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目的:探讨临床路径(Clinical pathway,CP)在行室间隔缺损修补术的患者的医疗管理中的应用效益。方法:选择成功行体外循环下单纯室间隔缺损修补术的患者,根据是否实施了临床路径管理分为CP组和非CP组。对两组患者的医疗临床指标及医疗质量指标进行对比分析。结果:204例患者(男92/女112)成功接受室间隔缺损修补术,CP组106例,非CP组98例。CP组平均住院天数、平均术前评估天数、平均抗菌药使用天数、平均住院总费用、平均药品费用均低于非CP组,差异均有统计学意义(P<0.01)。两组并发症发生率差异无统计学意义(P=0.81),CP组甲级病历率及患者满意度明显提高(P<0.05)。结论:临床路径是提高室间隔缺损修补术医疗管理质量的有效方法。
Objective: To explore the clinical application of clinical pathway (CP) in the medical management of patients undergoing ventricular septal defect repair. Methods: Patients who underwent simple ventricular septal defect repair under cardiopulmonary bypass were divided into CP group and non-CP group according to whether clinical path management was implemented. The two groups of patients with medical clinical indicators and medical quality indicators for comparative analysis. Results: 204 patients (male 92 / female 112) successfully underwent ventricular septal defect repair, 106 in the CP group and 98 in the non-CP group. The mean length of hospital stay, average number of preoperative assessments, average days of antibacterial use, average cost of hospitalization, and average cost of drugs in the CP group were all significantly lower than those in the non-CP group (P <0.01). There was no significant difference in the incidence of complications between the two groups (P = 0.81). Grade A medical records and patient satisfaction were significantly improved (P <0.05). Conclusion: Clinical pathway is an effective way to improve the quality of medical management of ventricular septal defect repair.