The Clinical Analysis Of Optimizing TCM Clinical Pathway For The Treatment Of Femoral Neck Fracture

ObjectiveThrough analysing and comparing the clinical data before and after the optimization of the TCM clinical pathway of femoral neck fracture at the fourth department of Obstetrics in Panyu Hospital of Chinese Medicine, the effects of the optimized items and their impacts on the clinical pathway were evaluated, in order to provide evidence and directions for optimizing the TCM clinical pathway of femoral neck fracture.MethodsThis was an asynchronous retrospective cohort study that analysed and compared the clinical data of the patients who were brought into TCM clinical pathway of femoral neck fracture at the fourth department of Obstetrics in Panyu Hospital of Chinese Medicine from January2009to June2013. The objects of the study were divided into the pre-optimized group (inpatients from January2009to December2010) and the post-optimized group (inpatients from January2011to June2013). The data of study mainly included their postoperative uroschesis, postoperative constipation, postoperative functional exercises, hospitalization time, hospitalization cost, etc. Also, the relevant literature on femoral neck fracture, the TCM clinical pathway and its optimized items were researched.ResultsThis study collected a total of85valid cases, the pre-optimized group had41cases and the post-optimized group had44. Both groups were of no significant differences in the composition of patients and the incidence of postoperative uroschesis and constipation(P>0.05). The post-optimized group was better than the pre-optimized group in lower incidence of reinserting catheter, earlier postoperative bowel movement and postoperative functional exercises (P<0.05). On the other hand, the average hospitalization time of the pre-optimized group was23.51±6.10days, which fell to19.59±4.50days of the post-optimized group(P<0.05). The average daily hospitalization cost rose from the pre-optimized group’s486.07±120.06yuan to the post-optimized group’s548.63±139.54yuan(P<0.05). Also, there were no significant differences in total hospitalization cost, net hospitalization cost and postoperative joint function score between the two groups.ConclusionThe optimized clinical pathway not only had different degrees of improvement on postoperative uroschesis, postoperative constipation and starting time of postoperative functional exercises, but also reduced hospitalization time. Although there were no significant differences on total hospitalization cost and net hospitalization cost, a downward trend was shown after the clinical pathway was optimized. Besides, no significant changes were made on the postoperative joint function score before and after the optimization. The research results show that the optimized TCM clinical pathway of femoral neck fracture has good effects. Therefore, the TCM clinical pathway of femoral neck fracture should be continuously optimized, so that it can fully develop its normative, excellent and high-efficient functions.