慢性轻度铅中毒诊疗中规范化医疗护理模式的应用

Application of standardization of medical care model for chronic mild lead poisoning

目的制定慢性轻度铅中毒的规范化医疗护理模式，评价其应用于临床的实际效果。方法选择2014年1至12月在湖南省职业病防治院住院的60例慢性轻度铅中毒患者为观察组，2013年1至12月住院的60例慢性轻度铅中毒患者为对照组；比较两组在治疗效果、患者满意度、住院时间和住院费用等方面的差异，并分析临床路径的变异情况。结果两组患者均未出现药物不良反应；观察组患者的治愈率（96．7％）、患者满意度（98．3％）、健康知识掌握率（95．0％）均明显高于对照组（85．0％、88．3％、81．7％），差异均有统计学意义（P〈0．05）；观察组所用的治疗疗程（3．2±0.6）少于对照组（3．4±0．7），住院费用[（5773．5±1242．1）元】低于对照组[（6354．7±1177．0）元]，住院时间【（21．9±6．7）d】少于对照组【（24．6±7．9）d]，差异均有统计学意义（P〈0．05）。临床路径的总变异率为13．3％。结论该临床路径可以提高治愈率、患者满意度和健康知识掌握率，缩短住院时间，降低医疗费用，且变异率较低。

Objective To standardize the treatment and evaluate the clinical application effectiveness of clinical pathway （CP） in chronic mild lead poisoning. Methods 60 patients with chronic mild lead poisoning hospitalized from Jan. 2014 to Dec.2014 were enrolled for the study group, 60 patients with chronic mild lead poisoning hospitalized from Jan.2013 to Dec.2013 were enrolled for the control group. The study group were cared according to clinical pathway, the control group received routine therapy; the clinical application effectiveness were compared between the two groups. Results No adverse drug reactions occurred in both groups. The curative ratio was significantly higher in the study group than in the control group （96.7% vs 86.0%, P〈0.05）, the rate of patients＇ satisfaction to medical care significantly higher in the study group （98.3% vs 88.3%, P〈0.05）, the rate of health education awareness higher in the study group （95.0% vs 81.7% ,P〈0.05）, the course of treatment shorter in the study group （3.2±0.6 vs 3.4±0.7, P〈0.05）, the medical cost less in the study group （5773.5 yuan± 1242.1 yuan vs 6354.7 yuan± 1177.0 yuan, P〈0.05 ）, the length of hospitalization was shorter in the study group （21.9 d±6.7 d vs 24.6 d±7.9 d, P〈0.05）. The variation rate of clinical pathway was 13.3% in clinical pathway group. Conclusion The implementation of clinical pathway could improve the curative ratio, satisfaction, and health education awareness. The course of treatment, length of hospital stay and costs of hospitalization in the study group could be obviously shorter and less, and there is a little variation rate in the clinical pathway.