【作者】 王磊； 张敏州； 张军； 杨广； 唐光华； 郭力恒； 陈全福； 张俭；

【机构】 广东省中医院；

【摘要】 目的:探讨急性心肌梗死(acute myocardial infarction,AMI)中西医结合临床路径的构建和疗效评价;方法:采用非同期队列研究,在治疗指南和益气活血法的基础上,建立AMI中西医结合临床路径,根据临床路径实施前后分为治疗组(临床路径组,71例)和对照组(非临床路径组,70例),观察两组的住院时间和住院费用,对于行直接PCI的亚组患者,记录其就诊-球囊扩张(door-to-balloon,DTB)时间;结果:治疗组住院时间低于对照组(9.80±5.62天vs.12.01±7.35天,P=0.047),两组住院费用无统计学差异。对于行PCI的亚组患者,治疗组的DTB时间(82.56±17.36分钟vs.119.19±30.88分钟,P<0.001)、住院时间(9.69±5.59天vs.13.34±7.49天,P=0.005)和住院费用均低于对照组。结论:以益气活血法为基础的急性心肌梗死中西医结合临床路径,可以降低AMI住院时间,控制直接PCI患者的住院费用和DTB时间,充分体现出中西医结合临床路径在AMI医院管理和质量控制方面的价值。更多还原

【Abstract】 Objective:To research the method of construction and evaluate the efficiency of clinical pathway based on Integrated Medicine for patients with acute myocardial infarction(AMI).Methods:The clinical pathway of AMI was designed based on the guidelines and experience of benefiting vital Qi and promoting blood circulation.The study performed retrospective cohort study of patients with AMI who were divided into therapy group(71 patients )and control group(70 patients) corresponding to the periods before and after the implementation of the clinical pathway.The length of stay,cost of hospitalization in both groups and door-to-balloon(DTB) time in subgroup which received primary PCI were analyzed.Results:The length of stay of therapy group was lower than that in control group(9.80±5.62 days,12.01±7.35 days,respectively,P=0.047).There was no statistical difference in the costs of hospitalization between two groups.In subgroup of patients underwent PCI,the DTB time(82.56±17.36min,119.19±30.88min,respectively,P<0.001),length of stay(9.69±5.59days,13.34±7.49days,respectively,P=0.005)and costs of hospitalization in therapy group were all smaller than those in control group.Conclusions:The clinical pathway based on the therapy of benefiting vital Qi and promoting blood circulation could decrease the length of stay of patients with AMI and reduce the DTB time and costs of hospitalization for patients underwent primary PCI,which reveals that clinical pathways play key role in quality control and management for AMI.更多还原