腹腔镜胆囊切除术临床路径实施效果评价
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史勇,E-mail:maren517@163.com

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Effect of clinical pathways in laparoscopic cholecystectomy surgery
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    目的 评价分析腹腔镜胆囊切除术临床路径实施效果。 方法 回顾性研究分析从2008年5月至2013年7月该院做为卫计委西部地区内镜与微创专业技术培训基地总共实施腹腔镜胆囊切除术440例,从2009年11月开始实施临床路径管理,至今完成260例手术。笔者与路径前160例手术对比分析平均手术时间、平均住院天数及并发症。 结果 平均住院天数路径组较路径前组明显缩短(1.9±0.4) vs (2.5±0.9)d,P <0.01,平均手术时间也缩短(22±4) vs (35±6)min,P <0.01,手术并发症相应减少(6.2% vs 10.6%,P <0.01)。 结论 实施临床路径是一种有效的医院医疗管理标准化模式,能提高效率,降低费用优化资源,同时减少手术并发症。

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    【Objective】 To review the effects of a laparoscopic cholecystectomy clinical pathway. 【Methods】 This retrospective and comparative study was performed on all patients undergoing laparoscopic cholecystectomy over a 5-year period. This period covered the 30 months prior to the introduction of the pathway (CP group), and the 30 months following its introduction (pre pathway group).【Results】There was a significant reduction in the length of hospital stay of pathway group patients [(CP group (1.9±0.4)d vs. pre-CP group( 2.5±0.9)d, P <0.01]with these pre-pathway group patients. Median operative time was significantly shorter in the CP group [CP group (22±4)min vs. pre-CP group (35±6)min, P <0.01]. There was significant difference in mortality, morbidity, and re-admissions (CP group 6.2% vs. pre-CP group 10.6%, P <0.01). 【Conclusion】 Clinical pathway implementation resulted in a significant reduction in the length of stay, morbidity, re-admissions and achieved a more efficient management of hospitalized patients without compromising outcome.

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史 勇,杨 森,顾 霞.腹腔镜胆囊切除术临床路径实施效果评价[J].中国内镜杂志,0,():639-641

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  • 收稿日期:2014-01-06
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