桡骨远端骨折门诊临床路径的应用效果

Application effect on outpatient service clinical pathway of distal radius fracture

目的探讨对桡骨远端骨折患者实施门诊临床路径的可行性。方法选取2010年1月～2013年12月武汉市中医医院门诊诊疗的桡骨远端骨折患者146例，按照随机数字表法分为CP治疗组和对照组，每组各73例，CP治疗组实施门诊临床路径，对照组采用诊疗常规。比较两组患者治疗天数、总费用、满意度以及Gaaland-Werley腕关节评分。结果CP治疗组的治疗天数、总费用均明显低于对照组[（26．83±4．15）比（30．19±6．78）d、（2247．27±255．38）比（2813．41±437．37）元1，差异有统计学意义（P〈0．05）；CP治疗组的满意度评分、治疗后Garland-Werley腕关节功能均明显优于对照组，差异有统计学意义（P〈0．05）。结论开展桡骨远端骨折门诊临床路径可以缩短治疗时间，减少医疗总费用，提高患者满意度，改善腕关节预后，值得临床推广。

Objective To observe and analysis the feasibility of outpatient service clinical pathway on distal radius fracture. Methods From January 2010 to December 2013, in Wuhan Hospital of Traditional Chinese Medicine, 146 out- patient service patients with distal radius fracture were selected, and according to random number table, they were divid- ed into CP treatment group and control group, with 73 cases in each group. The CP treatment group were given outpa- tient service clinical pathway, the controlled group were given conventional diagnosis and treatment of distal radius fracture. The treatment days, total costs, patient satisfaction, and Gartland-Werlley scale of two groups were compared. Results The treatment days and total costs of CP treatment group were obviously lower than those of the control group [（26.83±4.15） vs （30.19±6.78） d, （2247.27±255.38） vs （2813.41±437.37） yuan], the differences were statistically signifi- cant （P 〈 0.05）. The patient satisfaction and Gartland-Werlley scale of CP treatment group were better than those of the control group, the differences were statistically significant （P 〈 0.05）. Conclusion Clinical pathway for outpatient on distal radius fracture can shorten treatment days, reduce medical total costs, improve patient satisfaction, optimize func- tion of wrist joint, and it is worth widely used.