临床路径在进展期胃癌手术治疗中的实施效果与评价

目的评价临床路径在进展期胃癌手术治疗中的实施效果。方法选取2012年3月至2013年5月因进展期胃癌行手术治疗的病人为研究对象,其中路径组133例(2012年9月至2013年5月),非路径组52例(2012年3月至2012年9月),路径组采取基于加速康复外科和围手术期营养支持的临床路径模式,非路径组采用传统的治疗模式,对两组病人的住院天数、医疗费用、术后死亡率、术后并发症进行对比分析。结果两组病人间术后死亡率、并发症发生率差异无统计学意义;路径组总住院日为(23.5±6.5)d、术后住院日为(12.6±2.6)d,较非路径组的(26.5±7.6)d和(14.0±2.8)d明显缩短(P0.01);路径组住院费用为(46 610±6 460)元,明显低于非路径组的(51 546±6 780)元,两者差异具有统计学意义(P0.01)。结论实施路径模式能够明显降低进展期胃癌手术病人的总住院日、术后住院日和住院费用。

Impact and evaluation of a clinical pathway on perioperative outcomes in patients undergoing resection for advanced gastric carcinoma

Objective To evaluate the effect of a clinical pathway on perioperative outcomes in patients undergoing resection for advanced gastric carcinomas.Methods 185 cases of advanced gastric carcinomas admitted to our department for resection from March 2012 to May 2013 were categorized into pathway group and non-pathway group.133 patients in the pathway group were managed according to a multidisciplinary program.The clinical outcomes and hospital costs were assessed and compared.Results The two groups were similar in terms of the postoperative mortality and the incidence of complications.The total and postoperative lengths of hospital stay in the pathway group were extremely shorter than in non-pathway group,and the cost of hospitalization in the pathway group was 46 610±6 460 yuan RMB,which was extremely lower than in non-pathway group (51 546±6 780 yuan RMB).Conclusions The clinical pathway can obviously reduce the total and postoperative lengths of hospital stay and the cost of hospitalization for the treatment of advanced gastric carcinomas.