临床路径在腹膜透析相关性腹膜炎的应用价值

【目的】探讨临床路径在腹膜透相关性腹膜炎患者治疗中的应用效果。【方法】将在本科住院的2012年7月起至2013年7月启用临床路径的腹膜透析相关性腹膜炎49例患者（试验组）与2011年6月至2012年6月未启用临床路径前的腹膜透析相关性腹膜炎的49患者（对照组）进行研究，观察比较两组患者腹透液培养的阳性率、腹透液转清的时间、住院天数及住院费用及复发情况等方面的差异。【结果】两组患者治疗前临床相关指标相比较无明显差异，试验组腹透液细菌培养阳性率稍高于对照组，但两组相比较差异无显著性（P＞0．05）；试验组腹膜透析液检测好转及恢复正常时间均低于对照组，住院天数和人均住院费用较对照组显著降低，腹膜炎复发显著减少，且两组相比较差异均有显著性（P＜0．05）。【结论】在腹膜透析腹膜炎的治疗中采用临床路径，可促进患者的临床好转、减少了患者的住院天数及住院费用，并能显著减少腹膜炎复发，值得临床推广应用。

Value of Clinical Pathway in Peritoneal Dialysis-related Peritonitis

Obj ective]To explore the efficacy of clinical pathway in the treatment of patients with perito-neal dialysis-related peritonitis.Methods]Totally 49 patients with peritoneal dialysis-related peritonitis who were enrolled into clinical pathway in our department from July 2012 to July 2013 and 49 patients with perito-neal dialysis-related peritonitis patients who were not enrolled into clinical pathway from June 2011 to June 2012 were investigated.The positive rate of dialysate culture,the time of dialysate into clear liquid,hospital day,hospitalization expensens and recurrence in two groups were observed and compared.Results]There was no significant difference in clinical indexes between two groups before treatment.The positive rate of dialysate culture in the experiment group was slightly higher than that in control group,but there was no significant difference between two groups（P〉0.05）.The time of dialysate turning better or normal in experiment group was lower than that in control group.Compared with the control group,the hospital day,per capita hospitali-zation expenses and the recurrence of peritonitis in experiment group were markedly decreased,and there were significant differences between two groups（P〈0.05）.Conclusion]Clinical pathway in the treatment of per-itoneal dialysis-related peritonitis can promote clinical improvement,reduce hospital day and hospitalization ex-penses and decrease the recurrence of peritonitis.Therefore,it is worthy of clinical promotion.