临床路径应用于胆囊结石腹腔镜胆囊切除术的变异分析与管理

目的分析临床路径应用于胆囊结石腹腔镜胆囊切除术的变异情况及管理措施。方法选取我院实施胆囊结石腹腔镜切除术临床路径患者92例，详细记录并说明变异情况，按不同评价方法对变异进行分析。结果正性变异发生率为73．91％，负性变异发生率为26．09％;疾病转归造成的变异发生率为56．52％，医务人员造成的变异发生率为33．70％，医院系统造成的变异发生率为6．52％，病人需求所造成的变异发生率为3．26％：可控变异发生率为43．22％，不可控变异发生率为56．78％。结论通过对胆囊结石腹腔镜胆囊切除术临床路径变异情况的分析，有利于医疗质量持续改进，并为科学制定临床路径提供依据。

Variance analysis and management of clinical pathway applied in gallstone undergoing laparoscopic cholecystectomy

Objective To analyze the variance factors and management measures of clinical pathway applied ih gallstone undergoing taparoscopic cholecystectomy. Methods Select 92 gallstone patients undergoing laparoscopic cholecystectomy of clinical pathway in the hosipital, record and describe variance factors, analyze the variance factors according to different methods of evaluation. Results The incidence of positive variance was 73.91%, the incidence of negative variance was 26.09% ; the incidence of disease outcome was 56.52%, the incidence of medica staff was 33.70%, the incidence of hospital system was 6.52%, the incidence of demand of patients was 3.26% ; the incidence of controllable variance factors was 43.22%, the incidence of uncontrollable variance factors was 56.78%. Conclusion The results suggest that analysis of clinical pathway variance factors for gallstone patients undergoing laparoscopic chotecystectomy are beneficial for continuous medical quality improvement and offer the scientific evidence for developing clinical pathway.