优化肺癌化疗临床路径的综合护理模式临床应用研究

Clinical Application Reach of Comprehensive Nursing Mode and Effective Clinical Pathway of Lung Cancer Chemotherapy

目的探讨个案管理与临床路径相结合的综合护理模式在肺癌化疗患者中的临床应用价值。方法选择肺癌化疗患者98例,将其随机分为研究组49例和对照组49例。研究组患者采用个案管理与临床护理路径相结合的综合护理模式,对照组患者采用传统护理模式。对比两组患者的依从性、对毒副作用耐受性、住院日数、住院费用、满意度。结果研究组和对照组患者的依从性分别为95.9%和81.6%,对毒副作用耐受性分别为93.8%和77.6%,严重毒副反应发生率分别为4.0%和16.3%,住院日数分别为(16.5±2.8)d和(22.3±2.5)d,住院费用分别为(23 718.6±892.5)元和(28 023.8±758.6)元,满意度分别为97.9%和75.5%,两组比较差异均有统计学意义(P<0.05)。结论建立科学、高效的个案管理与临床护理路径相结合的肺癌化疗综合护理模式,可明显提高患者的依从性,及时预防和处理化疗毒副反应,使严重毒副反应发生率下降,可显著降低患者住院日数和住院费用,大大改善患者生活品质和满意度,值得在临床广泛应用和推广。

Objective To explore the clinical application value of comprehensive nursing model based on case management and clinical pathway in lung cancer chemotherapy. Methods 89 cases with lung cancer chemotherapy were selected,and they were randomly divided into research group and control group,with 49 cases in each group. Research group applied clinical treatment and nursing with case management and clinical pathway,and the control group applied traditional nursing mode. Patients ＇ compliance,toleration to toxic and side effect,hospitalization days,hospitalization expenses and satisfaction of the two groups were compared. Results Patients ＇ compliances ofresearch group and control group are 95. 9% and 81. 6% respectively. Tolerations and side effects of two groups are 93. 8% 和 77. 6%.Hospitalization days are（ 16. 5 ± 2. 8） d 和（ 22. 3 ± 2. 5） d. Hospitalization expenses are（ 23718. 6 ± 892. 5） yuan and（ 28023. 8 ± 758. 6）yuan. The satisfaction degrees are 97. 9% and 75. 5%. The differences of two groups have statistical significance（ P 〈 0. 05）. Conclusion Scientific and effective nursing mode in lung cancer chemotherapy with case management and clinical pathway can significantly raise patients＇ compliance,reduce the rate of side effect,decrease hospital days and hospitalization expenses,and improve patients＇ life quality and satisfaction degree. So it is worthy of wide application and promotion in clinical practice.