临床路径在显微椎间盘手术患者中应用探究.docVIP

临床路径在显微椎间盘手术患者中应用探究 　【摘要】; 目的; 建立完善的显微椎间盘手术患者的临床路径。方法; 采用随机抽样法将患者分成两组，每组25例。对照组采用按常规医嘱进行护理，试验组采用制订好的临床路径进行护理，观察两组患者住院天数、卧床时间、医疗费用及患者满意度有无差异。结果; 试验组患者住院时间、卧床时间比对照组明显减少，满意度与对照组相比有明显提高，控制了一定的医疗费用。结论; 临床路径在显微椎间盘手术患者中的应用，可提高工作效率和患者的满意度，可控制成本和保证护理质量。 ; 【关键词】; 临床路径；显微椎间盘手术；护理质量 Application of clinical nursing pathway in intervertebral discs micro-operation ; WEI Xian-ru，HU Shu-yuan.The First Peoples Hospital,Changde 425003,China ; 【Abstract】; Objective; To establish the perfect clinical paths of intervertebral discs micro-operation.Methods; Using random sampling method,the patients were divided into two groups and each group had 25 cases.The normal nursing methods were used in the control group and the clinical paths were used in the experimental group.The patients duration in the hospital,the time in the bed,the medical cost and the degree of satisfaction were observed in each group and the differences were compared.Results; In experimental group,the patients time in the hospital,duration in the bed were less than that in the comparing group while the patients were more satisfied（all P＜0.05）.And to some degree the patients medical cost was controlled.Conclusion; Using the clinical paths in intervertebral discs micro-operation,we could improve the working efficiency and the patients degree of satisfaction,control the cost and guarantee the nursing quality. ; 【Key words】; clinical nursing paths;intervertebral discs micro-operation;nursing quality ; 临床路径（clinical pathway）又称临床程序，是为已确诊为某种疾病的一组患者制订的、以病人为中心，从入院到出院的一整套医疗护理整体工作计划。国外十几年的实践证明：临床路径的实施，对于缩短患者平均住院日、限制医疗费用增长、规范诊疗护理手段、加强医护合作、提高患者满意度等方面都能起到积极作用［1］。在美国，为了缩短患者住院日数，应用临床路径已10年，日本应用临床路径已有4～5年,对提高患者满意度极有作用［2］。为此我院成立了临床路径发展小组，引入临床路径应用于临床实践。而显微椎间盘手术（椎间盘镜）1999年由刘尚礼教授从美国引进中国，是一种非常正规的微创手术，它能够完成传统椎间盘切除术的绝大部分，而创伤很小，切口只有2.54cm，术中出血少（大约100～200ml），对患者来说是一个很大的福音，手术效果好，且安全有效，有效率超过90%，值得推广［3］。笔者对2004年3～12月在我院接受治疗的50例显微椎间盘手术患者进行两种护理方法的对比观察，现报告如下。 ; 1; 资料与方法 ; 1.1; 一般资料; 2004年3～12月入住我院骨科的腰椎间盘突出患者50例，男26例，女24例，年龄30～71岁。患者入院时均无严重并发症，心功能