慢性肾脏病3～5期中西医结合临床路径效果分析

目的:探讨慢性肾脏病3～5期中西医结合临床路径实施效果。方法:采用非同期历史对照,观察路径组和回顾性病案组住院天数、住院费用、肾功能指标情况。结果:经临床路径规范管理后,患者的住院天数较回顾性病案组(非路径组)缩短(P=0.008),路径组总费用较高于回顾性病案组总费用(P=0.100),其中中药费(P>0.05)、中成药(P<0.05)、化验费(P<0.05)较回顾性病案组升高。西药费(P>0.05)、检查费(P<0.05)较回顾性病案组降低。肾功能指标两组均有改善,组间比较无差异(P>0.05)。结论:慢性肾脏病3～5期中西医结合临床路径能缩短住院天数,有助于医疗费用的合理支出。其对于肾功能指标的改善仍有待长期的随访研究和开展平行对照研究进一步证实。

The effect of integrated chinese and western medicine clinical pathway for chronic kidney disease 3-5 stage

Objective To explore the effect of integrated chinese and western medicine clinical pathway for chronic kidney disease 3-5 stage.Methods The hospital stay,hospital expenses and kidney function were compared between the clinical pathway group and historical control group.Result The hospital stay was shorter and the total hospital expenses were higher in clinical pathway group than that in control group.In the clinical pathway group,the costs of Chinese medicine and laboratory fees were higher,the medicine fees and examination fee were lower than that in the control group.Kidney function improved in both groups,but without significant differences between the two groups.Conclusions Integrated chinese and western medicine clinical pathway for chronic kidney disease 3-5 stage can shorten the days in hospital,and help to cost medical expenses reasonably.The kidney function remains to be proved by long-term follow-up and head to head trial.