北京儿童医院先天性肌性斜颈临床路径实施前后效果评价

发布时间：2018-04-04 10:57

本文选题：先天性肌性斜颈　切入点：临床路径　出处：《中国研究型医院》2018年01期

【摘要】：目的:评估首都医科大学附属北京儿童医院先天性肌性斜颈患儿临床路径实施效果。方法:采用回顾性对照分析方法,以2009年1月~2012年1月未实施临床路径的156例先天性肌性斜颈患儿为对照组,以2013年1月~2016年1月实施临床路径的126例先天性肌性斜颈患儿为实验组,观察比较两组之间的差异。观察指标包括:术前住院天数、术后住院天数、住院总天数、住院费用、抗菌药物使用情况、再手术、并发症等。结果:实验组术前住院天数、术后住院天数、住院总天数;床位费用、麻醉费用低于对照组;手术费用、西药费用、一次性材料费用、住院总费用高于对照组,以上两组比较均具有统计学意义(P0.05)。对照组有2例患儿术后出现伤口渗血,实验组术后无明显并发症;对照组有1例患儿行二次手术,实验组无再次手术患儿;对照组术后抗菌药物使用时间超过24 h的比率为83.33%(130/156),而实验组术后抗菌药物使用时间超过24 h的比率为0.79%(1/126)。实施临床路径后变异率为49.64%(69/139)。结论:实施临床路径可以缩短先天性肌性斜颈患儿的住院天数,规范抗菌药物的使用,且术后无明显并发症,但住院费用较前增加,且实施过程中变异率较高,因此需对临床路径加以完善并推广使用。
[Abstract]:Objective: to evaluate the clinical effect of congenital muscular torticollis in Beijing Children's Hospital affiliated to Capital Medical University.Methods: 156 children with congenital muscular torticollis who had no clinical pathway from January 2009 to January 2012 were used as control group.From January 2013 to January 2016, 126 children with congenital muscular torticollis were selected as experimental group. The difference between the two groups was observed and compared.The observed indexes included: preoperative hospitalization days, postoperative hospitalization days, total hospitalization days, hospitalization expenses, antimicrobial use, reoperation, complications and so on.Results: the days of hospitalization before and after operation, the days of hospitalization after operation, the cost of bed and anesthesia were lower in the experimental group than those in the control group, the costs of operation, western medicine, disposable materials and total expenses of hospitalization were higher than those in the control group.The above two groups had statistical significance (P 0.05).Two children in the control group had bleeding after operation, but there were no obvious complications in the experimental group, while in the control group, there was a second operation, and there was no reoperation in the experimental group.In the control group, the rate of antimicrobial use more than 24 hours after operation was 83.33 / 156, while that of the experimental group was 0.79 / 1 / 126.The variation rate of clinical pathway was 49. 64% / 139%.Conclusion: the clinical pathway can shorten the hospitalization days of children with congenital muscular torticollis, standardize the use of antimicrobial agents, and there are no obvious complications after operation, but the cost of hospitalization is higher than before, and the rate of variation in the course of implementation is higher.Therefore, it is necessary to perfect and popularize the clinical pathway.
【作者单位】：济南市儿童医院;首都医科大学附属北京儿童医院骨科;
【分类号】：R197.5;R726.8

【相似文献】