我国临床路径研究现状及热点探析

目的：采用文献计量学方法分析我国临床路径的发布历程、实施现状及前沿趋势，旨在为临床路径的进一步实施与管理提供理论指导和参考。方法：对原国家卫生计生委发布的临床路径进行统计，从发布时间和临床路径的分类、版本、更新等角度进行分析，并对中国知网和万方数据知识服务平台收录的有关临床路径研究的期刊论文从年代、关键词等角度进行统计分析。结果：2009年以来，原国家卫生计生委已发布临床路径1 212个，覆盖20个病种、11类手术操作，其中通用版本996个、县医院适用版216个，并对85个临床路径进行了更新。目前我国临床路径年发文量稳定在800篇左右，研究处于稳定发展阶段。60%以上的临床路径在临床工作中得以实施，应用最多的是糖尿病、子宫肌瘤、剖宫产等临床路径，仍有近1/3的临床路径未见相关的应用报道。临床路径研究涉及六大领域。结论：有条件的医院应进一步扩大临床路径管理的范围及深度，将更多的病种纳入临床路径试点，为临床路径工作的开展提供有针对性的反馈意见。

Status quo and hotspots in studies on clinical pathways in our country

Objective To analyze the issuing date, implementation and frontiers of clinical pathways in our country by bibliometrics in order to provide theoretical guidance and reference for the implementation and management of clinical pathways. Methods The clinical pathways issued by the National Health and Family Planning Commission of People''s Republic of China were recorded. The issuing date, classification, editions, update of clinical pathways, and the publication time (year) of papers on clinical pathways and the key words in papers on clinical pathways from CNKI and Wanfang data service platform were analyzed. Results A total of 1212 clinical pathways have been issued by the National Health and Family Planning Commission of People''s Republic of China since 2009, which covered 20 kinds of disease, 11 types of surgical procedure, 996 general editions and 216 county hospital editions, and updated 85 clinical pathways. About 800 papers on clinical pathway were published each year, indicating that the studies on clinical pathway have come into a stable period. Over 60% of clinical pathways have been implemented in clinical practice. The clinical pathways were most frequently used in diabetes mellitus, hysteromyoma and cesarean section. However, no report was found on application of nearly 1/3 of clinical pathways. Six fields were involved in studies on clinical pathways. Conclusion The qualified hospitals should further expand the scope and depth of clinical pathways, bring more kinds of disease into clinical pathway experiments and provide feedback for the implementation of clinical pathways.