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目的引用不同参数比较输尿管结石实施临床路径模式与传统治疗模式的不同及原因分析。方法 164例输尿管结石分四组:A组为临床路径治疗单纯结石,B组为临床路径治疗结石合并其他疾病,C组为传统模式治疗单纯结石,D组为传统模式治疗结石合并其他疾病。全部病例均在各类麻醉下使用输尿管硬镜弹道碎石术。A组56例,B组30例,C组46例,D组32例。采用统计学方法从术前平均住院日、平均住院日、住院总费用、药占比、抗生素比、患者满意度调查等各参数进行比较。结果 A组各指标均优于B、C、D三组,差异有统计学意义(P<0.05);B组各指标与C组持平(P>0.05);B、C两组各指标均优于D组,差异有统计学意义(P<0.05)。结论无合并其他疾病的单纯输尿管中下段结石实施临床路径模式治疗效果较好,总体疗效满意,临床路径模式还需进一步完善。
Objective To compare the differences between the clinical path model and the traditional treatment model with different parameters in comparison with ureteral calculi and analyze the causes. Methods A total of 164 cases of ureteral calculi were divided into four groups: group A was treated by simple pathology, group B was treated by clinical pathology combined with other diseases, group C was simple stone treated by traditional model, and group D was treated by conventional model with stones and other diseases. All cases were ureteroscopic lithotripsy under various anesthesia. 56 cases in group A, 30 cases in group B, 46 cases in group C and 32 cases in group D. Statistical methods were used to compare the average length of preoperative stay, the average length of stay, the total cost of hospitalization, the proportion of drugs, the ratio of antibiotics, and the patient satisfaction survey. Results The indexes of group A were better than those of group B, C and D (P <0.05), and the indexes of group B were the same as those of group C (P> 0.05). The indexes of group B and C were superior In group D, the difference was statistically significant (P <0.05). Conclusions The treatment of middle and lower ureteral calculi in the middle and lower ureter without consolidation of other diseases is better in clinical path mode, and the overall curative effect is satisfactory. The clinical path model needs to be further improved.