肝泡型包虫病临床路径实施效果评价

Evaluation of clinical pathway in the therapeutic treatment hepatic alveolar echinococcosis

目的评价肝泡型包虫病(HAE)临床路径(CP)的实施效果。方法回顾性分析并比较纳入临床路径诊治的84例(CP组)和未纳入临床路径诊治的86例(非CP组)HAE病患者临床疗效。运用SPSS 19.0统计软件进行数据分析,术后各项指标以(x^-±s)表示,独立t检验;术后并发症发生率采用χ^2检验。以P<0.05为差异有统计学意义。结果CP组患者的住院时间(10.9±1.3)d和住院费用(3.5±0.3)万元低于非CP组[(14.1±1.2)d、(3.8±0.4)万元],P<0.05;CP组患者的满意度更高、出院时包虫病健康知识掌握情况亦优于非CP组(P<0.05)。两组患者在术后并发症发生情况方面差异无统计学意义(P>0.05)。结论实施HAE临床路径可有效缩短患者住院时间,降低诊疗费用、减轻患者经济负担,对提升患者满意度、普及包虫病健康知识具有积极作用,值得临床应用和推广,但临床路径的变异发生率较高,需要及时进行干预与不断优化管理以适用于临床。

Objective To evaluate the effect of clinical pathway(CP)in the therapeutic treatment hepatic alveolar echinococcosis(HAE).Methods The clinical data were analyzed retrospectively,including 84 patients in CP group and 86 patients in non-CP group.Statistical analysis was performed by using SPSS 19.0 software.Measurement data were expressed as mean±standard deviation and were examined by independent t test.Count data such as the incidence of postoperative complications were described by(n,%)and were examined by chi square test.The correlation between predicted resected liver volume and actual resected liver volume were also analyzed.A P value of<0.05 was considered as statistically significant.Results The hospitalization time of(10.9±1.3)d and hospitalization expenses of(35±3)thousand yuan in the CP group were significantly lower than(14.1±1.2)d and(38±4)thousand yuan in the non-CP group respectively,P<0.05;The patient’s satisfaction in CP group was higher,and the knowledge of echinococcosis health at discharge was better than those in non-CP group respectively(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion Implementing the clinical pathway of HAE could effectively shorten the hospitalization time,reduce the cost of treatment as well as the economic burden of patients,and has a positive effect on improving patient satisfaction and popularizing the health knowledge of echinococcosis.It is worthy of clinical application and promotion,but the incidence of mutations in the clinical pathway is high,requiring timely intervention and continuous optimization management for clinical use.