ClinicalⅠ Pathway Of Hemorrhagic Stroke With Integrated Chinese And Western Medicine

Objectives1.To construct the hemorrhagic stroke and Western medicine clinical pathway;2. The hemorrhagic stroke and Western medicine clinical pathway applied to clinical, preliminary discussion of the hemorrhagic stroke and Western medicine clinical pathway has exerted the practical significance in specifying the process of diagnosis and treatment, enhancing the clinical outcomes and medical quality, shortening the hospital days, lowering the hospitalization costs, advancing the reasonably utilization of medical resources, increasing patient satisfaction and has provided experience for making and practicing clinical pathway of other diseases.Methods1. Review research method:with the help of information system, we retrieved the information on hemorrhagic stroke patients from October 2007 to January 2009,and in order to better effect on the basis of the study, according to the theories and methods such as Evidence—based Medicine, Vilfredo Pareto Principle and so on, the research designed the hospitalization time, contents and items in diagnosis and treatment flow of clinical pathway.2.Randomized study of method:will the hospital emergency department and the Department of Neurology meet inclusion standards of patients into experimental groups and control groups.The experimental group in accordance with clinical diagnosis and care, the path to the control group, according to the conventional treatment and care. Through the hospital information system to collect information on the diagnosis and treatment of hospitalized patients. After a period of practice,systematic analysis and evaluation of the data by the hospital information system were conducted, the actual number of days in hospital to the patient, hospital fees, clinical outcomes, satisfaction and nursing execution, evaluation and analysis.Results1. Construction research draw an item at random 120 example patient's case of illness carries on the review investigation, male 68 examples, female 52 examples, age 35～90 years old, average age 64.25±11.92 year old; 12 example cures,87 examples change for the better,6 examples have not recovered,15 example deaths.The in hospital number of days median is 14 days.Carries on the reorganization to the sample case of illness doctor's advice project information after the classification the altogether 59 items, uses 59 items in the ratio to be bigger than 80% project to take the selected project, altogether 48 items.According to already the standard in hospital number of days which determined, the doctor's advice class and the non-doctor's advice class project content, has formulated the hemorrhagic stroke the cooperation of Chinese and Western medicine clinical pathway.2. In Clinical research,67 cases were collected and among them the experiment group was 34 cases, the control group was 33 cases. The baseline of two groups was camparable, which included sex, age, Clinical nervel function limitation score when they came to the hospital(.P>0.05). Days, the all-inclusive cost, every expenses in hospital are lower than that of the control group that the reality of group's patient of the experiment is in hospital, and there is prominent difference (P<0.05); Two group clinical total curative effect, Chinese medicine disease and comparative difference of physical sign have statistics meaning (P<0.05), the experiment group is superior to the control group. Two groups of patients are in hospital there is not obvious difference in the complication incidence and case fatality rate in hospital, but there are downward trends; Significance difference between two groups of patient's satisfaction (P<0.05); Chinese medicine characteristic treatment and dialectical to construct execution respect that protect, experiment group increase the trend than the control group to some extent, and the difference has statistics meaning (P<0.05).conclusion1. Implements the clinical pethway to be possible to enhance the clinical curative effect, guarantees the overall medical care quality.After implements the clinical pathway to be hospitalized the complication formation rate and in hospital case fatality rate has reduced.2. Implements the clinical pathway to be possible to reduce in hospital time.The experimental group compares the control group average in hospital date to reduce has 3 day approximately.3. Implements the clinical pathway to be possible to reduce the medical expense.The experimental group and the control group compare, are hospitalized the total expense, the daily average expense, the charges for medicine and the examination expense obviously reduce.4. Implements the clinical pathway to be possible to enhance the patient degree of satisfaction.5. The clinical pathway implementation standard diagnosing and treating behavior, reduced the nonessential inspection, the nonessential medication reduces the cost; Simultaneously promoted the medical personnel to assist, the medical trouble communication mutually, as well as assisted the hospital management to obtain the continually improvement.