小儿支气管肺炎实施中西医结合临床路径方案效果分析
2017,49(10):104-106
摘要：目的:观察小儿支气管肺炎实施中西医结合临床路径方案的临床效果。方法:纳入430例小儿支气管肺炎的病历资料,观察组258例为进入临床路径组的患儿,对照组172例为非临床路径干预的患儿。对比2组住院天数、住院总费用、中医中药的应用情况及抗生素使用情况,比较2组患者发热、咳嗽、气促、肺部啰音的消失时间,评估临床疗效。结果:观察组的住院天数及住院总费用均少于对照组(P<0.05),中成药、经皮导入治疗、穴位贴敷、推拿的使用率均高于对照组(P<0.01)。2组中药汤剂及其他疗法的使用率比较,差异均无统计学意义(P>0.05)。观察组头孢类抗生素、大环内酯类抗生素及2种或2种以上抗生素的使用率均低于对照组(P<0.01),咳嗽、发热、气促及肺部啰音消失时间均短于对照组(P<0.05)。观察组总有效率96.9%,高于对照组的92.4%,差异有统计学意义(P<0.05)。结论:小儿支气管肺炎患儿在实施中西医结合临床路径管理后,可规范诊疗行为,缩短住院天数,降低住院费用,提高临床疗效。
关键词：支气管肺炎; 小儿; 中西医结合; 临床路径; 抗生素; 住院时间;
Abstract：Objective：To observe the clinical effect of clinical pathway of integrated Chinese and western medicine therapy for bronchitis in children.Methods：Divided 430 cases of children with bronchitis into the observation group with 258 cases intervened by clinical pathway and the control group with 172 cases not being intervened by clinical pathway.Compared hospitalization days，total cost of hospitalization，application of Chinese medicine，and use of antibiotics in both groups.Compared the disappearance time of fever，cough，short breath，and lung rale in both groups，and evaluated the clinical effect.Results：Hospitalization days and total cost of hospitalization in the observation group were both less than those in the control group(P＜0.05).The usage rate of Chinese patent medicine，percutaneous administration，point application，and massage in the observation group was all higher than that in the control group(P＜0.01).Compared the usage rate of Chinese medicine decoction and the usage rate of other therapies between the two groups，there was no significance in the difference(P＞0.05).The usage rate of cephalosporins antibiotics，macrolide antibiotics，and two or more than two types of antibiotics in the observation group was all lower than that in the control group(P＜0.01).The disappearance time of fever，cough，short breath，and lung rale in the observation group was all shorter than that in the control group(P＜0.05).The total effective rate was 96.9%in the observation group，being higher than 92.4%in the control group(P＜0.05).Conclusion：The clinical pathway of integrated Chinese and western medicine therapy for bronchitis in children can regulate diagnosis and treatment behaviors，shorten hospitalization days，reduce hospitalization cost and enhance the clinical effect.
Key words：Bronchitis；Children；Integrated Chinese and western medicine therapy；Antibiotics；Clinical pathway；Hospitalization days
收稿日期：
基金项目：广东省中医院中医药科学技术研究专项资助项目（YK2013B2N18）
