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目的探讨新型腹腔镜胆囊切除术住院临床路径在临床中应用和可行性及对医疗质量效益的影响。方法回顾性分析2010年4月-2011年3月因胆囊结石合并慢性胆囊炎住院拟行腹腔镜切除术患者60例,采用随机对照的方法将其分成两组,每组各30例。其中A组采用临床路径治疗,B组非临床路径治疗,比较两组患者平均住院日、平均住院费用、术前等待时间等指标在两组间有无差异。结果纳入临床路径患者住院费用比未纳入者有所下降,平均住院日、术前等待时间缩短,差异有统计学意义(P=0.000),而术后并发症发生两组间无明显差异。结论临床路径具有良好的实用性,能够在保证医疗安全的情况下提高各项医疗指标,提高医疗效益,值得进一步推广。
Objective To investigate the clinical application and feasibility of new laparoscopic cholecystectomy in hospital and the impact on quality and medical benefits of laparoscopic cholecystectomy. Methods A retrospective analysis of 60 cases of hospitalized patients with gallbladder stones and chronic cholecystitis who underwent laparoscopic surgery from April 2010 to March 2011 was performed. The patients were divided into two groups (30 cases in each group) by randomized controlled method. Among them, group A was treated by clinical route, and group B was treated by non-clinical route. The mean hospital stay, average hospitalization cost and preoperative waiting time were compared between the two groups. Results Compared with the non-enrolled patients, the average length of hospital stay and the waiting time before operation were shorter in the clinical pathway patients (P = 0.000). There was no significant difference in postoperative complications between the two groups. Conclusion The clinical path has good practicability. It can improve various medical indexes under the circumstance of ensuring medical safety and improve medical benefit, which deserves further promotion.