经尿道输尿管镜治疗输尿管结石的临床路径在深圳街道医院的应用

Application research on clinical pathway of Trans-urethral ureteroscope in treatment of ureteral calculi in Shenzhen Street Hospital

目的探讨经尿道输尿管镜治疗输尿管结石临床路径在深圳街道医院的应用效果。方法我院于2014年7月开始对泌尿科输尿管结石的住院患者实施临床路径管理,选取2013年10月-2015年3月的输尿管结石患者,分别采用传统路径和临床路径管理,比较两组患者住院时间、抗生素使用时间、疗效、患者满意度和依从性。结果实施组住院时间、抗生素使用时间少于对照组,满意度及依从性评分高于对照组[（5.5±0.2）d比（6.4±0.5）d,（2.3±0.4）d比（4.4±0.7）d,（92.4±3.2）分比（85.6±2.3）分,（93.4±3.1）分比（84.7±2.7）分,P〈0.05]。实施组结石一次清除率和对照组比较无统计学意义（96.67%比93.33%,P〉0.05）。结论经尿道输尿管镜治疗输尿管结石临床路径在深圳街道医院实施在保障患者治疗效果前提下,缩短患者住院时间、抗生素使用时间,提高了患者的满意度和依从性,具有较高的临床实施价值。

Objective To explore the applicative effect of clinical pathway of trans-urethral ureteroscope in the treatment of ureteral calculi in Shenzhen street hospital. Methods Inpatients with ureteral calculi in urological department in our hospital were received clinical pathway management from July 2014. Patients with ureteral calculi who were admitted to our hospital from October 2013 to March 2015 were randomly selected and they were respectively received traditional pathway and clinical pathway management. Hospitalization stay, antibiotics consumption time, curative effect, satisfaction degree and compliance of patients in two groups were compared. Results Hospitalization stay and antibiotics consumption time in the implementation group were（5.5±0.2）d and（2.3±0.4）d respectively, shorter than those of the control group（6.4±0.5）d and（4.4±0.7）d. Scores of satisfaction degree and compliance of the implementation group were（92.4±3.2） and（93.4±3.1） respectively, higher than that of the control group（85.6±2.3） and（84.7±2.7）（P〈0.05）. Calculi clearance rates in one time of the implementation group and the control group had no statistical significance（96.67%/93.33%,P〈0.05）. Conclusion Clinical pathway of trans-urethral ureteroscope in treatment of ureteral calculi in Shenzhen street hospital can shorten hospitalization stay and antibiotics consumption time and improve satisfaction degree and compliance of patients under the premise of guaranteeing curative effect of patients, which is worthy of higher clinical implement value.