients with pituitary adenoma who were treated via transsphenoidal resection and subordinated to a standardized clinical pathway. Methods From January 2011 to June 2012, a series of 62 consecutive cases that undergone transsphenoidal resection were enrolled and retrospectively analyzed. Patients were randomly distributed to either clinical pathway group in which a standardized clinical pathway was assigned, or control group in which normal nursing services were offered. Hospitalization days, costs, satisfaction with medical workers and the knowledge of health education were compared between the two groups. Results The average hospitalized days of clinical pathway group were （12. 41 ± 1. 12）d and the costs of clinical pathway group were （24 568 ± 158） yuan, which were （14. 56 ± 1. 56）d and （27 431 ± 287） yuan in control group respectively, and the differences were statically significant （t=6. 25,48. 65,respectively;P〈0. 01）. The understanding degree to health education knowledge and the satisfaction with nurses of the clinical pathway group were 48. 4% and 83. 9%,which better than 19. 3%and 54. 8% in the control group （P 〈 0. 05）. Conclusions The clinical pathway could increase the understanding degree to health education knowledge and the satisfaction with nurses of patients with pituitary adenoma who are treated via transsphenoidal resection, and guarante the quality of medical and nursing care.