职业性慢性轻度铅中毒临床路径构建

Establishing a clinical pathway for occupational chronic mild lead poisoning

目的构建合理的以项目时间为框架的职业性慢性轻度铅中毒标准住院流程的临床路径,制定合理、有效的诊断治疗管理模式。方法选择职业性慢性轻度铅中毒为临床路径的病种,以GBZ 37—2015《职业性慢性铅中毒的诊断》为基础,以循证医学证据和指南为指导,结合文献研究、病例分析和专家咨询,结合该病种的最佳治疗方案,制定临床路径文本,并进行初步临床验证。结果制定职业性慢性轻度铅中毒的相应临床路径的规范化文件,包括标准住院流程、医师版临床路径《临床路径表单》和《患者版临床路径告知书》。初步临床验证结果显示,该临床路径有利于规范诊断治疗行为,提高医疗质量,缩短住院时间,降低住院费用,减少医疗资源浪费。结论职业性慢性轻度铅中毒临床路径科学、规范、合理、实用,有利于促进疾病治疗的组织和管理。

Objective To establish an effective clinical pathway of hospitalization process for occupational chronic mild lead poisoning within the framework of project time; to formulate a rational and effective management model for the diagnosis and treatment. Methods Occupational chronic mild lead poisoning was selected as a disease for pilot study based on GBZ 37-2015 Diagnosis of Occupational Chronic Lead Poisoning. According to evidence-based medicine criteria,the clinical procedure was developed,preliminary used and evaluated in clinical practice in several hospitals,with the best treatment scheme of the disease. The principal methods used are literature research,case analysis and expert consultation.Results Standardized documents relevant to clinical pathway for occupational chronic mild lead poisoning have been formulated,including standardized in-hospital treatment process,Clinical Pathway Forms for medical staff and Consent Documents of Clinical Pathway for Patients. Preliminary clinical research showed that this clinical pathway is conducive to standardizing medical process,improving medical quality,shortening the time in hospital,reducing medical cost and the waste on medical resources. Conclusion The results confirm that the clinical pathway for occupational chronic mild lead poisoning is scientific,rational,normative and practical. It will surely contribute to promote the management of disease diagnosis and treatment.