肛瘘切除术的临床路径的研究及-第三军医大学学报.doc

肛瘘切除术临床路径研究 杨勇军1﹡、唐学贵1、刘芳1、吴至久1、何德才1、张峰 2、刘仕鸿3、田小兵4 （1川北医学院附属医院肛肠科,四川南充，637000； 2成都中医药大学附院肛肠科，四川成都，610072；3川北医学院2010级研究生，4川北医学院预防医学系，四川南充，637000） 要： 目的 为了制定低位单纯性肛瘘诊治过程中的肛瘘的 试验组90例平均住院费用3331.26±341.94元，平均住院时间11.59±1.98天，患者及家属满意度99.68±0.91%；对照组90例平均住院费用4154.77±501.55元，平均住院时间18.94±2.94天，患者及家属满意度87.67±4.00%。两组均无术后感染和并发症及后遗症发生，无不良事件和实验室检查结果异常。结论 我们认为肛瘘切除术的临床路径具有良好的透明度、规范化的流程、良好的病人依从、有效地提高肛瘘的医疗质量，降低了住院费用，缩短了住院时间，提高了患者及家属满意度，而且安全性高，从而减少医疗缺陷，降低医疗成本，改善医患关系，和谐医疗环境，在基层医院在肛瘘 关键词：肛瘘；手术；临床路径；研究；安全性评价 The Research and the Safety Evaluation of the Clinical Pathway of the anal Fistulectomy Yang Yongjun*, Tang Xuegui , Liu Fang et al (*The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 63700) 【abstract】: objective: To establish the optimization and the best clinical pathway in the diagnoses and treatment of the low and simple anal fistula， and in order to standardize the medical service and the management mode of the low set and simple anal fistula. Method: According to the diagnoses and exclusion criterion published inthe handbook of diagnoses and treatment for anal fistula, 180 patients with confirmed diagnosis of low set and simple anal fistula were assigned to 2 groups by the randomized, single blind way. The 90 patients in the treatment group were intervene in accordance with the rigorous clinical pathway (flow graph), while the 90 patients in the control group were treated with the traditional diagnoses and treatment way and nursing intervention. Results: The average cost of hospitalization of the patients who in the treatment group is 3331.26RMB(±341.94RMB) and the average length of stay is 11.59D(±1.98D),the degree of satisfaction of patient and the dependent in a family is 99.68%(±0.91%); the average cost of hospitalization of the patients who in the control group is 4154.77RMB(±501.55RMB) and the average length of stay is 18.94D(±2.94D), the degree of satisfaction of patient and the dependent in a family is 87.67%(±4.00%).Both have n