关键词: 晚期血吸虫病；肝纤维化；临床路径；效果评价

Abstract: Objective To assess the effectiveness of the clinical pathway for the treatment of advanced schistosomiasis hepatic fibrosis. Methods The duration of hospital stay， gross hospitalization expense， individual?paid expense， interior diameter of portal vein， levels of four serum hepatic fibrosis?related parameters （PIIIP， CIV， HA， and LN）， and activities of ALT， AST and γ?GT were assessed and compared between the advanced schistosomiasis patients receiving the clinical pathway and ones receiving non?clinical pathway. Results There were 142 advanced schistosomiasis patients with hepatic fibrosis receiving the clinical pathway of anti?hepatic fibrosis. Compared with the patients receiving non?clinical pathway， the gross hospitalization expenses reduced by 11.2% （t = 6.310， P < 0.05）， and the individual?paid expenses reduced by 16.1% （t = 4.326， P < 0.05）. The mean HA level was twice higher than the normal range， with a positive rising from 70.4% to 83.1%， and the abnormal rates of CIV and γ?GT were 64.1% and 28.9% respectively. Conclusions The clinical pathway can drastically reduce the treatment expenses in advanced schistosomiasis patients with hepatic fibrosis. However， the patients have a trend towards the persistent disease progression. Therefore， the researches of more effective therapeutic methods for advanced schistosomiasis hepatic fibrosis are urgently needed.

Key words: Advanced schistosomiasis； Hepatic fibrosis； Clinical pathway； Effectiveness evaluation