慢性硬膜下血肿临床路径对抗菌药物合理使用的作用

目的探讨慢性硬膜下血肿临床路径对抗菌药物合理使用的影响。方法选取2009年5月至2010年5月,实行临床路径管理之前按照传统医疗模式治疗慢性硬膜下血肿患者64例(对照组);2010年5月至2011年7月实行临床路径管理治疗的慢性硬膜下血肿患者60例(观察组),对照组依照经验预防使用抗菌药物治疗。观察组根据慢性硬膜下血肿的发生及发展的临床特点制定预防应用抗菌药物治疗方案并按照临床路径表开展医疗活动。观察两组患者的住院时间及抗生素的使用情况。结果观察组的住院时间为(8.46±2.67)d,明显低于对照组的(10.88±4.12)d;观察组和对照组的抗菌药物的使用率分别为68.33%、100%,观察组明显低于对照组;观察组抗菌药物的使用时间为(1.58±1.24)d,对照组为(7.64±1.52)d,观察组使用时间明显少于对照组;观察组的抗菌药物的费用是(247.82±89.62)元,相比于历史对照组的(2396.53±158.8)元明显降低,差异均有统计学意义(P0.05)。结论临床路径对于慢性硬膜下血肿的患者而言,在抗菌药物的使用方面具有较好的指导作用。有助于降低抗菌药物的使用率,规范使用时机、疗程,降低抗菌药物的总费用。

Effect of chronic subdural hematoma clinical pathway on the rational usage of antimicrobial agents

Objective The effect of chronic subdural hematoma clinical pathway on the rational using of antimicrobial agents is studied. Methods A total of 64 patients with chronic subdural hematoma treated with traditional medical model were enrolled in control group from May 2009 to May 2010; a total of 60 cases treated with clinical pathway management were enrolled in the observation group from May 2010 to July 2011. The control group took the antibiotics according to the treatment experience, while observation group was treated by a therapeutic schedule about preventive application of antibiotics on the basis of clinical characteristics of the occurrence and development of chronic subdural hematorrka and took the medication according to the clinical pathway. Then the length of hospital stay of two groups and the usage of antibiotics were observed. Results Hospital stay of the observation group was [ （ 8.46 ± 2. 67 ） d I, which was significantly lower than that of control group [ （10. 88± 4. 12） d ]. The rate of using antibiotics in observation and control groups was 68.33% and 100%, respectively. The application period of antibiotics in observation group [ （ 1.58 ± 1.24 ） d ] was shorter than that of control group [ （7.64 ± 1.52 ） d ]. And there was significant difference in the hospitalization expenses between observation group and control group （ P 〈0. 05 ）. Conclusion For patients with chronic subdural hematoma, the clinical pathway plays a good role in guiding the using of antibiotics, which can decrease the hospitalization expenses, reduce the usage of antibiotics, and standardizing the opportunity and treatment course.