目的:评价临床路径下开展小切口非超声乳化白内障摘除术的手术效果和患者的住院天数、住院费用等卫生经济学指标,制定一套适合基层医院开展白内障复明工程的管理体系和手术方法。方法:制定与实施老年性白内障的临床路径表,在临床路径下将96例老年性白内障患者随机分为两组,A组采用小切口非超声乳化白内障摘除术,B组采用超声乳化白内障吸除术,并观察比较两组患者术后第1d远视力、术中术后并发症、患者住院天数与住院总费用的不同。结果:A组与B组患者术后第1d远视力较术前均有明显提高(P<0.01),但两组术后远视力比较,差异无统计学意义;A组术后角膜水肿发生率低于B组,差异有统计学意义(P<0.05),其余各并发症发生情况差异无统计学意义;A组与B组住院日比较差异无统计学意义,但A组住院费用明显低于B组,差异有显著统计学意义(P<0.01)。结论:基层医院在临床路径下开展小切口非超声乳化白内障摘除术能提高医疗质量,降低医疗成本,减少医疗资源的消耗,让更多白内障盲患者受益。符合卫生经济学的根本宗旨,值得推广。

·AIM:To evaluate the surgical results and indicators of health economics(including length of stay,hospital costs)in patients with small incision phacoemulsification cataract surgery by clinical pathway,and to develop the system management and methods of cataract surgery project for primary hospital.·METHODS:The clinical pathway table of of senile cataract were developed and implemented,after that,96 patients with senile cataract were randomly divided into two groups:without small incision phacoemulsification cataract surgery(group A)and with phacoemulsification than surgery(group B),and the vision,complications,hospitalization days and total cost in the postoperative day 1 of the both groups were observed.·RESULTS:Both groups were significantly improved in visual acuity in the postoperative day 1(P <0.01),but there were no significant differences(P> 0.05)compared both groups;group A had the lower incidence of corneal edema than B group,the difference was statistically significant(P <0.05),but there were no significant difference in the incidence of complications and hospitalization days(P> 0.05);but,the average cost of hospitalization of the A group was lower than that of B group(P <0.01).·CONCLUSION:The small incision phacoemulsification cataract surgery by the clinical pathway have the better visual acuity,fewer complications,shorter hospitalization days,fewer financial burden,and in line with the fundamental purpose of health economics,which is worth promoting in the primary hospital.·

R779.66