回顾性分析临床路径在全髋关节置换术患者围手术期的应用效果

Retrospective Analysis on the Application Effect of Clinical Pathway in Perioperative Period of Total Hip Replacement Patients

目的回顾性分析临床路径在全髋关节置换术患者围手术期应用效果。方法研究对象来自在重庆某医院骨科接受全髋关节置换术、并于2014年12月-2015年12月出院的患者163例,根据纳入临床路径与否,将患者分为对照组102例(A组)和路径组61例(B组)。比较两组患者的平均住院总费用、平均手术费用、平均材料费用、平均药物费用、平均检查检验费、平均住院日、平均术前住院日等。结果两组平均住院总费用、平均手术费用、平均材料费用等指标无明显差异,但实施路径组(B组)平均药物费用、平均检查化验费用较对照组(A组)明显降低,平均住院日及平均术前住院日较对照组(A组)明显缩短。结论通过两组患者的临床数据调查发现实施临床路径患者(B组),比未实施临床路径患者(对照组A组)的平均住院日、平均术前住院日、以及检查药物费用有所下降。临床路径能保障医疗质量和医疗安全,降低百姓的就医门槛,值得推广。

Objective To retrospectively analyze the application effect of clinical pathway for total hip replacement patients in perioperative period. Methods The study objects were 163 total hip replacement patients discharged from department of orthopedics in the First Affiliated Hospital of Chongqing Medical University from December 2014 to December 2015. According to whether they were implemented in clinical pathway or not,those subjects were divided into control group （102 patients,Group A） and group of clinical pathway （61 patients,Group B）. Average total hospitalization expenses,average operation expenses,average material expenses,average medicine expenses,average auxiliary examinations expenses,average hospital stay and average preoperative hospital stay were compared. Results There were no significant differences in average total hospitalization expenses, average operation expenses and average material expenses between two groups,whereas average medicine expenses and average auxiliary examinations expenses were obviously lower in group of clinical pathway （Group B）. Average hospital stay and average preoperative hospital stay of Group B were significantly shorter than those of control group （Group A）. Conclusions It indicated that the clinical pathway could reduce the average length of stay,the average of preoperative stay,the average auxiliary examination expenses,and the drug expenses in the application of total hip arthroplasty. Clinical pathway could guarantee medical quality and safety,and decrease medical threshold which was worth spreading.