常见肿瘤单病种限价的临床路径(修改版).doc

常见肿瘤单病种限价临床路径 （2015年版） 南通市肿瘤医院 2015年5月  序 言 临床路径（Clinical pathway）是指针对某一疾病建立一套标准化治疗模式与治疗程序，是一个有关临床治疗的综合模式，以循证医学证据和指南为指导来促进治疗组织和疾病管理的方法，最终起到规范医疗行为，减少变异，降低成本，提高质量的作用。相对于指南来说，其内容更简洁，易读、适用于多学科多部门具体操作，是针对特定疾病的诊疗流程、注重治疗过程中各专科间的协同性、注重治疗的结果、注重时间性。 单病种限价是指医疗机构对住院病人提供医疗服务过程中，以病种为单位向患者收取费用，病人须支付的治疗费用如果超出了限价，多出部分由医疗机构承担。常见肿瘤临床路径与单病种限价的有机结合能规范医疗行为、提高医疗质量、降低患者费用、提升医院效益，进而提高患者满意度。 窗体底端 本书根据卫生部临床路径制定，汇编了肿瘤科常见疾病的临床路径。具体内容涉及胃癌临床路径、原发性肺癌临床路径、食管癌临床路径等，涵盖了手术、化疗、放疗等不同方式，希望能在医疗实践中给各位同仁带来帮助。 南通市肿瘤医院 2015年5月 目 录 一、胃癌临床路径········································1 (一)胃癌手术治疗临床路径·····························1 (二)胃癌化疗临床路径·································7 (三)胃癌放射治疗临床路径·····························12 二、原发性肺癌临床路径·································18 (一)原发性肺癌手术治疗临床路径·······················18 (二)原发性肺癌化疗临床路径···························23 (三)原发性肺癌放射治疗临床路径·······················30 三、食管癌临床路径·····································35 (一)食管癌手术治疗临床路径···························35 (二)食管癌化疗临床路径·······························41 (三)食管癌放射治疗临床路径···························47 四、结肠癌临床路径·····································52 (一)结肠癌根治性切除手术临床路径·····················52 (二)结肠癌化疗临床路径·······························59 五、直肠癌临床路径·····································65 (一)直肠癌手术治疗临床路径···························65 1.直肠癌低位前切除手术临床路径·····················65 2.直肠癌腹会阴联合切除手术临床路径·················72 (二)直肠癌化疗临床路径······························80 (三)直肠癌放射治疗临床路径····························87 六、乳腺癌临床路径········································93 (一)乳腺癌改良根治术临床路径··························93 (二)乳腺癌化疗临床路径································98 (三)乳腺癌术后放射治疗临床路径························104 七、宫颈癌临床路径·······································110 八、弥漫大B细胞淋巴瘤临床路径···························115 九、下咽癌临床路径······································122 十、甲状腺肿瘤临床路径··········