Objective To systematic evaluate the curative effectiveness of clinical pathways on patients with chronic subdural hematoma.Methods Systematic literature retrieval was carried out to obtain randomized controlled trials of clinical pathways on chronic subdural hematoma before December 2012.Data collection and methodological quality assessment were performed by two individual reviewers.A Meta-analysis was performed by HevMan 5.0 software.Results Totally 10 studies were included, containing 599 patients.Meta-analysis showed: clinical pathways could improve patient satisfaction [OR = 4.48, 95%CI (1.95,10.26), P = 0.0004], improve patient health knowledge score [MD = 9.10, 95% CI (6.41,11.79), P < 0.000 01] reduce the average hospilalization time [MD = -4.20, 95%CI (-5.60, -2.80), P < 0.000 01], reduce postoperative complications (OR = 0.27, 95%CI (0.12, 0.62), P = 0.002) and the medical expenses [MD = -1.88, 95%CI (-2.69, -1.07), P < 0.000 01].Conclusion Clinical pathways can improve the efficacy on patients with chronic subdural hematoma, reduce medical expenses.%目的 系统评价慢性硬膜下血肿患者采用临床路径的护理效果.方法 计算机检索有关临床路径护理慢性硬膜下血肿患者的随机对照研究,时间截至2012年12月.由2位研究者评价纳入研究的质量、提取数据,采用Rev Man 5.0 软件数据处理.结果 共纳入10篇研究,包括599例患者.Meta分析结果示:临床路径可提高患者满意度[OR = 4.48,95%CI(1.95,10.26),P = 0.0004],提升患者健康知识评分[MD = 9.10,95%CI(6.41,11.79),P < 0.000 01],减少平均住院时间[MD = -4.20,95%CI(-5.60,-2.80),P < 0.000 01],降低术后并发症[OR = 0.27,95%CI(0.12,0.62),P = 0.002]及医疗费用[MD = -1.88,95%CI(-2.69,-1.07),P < 0.000 01].结论 采用临床路径护理慢性硬膜下血肿患者可以改善预后,降低医疗费用.
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