陈淑媛 董艳 赵玉

摘要 目的：观察临床路径在急性中、重度一氧化碳中毒急诊救治过程中的应用效果。方法：选择2016年10月～2019年3月唐山市人民医院急诊科救治的急性中、重度一氧化碳中毒患者178例为研究对象，其中2016年10月～2017年12月90例为对照组，实施急诊常规急性一氧化碳中毒救治;2018年1月～2019年3月88例为观察组，实施急性一氧化碳中毒临床路径救治。比较两组急救时间、平均住院时间、平均住院费用，患者满意度。结果：观察组急救时间短于对照组，住院天数少于对照组，住院费用少于对照组，患者满意度高于对照组，差异均有统计学意义（P<0.05）。结论：急性一氧化碳中毒临床路径的实施可规范医疗行为，提高急性一氧化碳中毒患者的抢救时效，提高患者满意度。

【关键词】临床路径，急性一氧化碳中毒，抢救时效，满意度

中图分类号  R595.1    文献标识码  B    文章编号  1671-0223（2020）02-061-04

Abstract  Objective To observe the effect of clinical pathway on the emergency treatment of acute moderate and severe carbon monoxide poisoning. Methods 178 patients with acute moderate and severe carbon monoxide poisoning treated in the emergency department of Tangshan people's Hospital from October 2016 to March 2019 were selected as the study objects， 90 patients in the control group from October 2016 to December 2017 were treated with routine emergency treatment of acute carbon monoxide poisoning， 88 patients in the experimental group from January 2018 to March 2019 were treated with clinical pathway treatment of acute carbon monoxide poisoning. The first aid time， average hospitalization time， average hospitalization cost and patients' satisfaction were observed. Results In the experimental group， the first aid time was shorter than that in the control group， the hospitalization days were shorter than that in the control group， the hospitalization expenses were lower than that in the control group， and the patient satisfaction was higher than that in the control group （P< 0.05）. Conclusion The implementation of clinical pathway of acute carbon monoxide poisoning can standardize the medical behavior， improve the rescue effectiveness of patients with acute carbon monoxide poisoning， and improve patients' satisfaction.

Key words Clinical pathway; Acute carbon monoxide poisoning;Rescue effectiveness;Satisfaction

急性一氧化碳中毒是常見的中毒之一[1]，其致残率及致死率依旧高[2]。有必要采取规范的一氧化碳中毒的救治措施，提高治疗质量及安全。临床路径是指医生、护士及其他专业人员，针对某个病种或手术，以循证医学为基础，制定的有严格工作顺序和准确时间要求的程序化、标准化的诊疗计划[3]，以提高医疗质量和保障医疗安全[4]。我院自2018年1月起采用临床路径对急性一氧化碳中毒患者实施救治，减少了患者的康复延迟，使患者获得有效的医疗护理服务，现报道如下。

1对象与方法

1.1 研究对象

选择2016年10月～2019年3月唐山市人民医院急诊科救治的急性中、重度一氧化碳中毒患者205例为研究对象。急性一氧化碳中毒诊断及分级参照《职业性急性一氧化碳中毒诊断标准》[5]，排除出现一氧化碳中毒迟发脑病的病例。……