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目的研究自然分娩临床路径的应用情况,针对具体情况提出合理化改进措施。方法采用1:1病例对照研究方法,选取2012年1月-2015年12月期间纳入自然临产阴道分娩临床路径的产妇为临床路径组,对照严格按年龄、民族、职业、孕次、孕周、新生儿体重、付费方式进行匹配。运用SPSS17.0对两组平均住院日、费用情况以及产妇满意率进行统计分析。结果病例对照共55对,两组研究对象在匹配变量年龄、孕周、新生儿体重差异无统计学意义(P>0.05),具有可比性。实施临床路径后,临床路径组的住院天数由4.07天下降到2.11天,住院总费用由2162.44元下降到1728.76元,两组在住院天数和住院总费用方面比较有统计学意义(P<0.05)。临床路径组产妇对检查预约时间、治疗与病情的知情、治疗决定的知情和此次治疗4个方面的满意率高于对照组的满意率,差异具有统计学意义(P<0.05)。结论产科实施临床路径后,平均住院日下降,住院费用也得到有效的控制,提高产妇满意率的同时增进了医患沟通。但在临床路径告知方面还有所欠缺,需要改进。
Objective To study the application of clinical path of natural childbirth and put forward reasonable measures to improve the specific situation. Methods A 1: 1 case-control study was conducted in this study. Maternal women included in the clinical pathway of spontaneous vaginal delivery during January 2012 to December 2015 were selected as the clinical pathway group. The control group was strictly controlled according to age, ethnicity, occupation, pregnancy time, gestational age, Neonatal weight, pay to match. SPSS17.0 was used to analyze the average length of stay, cost and maternal satisfaction rate in two groups. Results A total of 55 case-control cases, two groups of subjects in the matching variables age, gestational age, newborn weight difference was not statistically significant (P> 0.05), comparable. After the implementation of the clinical pathway, the hospitalization days of the clinical pathway group decreased from 4.07 days to 2.11 days, and the total cost of hospitalization decreased from 2162.44 yuan to 1728.76 yuan. The two groups had statistically significant differences in the days of hospitalization and total hospitalization (P0.05) . Clinical pathology group of maternal examination appointment time, the treatment and the condition of the informed, the decision-making informed and the treatment of four aspects of the satisfaction rate was higher than that of the control group, the difference was statistically significant (P <0.05). Conclusion Obstetric implementation of clinical pathways, the average hospital stay decreased, hospitalization costs have been effectively controlled, improve maternal satisfaction rate, while improving communication between doctors and patients. However, there are still some shortcomings in the clinical path of notification, which needs improvement.