基于PDCA循环的临床护理路径对脑梗死患者生活质量的影响分析

[摘要] 目的 探讨基于PDCA循环的临床护理路径对脑梗塞患者生活质量（QOL）的影响。 方法 80例脑梗死病例根据入院顺序分为治疗组40例与对照组40例，两组均首先采用常规药物治疗，治疗组在上述基础上给予基于PDCA循环的临床护理路径方法，对比两者的总体疗效与神经功能缺损评分，同时分析两者治疗后的QOL状况。 结果 护理后治疗组的第1周与第4周的神经功能缺损评分明显少于对照组（P < 0.05）。治疗组的临床总有效率（90.0%）明显高于对照组（67.5%）（P < 0.05）。治疗组患者治疗后在QOL的4个维度得分及总分上均明显高于护理前（P < 0.05），而对照组QOL得分无明显变化（P ＞ 0.05）。 结论 基于PDCA循环的临床护理路径在脑梗死患者中的应用可以改善神经功能缺损评分，从而提高治疗疗效，并且可以使患者随访期间的QOL得到改善，值得推广应用。

[关键词] PDCA循环；临床护理路径；脑梗死；生活质量

[中图分类号] R473.74 [文献标识码] C [文章编号] 1673-7210（2012）08（a）-0144-03

Effect of clinical care path on the life quality of cerebral infarction patients based on the PDCA cycle approach

ZHOU Zaixia

Department of Neurology, Binzhou Central Hospital, Shandong Province, Binzhou 251700, China

[Abstract] Objective To investigate the quality of life effects of clinical care path based on the PDCA cycle approach for cerebral infarction. Methods 80 cases of cerebral infarction were equally divided into treatment group (n = 40) and control group (n = 40) under a hospital order, both groups firstly were used conventional drug therapy, the treatment group were added the clinical care path based on the PDCA cycle approach; total efficacy, the neurological deficit score were compared and the quality of life in both treatment status were analyzed. Results The neurological deficit score of the treatment group after care one week and four weeks were significantly less than the control group (P < 0.05), and the clinical total efficiency of the treatment group (90.0%) was significantly higher than the control group (67.5%) (P < 0.05). The four dimensions of quality of life scores and total scores in the treatment group were significantly higher than before care (P < 0.05), while the scores mentioned above in control group were unchanged (P > 0.05). Conclusion Clinical care path based on the PDCA cycle approach for cerebral infarction can improve neurological function, thereby enhance treatment efficacy, and can make better life of patients during follow-up whice is worthy of clinical application.

[Key words] PDCA cycle; Clinical care path; Cerebral infarction; Quality of life

脑梗死是脑血管病中发生率最高的一种，也是人类致死致残的主要原因之一。目前，世界范围内脑血管病的发生率为150/10万～200/10万人口，只有10%的患者可完全恢复正常功能，48%的患者遗有偏瘫，22%的患者无法行走[1]。生活质量（QOL）是随着人类疾病谱的变化、新的健康观的产生和医学模式的转变而产生的，是全面评价疾病和治疗对患者的生理健康、心理状况、独立能力以及社会关系方面的影响的一种全新的医学评价技术[2]。脑梗死患者QOL低下主要表现在意识、运动、知觉、认知、语言、精神情绪方面功能障碍，增加社会及家庭负担。临床路径作为一种新的质量管理模式，以其在提高医疗质量，保障医疗安全，降低医疗费用方面的巨大作用，得到了神经内科广大医生的应用关注[3]。本文为此具体探讨了基于PDCA循环的临床护理路径对脑梗死患者QOL的影响，现报道如下：