快速康复外科在成人腹股沟疝临床路径质量管理中的应用

The Application of Enhanced Recovery After Surgery in Quality Management of Adult Inguinal Hernia Clinical Pathway

目的探讨围手术期间实施快速康复外科对成人腹股沟疝临床路径的影响。方法 436例成人腹股沟疝临床路径患者随机分为两组,每组218例,分别为观察组(快速康复组)和对照组(传统治疗组),分析对比两组患者术后平均住院天数、平均住院总费用、平均药物费用、术后并发症发生率及临床路径变异率。结果与传统治疗组对比,快速康复组术后平均住院天数明显缩短、平均住院总费用及平均药物费用明显降低、术后并发症发生率明显减少、临床路径总变异率及负性变异率降低(P<0.01)。结论在成人腹股沟疝临床路径的围手术期治疗中实施快速康复外科,能明显减少患者医疗费用、降低术后并发症的发生率及临床路径负性变异率,从而达到促进患者早日康复的效果。

Objection To investigate the effect of enhanced recovery after surgery on the clinical path of adult inguinal hernia during the perioperative period. Methods 436 cases of adult inguinal hernia clinical pathway were randomly divided into two groups, 218 cases in each group. The observation group respectively（enhanced recovery after surgery group） and control group（conventional treatment group）, the average length of hospital stay, average hospitalization expenses, average drug cost, the incidence of postoperative complications and the negative variation rate of clinical pathway of adult inguinal hernia were analyzed and compared between the two groups. Results Compared with conventional treatment group, the average length of stay in the nhanced recovery after surgery group was significantly shorter, the average hospitalization cost and the average drug cost were significantly reduced, the incidence of postoperative complications was significantly reduced, the total variation rate and the negative variation rate of clinical pathway were reduced（P 〈 0.01）. Conclusion In the perioperative treatment of adult inguinal hernia clinical pathway, enhanced recovery after surgery can significantly reduce the medical cost, reduce the incidence of postoperative complications and the negative mutation rate of clinical pathway, so as to promote the early rehabilitation of patients.