[1]郑志黄陈刘堃黄建南许迅孙晓东孙涛.孔源性视网膜脱离日间手术临床路径应用效果探讨[J].中国卫生质量管理,2021,28(04):012-15.[doi:10.13912/j.cnki.chqm.2021.28.4.04 ]
　ZHENG Zhi,HUANG Chen,LIU Kun.Application Effect of Clinical Pathway of Rhegmatogenous Retinal Detachment Ambulatory Surgery[J].Chinese Health Quality Management,2021,28(04):012-15.[doi:10.13912/j.cnki.chqm.2021.28.4.04 ]
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孔源性视网膜脱离日间手术临床路径应用效果探讨
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《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R]

卷:
第28卷
期数:
2021年04期
页码:
012-15
栏目:
特别关注
出版日期:
2021-04-28

文章信息/Info

Title:
Application Effect of Clinical Pathway of Rhegmatogenous Retinal Detachment Ambulatory Surgery
作者:
郑志黄陈刘堃黄建南许迅孙晓东孙涛
上海交通大学附属第一人民医院
Author(s):
ZHENG Zhi; HUANG Chen; LIU Kun
Shanghai General Hospital, Shanghai Jiaotong University
关键词:
日间手术; 临床路径; 孔源性视网膜脱离
Keywords:
Ambulatory Surgery;  Clinical Pathway;  Rhegmatogenous Retinal Detachment
分类号:
R197.323;R774.1
DOI:
10.13912/j.cnki.chqm.2021.28.4.04
文献标志码:
B
摘要:
目的分析孔源性视网膜脱离日间手术临床路径应用效果，为推广日间手术临床路径提供借鉴。方法按照某院眼科拟定的孔源性视网膜脱离日间手术临床路径标准，采集2019年7月-12月诊治的24例日间手术临床路径患者和随机抽取的同期24例普通病房患者资料，分析比较两组患者的一般情况、住院时间、住院费用和诊疗质量等。结果日间手术临床路径患者术前待床日、平均住院日、平均住院费用、平均药品费用均优于普通病房患者（P<0.05）； 两组患者在眼内炎、术后并发症、非计划二次手术人数、出院当天再住院人数和出院后2 d～31 d内再住院人数方面无明显差异（P>0.05）。结论实施孔源性视网膜脱离日间手术临床路径对减轻患者经济负担，控制药占比，保障医疗质量，提高服务效率有明显效果。
Abstract:
ObjectiveTo analyze the effects of clinical pathway of ambulatory surgery for rhegmatogenous retinal detachment (RRD) and provide evidence for promoting the clinical pathway of ambulatory surgery．MethodsAccording to the standard for clinical pathway of ambulatory surgery for RRD designed by the department of ophthalmology in a hospital, 24 patients diagnosed and treated by ambulatory clinical pathway from July to December 2019 and 24 patients randomly selected from general ward during the same period were collected for analysis of general condition, length of stay, cost and quality of diagnosis and treatment between the two groups.ResultsThe bed time before operation, average hospitalization days, average hospitalization costs, and average drug costs of ambulatory pathway patients were superior to those of the ordinary ward patients (P<0.01).There were no significant differences between the two groups in endophthalmitis, postoperative complications, the number of unplanned secondary operations, the number of readmissions on discharge day and the number of readmissions within 2 days to 31 days after discharge (P>0.05).Conclusion The implementation of clinical pathway of ambulatory surgery for RRD can reduce the economic burden of patients, control the drug ratio, ensure the medical quality and improve the service efficiency.

参考文献/References:

［1］于丽华. 中国日间手术发展的历程与展望［J］.中国医院管理,2016,36(6):16-18. ［2］沈坚，吴恵静，滕知轶. 日间手术质量安全管理：上海市第一人民医院的实践［J］.中国卫生质量管理,2018,25(4):4-5, 9. ［3］孙博，刘雷，王东光. 国内日间手术发展进程、存在问题与对策建议［J］.中国卫生质量管理,2018,25(5):17-20. ［4］De Lathouwer C, Poullier JP. How much ambulatory surgery in the World in 1996-1997 and trends［J］.Ambul Surg,2000,8(4):191-210. ［5］Jarrett PE, De Lathouwer C, Ogg TW. The time has come to promote true day surgery［J］.Ambul Surg,2000,8(4):163-164. ［6］俞德梁，宁鹏涛，王娟，等. 关于日间手术定义与首批推荐适宜手术的思考［J］.医学与哲学,2015,36(24):5-7, 14. ［7］曾宪涛，蔡广研，陈香美，等. 制定/修订《临床路径释义》的基本方法与程序［J］.中华医学杂志,2017,97(40):3140-3142. ［8］解放军医学科学技术委员会眼科学分会. 我国眼科日间手术流程专家共识(2018年)［J］.中华眼科杂志,2018,54(12):883-886. ［9］魏誉民，梁苑，吴雁凌，等. 日间病房模式临床路径在白内障诊疗中的应用［J］.中国卫生质量管理,2016,23(4):55-57. ［10］魏誉民，潘健，林晓峰. 支付方式对白内障日间手术开展的影响研究［J］.中国卫生质量管理,2017,24(5):35-37. ［11］刘文雅，魏文斌，宋旭东，等. 老年性白内障日间手术临床路径模式效果分析［J］.中国医院管理,2017,37(9):42-44. ［12］Hilton GF, Josephberg RG,Halperin LS, et al. Office-based sutureless transconjunctival pars plana vitrectomy［J］.Retina,2002,22(6):725-732. ［13］Lee JC, Kim YC. Outpatient- and inpatient-based buckling surgery: a comparative study［J］.Clin Ophthalmol,2014,8:793-797. ［14］Zheng Y, Chen J, Zhong L, et al. Unplanned readmission after ocular trauma ambulatory surgery: a retrospective study of the Zhongshan Ophthalmic Center［J］.Journal of Evaluation in Clinical Practice,2019,25(5):822-826. ［15］Dotan A, Johnson D, Kherani A, et al. Success rates for retinal detachment repair in alberta: a physician learning program initiative［J］.Ophthalmologica,2019,241(3):170-172. ［16］Kontos A，Williamson TH.Rate and risk factors for the conversion of fovea-on to fovea-off rhegmatogenous retinal detachment while awaiting surgery［J］.Br J Ophthalmol，2017，101（8）：1011-1015. ［17］程洪霞.临床路径在眼科手术中的应用［J］.医学信息（下旬刊），2010，23（2）：40-41.

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更新日期/Last Update: 2021-04-28