(A) Applicable subjects.
First diagnosis of spermatic syringomyelia (ICD-10:N43.302).
Spermatic sheath reversal (ICD-9-CM-3:63.59) or spermatic sheath resection (ICD-9-CM-3:63.1) is performed.
(B) Diagnostic basis.
According to the Clinical Diagnosis and Treatment Guide-Urological Division (edited by the Chinese Medical Association, People’s Health Publishing House).
1, Medical history.
2.Ultrasound examination.
(C) Basis for selecting treatment plan.
According to the Clinical Technical Practice Specification – Urology Subvolume (edited by the Chinese Medical Association, People’s Military Medical Publishing House).
1.Meet the indications for surgery.
2.Be able to tolerate the surgery.
(D) The standard hospitalization day is ≤5 days.
(V) Entry pathway criteria.
1.The first diagnosis must be in accordance with ICD-10:N43.302 Spermatic syringomyelia disease code.
2. When the patient is combined with other diseases, but no special treatment is required during hospitalization nor does it affect the implementation of the clinical pathway process for the first diagnosis, the patient can enter the pathway.
(F) Preoperative preparation ≤ 2 days.
1. Items that must be examined before surgery.
(1) Blood routine, urine routine;
(2) Electrolytes, liver and kidney function, coagulation function;
(3) Infectious disease screening (hepatitis B, hepatitis C, AIDS, syphilis, etc.);
(4) X-ray chest film, electrocardiogram.
(2) Semen examination etc. can be selected according to the condition.
(7) Selection of medication.
Execute according to the guideline of clinical application of antibacterial drugs (Health Medical Development [2004] No. 285), and decide the selection and time of antibacterial drugs in combination with the patient’s condition. The first and second generation cephalosporins, ciprofloxacin are recommended.
(H) The day of surgery is ≤3 days after admission.
1.Anesthesia: decided according to the patient’s specific condition.
2.Surgical method: spermatic sheath reversal or spermatic sheath resection.
3.Intraoperative medication: anesthetic medication, antibacterial drugs, etc.
4.Blood transfusion: when necessary.
(ix) Postoperative hospital recovery ≤ 2 days.
1.Checkup items that must be reviewed: blood routine, urine routine.
2.The corresponding examination items can be selected according to the change of patient’s condition.
3.Postoperative medication.
(1) Postoperative antibacterial drugs: according to the “Guidelines for Clinical Application of Antibacterial Drugs” (Health Medical Development [2004] No. 285), the first and second generation cephalosporins and ciprofloxacin are recommended.
(2) Analgesic drugs.
(X) Discharge criteria.
1.General condition is good.
2.No abnormalities in the wound.
(xi) Variation and cause analysis.
1.Intraoperative and postoperative complications requiring further consultation and treatment, resulting in prolonged hospital stay and increased costs.
2.The original concomitant diseases were poorly controlled after surgery, requiring consultation with relevant departments for further consultation and treatment.
3.After hospitalization, other medical and surgical diseases appear and need further clear diagnosis, which can be entered into other pathways.