农村老年胆囊结石患者双向转诊过程中单病种临床路径应用.docVIP

农村老年胆囊结石患者双向转诊过程中单病种临床路径应用 　　[摘要] 目的 探讨单病种临床路径在农村老年胆囊结石患者双向转诊中的应用效果。 方法 选取2013年10月～2014年10月在苏州大学附属常熟医院（以下简称“我院”）行腹腔镜下胆囊切除术60岁及以上患者46例，随机分为试验组（n = 23）和对照组（n = 23）。试验组患者从入院手术到出院转回常熟市辛庄镇卫生院后续治疗均按胆囊结石单病种临床路径模式管理实施连续医疗护理；对照组患者则按传统治疗方法处理，痊愈后从我院直接出院。对两组患者的医院平均住院时间、抗生素使用时间、总住院费用、患者满意度等指标进行对比分析。 结果 试验组患者在平均住院时间、抗生素使用时间、总住院费用、患者满意度等方面均明显优于对照组（P 0.05或P 0.01）。 结论 单病种临床路径在农村老年胆囊结石患者双向转诊中效果明显，值得推广。 　　[关键词] 临床路径；胆囊结石；双向转诊 　　[中图分类号] R657.42 [文献标识码] A [文章编号] 1673-7210（2015）01（b）-0145-03 　　[Abstract] Objective To evaluate the application effect of clinical pathway of single-disease in dual referral mechanism of rural elderly patients with gallstone. Methods 46 patients （≥60 years old） who received laparoscopic cholecystectomy （LC） in Changshu Affiliated Hospital of Soochow University （our hospital for short） from October 2013 to October 2014 were collected. The samples were randomly divided into the path group and the control group， each consisting of 23 cases. Patients in the path group received continuous medical care according to clinical pathway of single-disease in our hospital and were referred to Xinzhuang Health Center after operation. The whole treatment followed the clinical pathway of single-disease management. The patients in the control group were treated with traditional treating method and recovered directly in our hospital. The average days in hospital， time of antibiotic use， the hospitalization costs and patients satisfaction were compared and analyzed in both groups. Results The average days in hospital， time of antibiotic use， the hospitalization costs and the patients satisfaction in the path group were all better than those of control group （P 0.05 or P 0.01）. Conclusion The clinical pathway of single-disease has obviously positive effect in the dual referral of elderly patients with gallstone and is worth of promoting. 　　[Key words] Clinical pathway； Gallstone； Dual referral 　　我国目前实行的双向转诊制度是按照患者疾病的实际需要，实现上下级医疗机构之间的资源共享，让患者在各级医院合理治疗[1]。而临床路径（clinical