临床路径应用于慢性鼻窦炎内窥镜术的效益评价

目的为了评估慢性鼻窦炎的内窥镜鼻窦手术临床路径的临床有效性、住院费用、临床安全性、病人和家属的满意度情况。方法回顾性分析2005年8月～2006年8月所有纳入的慢性鼻窦炎行鼻窦内窥镜手术治疗的病人,并同之前两年的相同手术的病人的情况相比较,包括住院时间、住院总的费用、病人及家属的满意度等。结果平均住院时间由前两年的9.3和9.2天降为6.4天(p<0.05);住院费用由前两年的7866.3元和7654.9元降为7195.6(元)(p<0.05);满意度由前两年的93%和95%升为96%(p<0.05)。结论慢性鼻窦炎内窥镜鼻窦手术的临床路径的制定有利于该病的规范性治疗,可缩短住院时间,减少住院费用,增加病人及家属的满意度。

EVALUATION OF THE BENEFIT OF IMPLEMENTING CLINICAL PATHWAY TO ESS

Objective To assess the clinical validity, expenditure in hospital, clinical safety and satisfactory degree of patients and household after Endoscopic Sinus Surgery (ESS)for chronic sinusitis(CS) according to clinical pathway for one year. Methods We retrospectively analyze all patients who underwent ESS for CS from August 2005 to August 2006, compared with patients who underwent the same surgery without clinical pathway in the prior two years, parameters measured included the time in hospital, the total expenditure, the satisfactory degree of patients and household. Results Compared with two years ago ,the mean time in hospital decreases to 6.4 days from 9.3,9.2 days(p<0.05);the expenditure decreases to 7 195.6(yuan) from 7 866.3,7 654.9(p<0.05),the satisfactory degree rises to 96% from 93%,95%(p<0.05). Conclusion The establishment of clinical pathway for CS with ESS is propitious to form normative treatment of this disease, abbreviate the time in hospital, reduce the expenditure in hospital, and increase the satisfactory degree of patients and household, respectively.