中文摘要：

目的对比分析佛山市第四人民医院对初治涂阳肺结核患者进行临床路径管理的效果,为结核病防治部门在制定初治菌阳肺结核的治疗决策提供科学依据。方法参照2012年版初治菌阳肺结核临床路径标准,收集2012年7月至2014年12月间住院治疗并进入临床路径管理的初治菌阳肺结核病例建立研究组;收集2010年7月至2012年6月间未开展临床路径管理时住院治疗的初治菌阳肺结核病例,参照临床路径的条件,对病情差异无统计学意义,无严重并发症的患者作为入组条件,建立对照组。利用SPSS 16.0统计分析软件对2组患者的治疗效果、平均住院日、住院费用、费用构成等数据进行相关分析。结果 2组患者差异无统计学意义,具有可比性,研究组住院天数显著少于对照组（t=28.7,P〈0.01）;住院总费用显著低于对照组（t=20.54,P〈0.01）;分项费用（西药费、床位费、检查费、诊疗费）低于对照组（P〈0.01或P〈0.05）;治疗效果差异无统计学意义,研究组发生并发症较对照组明显减少（χ^2=58.28,P〈0.05）。结论在初治菌阳肺结核的治疗方案没有明显变化,病情差异无统计学意义,对初治菌阳肺结核患者实施临床路径管理,可以缩短住院总天数、降低住院费用、减少并发症的发生率。

英文摘要：

Objective To provide a scientific basis for tuberculosis treatment decisions ,comparativing analysis of the clinical pathway management on new smear-positive pulmonary tuberculosis patients. Methods Collected new smear- positive pulmonary tuberculosis patients from July 2012 to October 2014 in our hospital as research group. Collected who were new smear-positive pulmonary tuberculosis patients not carried out the clinical pathway management from July 2010 to June 2012 as control group. The cases of control group were collected according to the clinical pathway management condition. Using SPSS16.0 statistical analysis software to analyze the data of the treatment outcome, average hospitalization days and hospitalization expenses. Results The average hospitalization days of research group was significantly less than the control group （t=28.7, P〈0.01 ）. The hospitalization expenses of research group was significantly lower than the control group （t=20.54, P〈0.01）. The diagnosis and treatment expense was lower than the control group （P〈0.05）. The complications of research group was significantly reduce than the control group （χ^2=58.28, P〈0.05）. Conclusion The clinical pathway management on new smear-positive pulmonary tuberculosis patients can shorten the average hospitalization days, decrease the hospitalization expenses and incidence of complications.