儿童腹股沟疝快速康复临床路径的应用价值

目的：观察快速康复临床路径治疗儿童腹股沟疝的安全性及应用价值。方法回顾性分析2013年1月至2014年2月，南方医科大学附属南海医院入院的腹股沟疝患儿170例，按照是否进入快速康复临床路径分为快速康复路径组（观察组）和普通临床路径组（对照组）。观察组患儿（86例）采用快速康复临床路径，对照组患儿（84例）采用普通腹股沟疝临床路径。比较二组患儿的复苏时间、术后不良反应、并发症、住院时间、住院费用。结果二组患儿均无并发症出现。观察组复苏时间为（9±4）min，对照组复苏时间（18±9）min，二组比较差异有统计学意义（t＝－23．686，P＝0．00）；观察组术后不良反应发生率为9．3％，对照组为23．8％，二组比较差异有统计学意义（χ2＝6．501，P＝0．11）；观察组住院时间（1．2±0．2）d，对照组住院时间（2．9±0．7）d，二组比较差异有统计学意义（t＝－25．646，P＝0．00）；观察组住院费用（4864±360）元，对照组住院费用（5311±463）元，二组比较差异有统计学意义（t＝－7．340，P＝0．00）。结论快速康复临床路径应用于儿童腹股沟疝治疗是安全可行的，利于患儿的快速康复并减少住院时间，减轻患者家属的经济负担。

The application of fast-track clinical pathway for pediatric inguinal hernia

Objective To evaluate the feasibility and clinical value of fast-track clinical pathway for pediatric inguinal hernia.Methods The children with inguinal hernia who were admitted to the Nanhai Hospital of Southern Medical University from January 2013 to February 2014 were randomly divided into two groups：fast-track clinical pathway group （n=86,as observation group）and general clinical pathway group （n=84,as control group）.The recovery time,adverse reactions,complications,length of stay and cost of hospitalization were compared between these two groups.Results There were no complications in the two groups.Compared with the control group,the fast-track clinical pathway group had shorter recovery time （18 ±9 minutes：9 ±4 minutes,t =-23.686,P=0.00）,less postoperativeadversereactions （23.8%：9.3%,χ2 =6.501 ,P=0.1 1 ）,shorter length of stay （2.9 ±0.7 days：1 .2 ±0.2 days,t=-25.646,P=0.00）and less hospitalization cost （5 311 ±463 yuan：4 864 ±360 yuan,t =-7.340,P=0.00）. Conclusion Fast-track clinical pathway for pediatric inguinal hernia is safe and feasible.It can shorten hospitalization time and reduce medical costs.