临床护理路径在胃癌新辅助化疗患者中的应用
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[摘要] 目的 探讨在胃癌术前行新辅助化疗患者中实施临床护理路径的可行性及效果。 方法 将2008年1月～2011年9月60例胃癌术前行新辅助化疗的患者随机分为试验组和对照组各30例。试验组应用临床护理路径管理，对照组按照常规工作模式管理，比较两组患者的平均住院天数、住院费用、健康知识掌握情况及满意度。 结果 试验组患者的平均住院天数、平均住院费用较对照组少（P < 0.05），健康知识掌握情况及满意度较对照组高（P < 0.05）。结论 对胃癌术前行新辅助化疗的患者实施临床护理路径管理，可缩短平均住院日，降低费用，增强患者对健康知识掌握情况及患者对护理的满意度。
[关键词] 临床护理路径；胃癌；新辅助化疗
[中图分类号] R735.2 [文献标识码] B [文章编号] 1673—9701（2012）25—0108—02
Application of clinical nursing pathway in patients with gastric cancer by neo—adjuvant chemotherapy
YING Jinbo1 WU Haibin2 MA Chen1
1.Minimally Invasive Hernia Anorectal Surgery，Ningbo First Hospital，Ningbo 315010，China； 2.Medical School of Ningbo University，Ningbo 315211，China
[Abstract] Objective To explore the efficacy of application of clinical nursing pathway for patients undergoing gastric cancer with neo—adjuvant chemotherapy. Methods A total of 60 patients were about to undergo gastric cancer with neo—adjuvant chemotherapy from January 2008 to September 2011 were divided into clinical—path group and routine nursing group （30 cases each） randomly. Patients of routine nursing group were given nursing care based on traditional nursing flow—sheet. Patients of clinical—path group were given care according to clinical nursing path. There average hospitalization days，average medical cost， satisfaction degree of patients and mastering of health knowledge of patients between the two groups were compared with each other. We used SPSS 11.5 software package for statistical analysis. Significance was set at （P < 0.05）. Results There were statistical significant differences in terms of average hospitalization days，average medical cost，satisfaction degree of patients，nursing quality and mastering of health knowledge between the two group cases（P < 0.05）. Conclusion Applying clinical path for patients undergoing gastric cancer with neo—adjuvant chemotherapy can shorten average days， reduce medical cost. And they could enhancement of satisfaction degree of patients and mastering of health knowledge of patients.
[Key words] Clinical nursing pathways； Gastric cancer； Neo—adjuvant chemotherapy
胃癌是病死率极高的恶性肿瘤之一，我国胃癌呈逐年上升趋势[1]。由于肿瘤起病隐匿，且约2/3患者就诊时已为中晚期[2]，失去手术机会，于是近年提出了新辅助化疗的概念。新辅助化疗可以降低肿瘤细胞的活性，控制、减小原发灶及微小转移灶，甚至可以消灭转移灶及血液中散在的癌细胞， 使术中种植、术后复发转移的可能性降低。研究发现益气健脾汤治疗能提高晚期胃癌患者免疫功能、治疗的有效率并能延长生存期、减轻化疗的不良反应[3，4]。
临床护理路径（CNP）是近些年产生、发展起来的一种新型的单病种质量管理模式，它以较短的平均住院日、合理支付医疗费用为特征，设计最佳的医疗和护理方案[5]。使诊疗、护理有序进行，减少漏项，提高质量。为探讨临床护理路径应用于胃癌行新辅助化疗患者的可行性及效果，2008年1月～2011年9月将临床护理路径应用于30例在我院外科行新辅助化疗联合益气健脾汤的胃癌患者中，并与常规工作模式管理进行比较，现报道如下。