慢性心力衰竭中西医结合临床路径构建及实施

目的评价慢性心力衰竭中西医结合临床路径对住院天数、住院费用及临床疗效的影响。方法制订慢性心力衰竭中西医结合临床路径表，选择2006年7月-2007年10月慢性心力衰竭病人160例分为2组，中西医结合临床路径组（治疗组）87例按路径表实施诊疗过程，平行对照组73例按习惯完成治疗；同时筛选2005年12月-2006年6月符合本研究条件的病人74例，作为历史对照组，经统计学检验，比较路径实施后患者平均住院日、住院总费用及临床疗效包括心功能NYHA分级、6min步行试验、心率、左室射血分数等的变化。结果治疗组与平行对照组相比，平均住院天数减少3天（P〈0．01），住院总费用呈减少趋势（P〈0.05），临床疗效有所提高（P〈0．05）。治疗组与历史对照组相比，平均住院天数无差别（P〉0．05），住院总费用明显减少（P〈0.01），临床疗效显著提高（P〈0．01）。结论实施慢性心力衰竭中西医结合临床路径能够提高医疗质量。

Construction and Implementation of Integrated Traditional Chinese and Westem Medicine Clinical Pathway Patients with Chronic Heart Failure

Objetive To study the effect of construction and implementation of integrated traditional Chinese and western medicine clinical pathway patients with chronic heart failure .Methods Making a special form of integrated traditional Chinese and western medicine clinical pathway patients with chronic heart failure. The study was conducted in 160 patients. They were randomly divided into 2 groups: treatment group ( n=87) and parallel control group (n=73). In treatment group, the therapy including conventional treatment and TCM treatment; but in parallel control, basic therapy was given in the same way as in treatment group. The third group was the history control group ( n=74) therapy including conventional treatment study from December of 2005 to June of 2006. Result Compared with the parallel control group, the treatment group shortened hospitalization time, decreased hospitalization expenditure and increase healing effect. Conclusion Implementation of integrated traditional Chinese and western medicine clinical pathway patients with chronic heart failure will promote medical treatment quality.