一体化临床路径在缩短入院到溶栓时间中的实际运用

发布时间：2018-05-10 18:16

本文选题：入院到溶栓时间 + 临床路径　；参考：《中国新药与临床杂志》2017年05期

【摘要】：目的探讨一体化临床路径在缩短入院到溶栓(door-to-needle,DTN)时间中的作用。方法选择急性缺血性脑卒中且符合溶栓指征的患者115例,以开展一体化临床路径的时间点,将患者分为对照组(n=62)和观察组(n=53)。对照组采用传统急性脑卒中接诊流程,观察组采用将脑卒中院前、急诊、住院三方面治疗流程进行整合后形成的一体化临床路径。比较两组患者的一般临床资料及卫生经济学指标(包括DTN时间、住院时间、住院费用、再入院率等)。结果两组一般资料无显著差异(P0.05)。相对于对照组,观察组的DTN时间[(83.1±23.1)min vs.(99.0±39.8)min,P=0.012]及住院时间[(11.8±8.3)d vs.(15.7±10.1)d,P=0.028]显著降低,再入院率及总住院费用无显著差异(P0.05)。结论对于急性缺血性脑卒中的溶栓患者,一体化临床路径可降低DTN及住院时间,有一定的临床应用价值。
[Abstract]:Objective to explore the role of integrated clinical pathway in shortening the time from admission to thrombolytic door-to-needle tumor (DTNN). Methods 115 patients with acute ischemic stroke who were in accordance with thrombolytic indication were divided into two groups: control group (n = 62) and observation group (n = 53). The control group adopted the traditional acute stroke consultation procedure, the observation group adopted the integrated clinical path after the integration of the three treatment processes before the stroke intermediate people's court, emergency treatment and hospitalization. The general clinical data and health economic indexes (including DTN time, hospitalization cost, readmission rate, etc.) were compared between the two groups. Results there was no significant difference in general data between the two groups (P 0.05). Compared with the control group, the DTN time [83.1 卤39.8min] and the hospitalization time (11.8 卤8.3 vs.(15.7 卤10.1 vs.(15.7 卤10.1d) in the observation group were significantly decreased, but there was no significant difference in readmission rate and total hospitalization cost (P 0.05). Conclusion for acute ischemic stroke patients with thrombolytic therapy, the integrated clinical pathway can reduce DTN and hospital stay, which has certain clinical application value.
【作者单位】：嘉定区中心医院院部;嘉定区中心医院神经内科;嘉定区中心医院质控部;
【基金】：上海市嘉定区科委项目基金(2015007)
【分类号】：R743.3

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