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目的:讨论乳腺癌围术期患者应用中西医结合单病种临床路径管理的作用。方法:选取2012年3月~2015年6月期间常山县人民医院收治的患者130例,所有患者均经临床诊断为原发性乳腺癌可进行手术者,采用随机数字表法将其分观察组和对照组,每组各65例,观察组患者行围术期中西医结合单病种临床管理模式,对照组患者接受常规围术期管理,比较两组患者住院费用、手术情况及临床路径变异情况。结果:观察组发生临床路径变异16例,未发生中途退出患者。观察组检查费、治疗费、中成药费及日平均费用明显低于对照组(P<0.05),观察患者麻醉相关并发症、手术相关并发症虽低于对照组,但差异无统计学意义(P<0.05),两组均无1例非计划转入ICU,观察组患者满意度虽高于对照组,但差异亦无统计学意义(P>0.05),观察组等候天数及住院天数明显短于对照组(P<0.05)。结论:临床路径应用于乳腺癌围术期患者中西医结合单病种管理可有效降低患者住院费用,缩短住院时间,进一步提高医院服务质量。
Objective: To discuss the role of clinical pathway management in the application of integrated Chinese and Western medicine in perioperative patients with breast cancer. Methods: A total of 130 patients admitted to Changshan County People’s Hospital from March 2012 to June 2015 were enrolled. All patients were clinically diagnosed as primary breast cancer and were treated by random number table. The patients were divided into observation group And control group, 65 cases in each group. The patients in the observation group underwent perioperative clinical management of single disease with integrated traditional Chinese and western medicine. The patients in the control group underwent routine perioperative management. The hospitalization costs, operation conditions and clinical pathological changes of the two groups were compared . Results: There were 16 cases of clinical pathological changes in the observation group without exiting the patients. In the observation group, the examination fees, the treatment fees, the costs of proprietary Chinese medicines and the daily average cost were significantly lower than those in the control group (P <0.05). The anesthesia-related complications in the observation group were lower than those in the control group, but the differences were not statistically significant P <0.05). None of the two groups were transferred into the ICU unplanned. The satisfaction of the observation group was higher than that of the control group, but the difference was not statistically significant (P> 0.05). The observation group’s waiting days and hospitalization days were significantly shorter In the control group (P <0.05). Conclusion: The application of clinical pathology in the management of patients with breast cancer during the integration of TCM and WM can reduce the hospitalization costs, shorten the length of hospital stay and further improve the quality of hospital services.