职业性三氯乙烯药疹样皮炎临床路径研制

Clinical pathway on occupational medicamentosa-like dermatitis due to trichloroethylene

目的建立职业性三氯乙烯药疹样皮炎(OMDT)临床路径。方法选择OMDT为临床路径的病种,在循证医学和临床资料分析的基础上,结合专家咨询和GBZ 185—2006《职业性三氯乙烯药疹样皮炎诊断标准》确定OMDT的诊断与治疗方案,制定临床路径文本,并进行初步临床验证。结果制定供医护人员使用的OMDT临床路径文本,包括标准住院流程(包括糖皮质激素的规范使用方案)、《临床路径表单》、《接受糖皮质激素治疗知情同意书》;制定供患者或其家属使用的患者版《临床路径告知书》。经初步临床验证,该临床路径有利于优化医疗流程,患者均无出现病情反跳和并发症,且患者对OMDT的认知程度和治疗的满意度均提高。结论 OMDT临床路径科学、合理,有利于规范医疗行为。

Objective To establish the clinical pathway of occupational medicamentosa-like det^natitis due to trichloroethylene （OMDT）. Methods OMDT was selected as the clinical disease category. The diagnosis and treatment schemes of OMDT were determined and the clinical pathway was developed on the basis of evidence-based medicine, clinical data analysis, and the expert opinion as well as GBZ 185--2006 Diagnostic Criteria of Occupational Medicamentosa-like Dermatitis due to Trichloroethylene. The initial clinical validation was performed. Results We formulated the clinical pathway of OMDT for medical staffs, including standard hospitalization procedures （including normative use of glucocortieoids ） , Clinical Path Form, and Informed Consent for Glucocorticoid Therapy. The Clinical Pathway Notification of OMDT for patients or their family members was established. Based on the initial clinical verifications, the clinical pathway was conducive to optimize the medical process, none of the patients suffered from rebounds and complications, and the awareness of OMDT and satisfaction with treatments were improved. Conclusion The clinical pathway for OMDT is scientific and reasonable, which is suitable for use to regulate medical behaviors.