子宫切除术的临床路径变异分析及改进措施

目的分析临床路径应用于子宫切除术中的变异情况和改进措施。方法选取我院进入临床路径并实施开腹或腹腔镜两种途径行子宫切除术的病例共150例，详细记录并说明变异情况，按变异的性质进行评价并分类统计。结果无变异16例（16／150），中途退出路径管理11例（11／150），发生变异134例（134／150），共发生261次变异。其中正性变异39次（39／261），负性变异222次（222／261）。结论通过对子宫切除术-临床路径变异情况的分析，有利于医疗质量的持续改进，制定出更加科学合理的临床路径。

Analysis and Improvement Measures for Clinical Pathway Variation for Hysterectomy

Objective To analyze the application result of clinical pathway in hysterectomy and the variation of the pathway so as to put forward improvement measures. Methods 150 cases received hysterectomy by laparoscopy or laparotomy managed by clinical pathway and their variations were recorded in detail and analyzed statistically on the basis of the variation categories. Results There was no variation in 16 cases （16/150）; 11 patients dropped out of clinical pathway （11/150）; variation was found in 134 cases （134/150）, and the total number of variations were 261 times, of which 39 were positive variations （39/261） and 222 were negative variations （222/261）. Conclusion The analysis of clinical pathway variations in the hysterectomy is beneficial to the continuous quality improvement of medical service and making more effective and scientific clinical pathway.