急性心肌梗死中西医结合临床路径的构建及初步评价研究.pdfVIP

中闺中荫阪销合杂志2011 年 1 月第31 #第 1 期 CJITWM ， January 2011 , Vol. 31 , No. 1 ·丁· ·临床论著· 急性心肌梗死中西医结合临床路径的 构建及初步评价研究 五磊张敏州张军杨广唐光华郭力性陈全福张俭 摘要 目的探讨急性心肌梗死(acu怡 myocardial infarction , AMI) 中西医结合临床路径(clinical path- way ， CP) 的构建和疗效评价。为浩 采用非问期队列研究，在治疗指南和益气活血法的基础上，建立 AMI 中 西服结合临底路径，根据临床路径实施前后分为 CP 纽(71 例)和非 CP 组(70 例) ，观事两姐的总住院时间、 ICU 住院时间和总住院费用，对于行直接 PCI 的亚组患者，比校其就诊一球囊扩张(door-to-balloon , DTB) 时 间。结果 CP 组总住院时间(天)低于非 CP 纽(9.80 土 5.62ω12.01 :t: 7.35 ,P0.05) ，两组住院费用差异 元钝计学意义。对于行PCI 的亚组患者，CP 组 DTB 时间(min ， 82.56 士 17.36ω119. 19 士 30.88 ,P 0. 01) 、 总住院时间(9.69 土 5.59 vs 13. 34 士7.49 ， P0.01) 和住院费用均低于非 CP 组。结论 以益气活血法为基 础的急性心肌梗死中西医结合临底路径，可以降低 AMI 住院时间，控制直接PCI 患者的住院费用和 DTB 时 间，充分体现出中西医结合l降尿路往在 AMI 医院管理和质量控制方面的价值。 关键词 怠性心肌梗死;临尿路径:中西民结合;品气活.lÚt 巨臼g翩恤剧M胁ur刚忧田昭 γ帽回啕 Pra回制硝俑 d 刨 l阳n恤陶gr唰刨ve Med阳l忡p阳a翩世由Y唰y 伽伽rωl阳n阳1M町啕m例d ÞJ.灿x翩 My回泪M刷 l阳n伽伽『唰佣 WANG Le创i. Z忖ANG Mi阳n Chù脚剧e Medici TU!l. Guang动。u (510120) ABSTRACT Objective To establish an integrative medícal approach (IMA) for clinical management of a- cute my∞a叫ial ínfarctíon (AMI) • and to test its efti佣cy. Me伽州s IMA was preliminaríly established al∞ording to the guidelines and based on the Chinese medical therapy of benefiting vi切I qi and promoting blood circulation. And adopting non-synchronous queue d倒ign. AMI patients were assigned to the IMA group (71 侃ses) and the non-IMA group(70 cases). they were managed following or didnt follow the established IMA respectively. The tωal ho叩italízation time (THT) , the ICU indwelling time ( ICUD) and the total medical 制penditure (TME) 时间­ tients were ∞mpared between groups. Moreover. for patients received primary PCI , the time for door-to-balloon ( DTB) was compared in addition. Results Comparisons between groups showed that THT in the IMA group was shorter than that in the non-IMA group (9. 8