临床路径实施在手足口病治疗中的疗效评估

目的引入新的临床指标评估实施临床路径前后手足口病患者的临床疗效。方法将临床收治的509例手足口病患者随机分成观察组和对照组,其中观察组366例,对照组143例。对照组按手足口病诊疗指南(2010年版),观察组按我院手足口病诊疗指南、参考其他医院对于此病的治疗方案以及结合以往的治疗经验制定的临床路径实施诊疗,通过比较两组平均体温恢复时间、平均血常规白细胞恢复时间、平均住院天数及平均住院费用等指标评估临床路径实施后的临床疗效。结果观察组和对照组在临床路径实施前后,平均体温恢复时间、平均血常规白细胞恢复时间、住院天数、住院费用等差异均有统计学意义(P0.05)。结论在手足口病治疗中,制定临床路径有助于减少患者的住院天数及住院费用,缩短体温恢复时间及血常规白细胞恢复时间,但仍需更多循证医学证据进一步论证。从长远上,临床路径实施有助于规范诊疗行为,优化护理服务流程,防止院内感染的发生,使临床资源得到更好的分配。

Effect of clinical pathway on treatment of patients of hand-foot-mouth disease

Objective To assess the clinical efficacy of clinical pathway for treatment of hand-foot-mouth disease （HFMD） cases. Methods The 509 clinical HFMD patients were randomly divided into experiment group （n=366） and control group （n=143）. The patients in control group was treated according to HFMD Guideline （2010 edition）, while those in the experiment group were treated with clinical pathway which was formulated based on the HFMD of Nanshan Hospital, therapeutic schedule of other hospitals and previous treatment expreience. The average body temperature recovery time, the average recovery time of blood leukocyte, the duration of average hospitalization and the average cost of hospitalization were compared between two groups. Results The duration of average temperature recovery, the average blood leukocyte recovery time, days of hospital stay and hospital costs in case group and control group were statistically significant （P〈0.05）. Conclusion Clinical pathways can help reduce the length of stay and hospital costs, shortening the recovery time of body temperature and blood leukocytes, but more evidence need to be further provided. Clinical pathway might help people standardize clinical behavior, optimize care service processes, prevent nosocomial infection, and allocate rationally the clinical resources .