妇科腹腔镜手术病人实施临床路径的效果评价

目的探讨临床路径（CP）在妇科腹腔镜手术病人中实施的效果与可行性。方法回顾性调查收集2008年6—7月妇科腹腔镜治疗病人196例的资料，分析制定CP（医护版和病人指导版），由有关专家审查确认后用于临床；分别收集开展CP前1个月96例病人（对照组）和开展CP后100例病人（实验组）的资料，分析两组病人的住院天数和费用、病人满意度，并实施CP后变异因素的分析。结果实验组平均住院天数（6．47±2．53）d，对照组（8．38±2．01）d；住院费用实验组（9080．62±139．12）元，对照组（9655．08±186．31）元，P均〈0．05；路径变异因素主要与医护人员的主观认识和病人对疾病的认识有关。结论CP能缩短住院天数、降低医疗费用、保证医疗护理质量、提高工作效率，更加受到护士的欢迎。

Effect evaluation of clinical nursing paths method on patients with gynaecological laparoscope operation

Objective To explore the clinical pathway (CP) in gynecology laparoscopic surgery patients in the implementation effect and feasibility. Methods 200 patients with gynaeeological laparoscope operation were analyzed retrospectively from June to July 7 in 2008. The CP, and the relevant guidelines were applied to clinics after clinical experts' confirmation. 96 cases before CP (control group) and 100 cases after CP (experimental group ) were collected and analyzed including hospitalized days and expenses, patient satisfaction, and variation factors of implementing CP. Results The average of hospitalized days were (6.47± 2.53 ) d in experimental group and 8.38 ± 2.01 d in the control group. The hospitalization expenses were $ (9 080.62 ± 139.12 ) in experimental group and $ ( 9 655.08 ± 186.31 ) in the control group ( P < 0. 05 ). Variation factors of CP were mainly included medical personnel and patients with subjective understanding on the disease. Conclusions CP is helpful to reduce the hospitalized days, shorten the medical expenses, and ensure the quality of medical care, improve work efficiency, even were welcomed by the nurse.