合并白内障的闭角型青光眼三种手术方式的临床经济学评价

Clinical economical evaluation for three surgery methods of angle-closure glaucoma combined cataract

目的采用成本-效果分析的方法对合并白内障的闭角型青光眼三种手术方式：(1)白内障现代囊外摘除人工晶状体植入联合小梁切除术、(2)超声乳化白内障吸除人工晶状体植入联合小梁切除术、(3)单纯超声乳化白内障吸除人工晶状体植入术做出临床经济学评价。方法综合《中华眼科杂志》等眼科专业杂志近三年来有关闭角型青光眼合并白内障手术治疗方面的论著资料,作为计算三种术式效果评价的依据,分别计算三种术式的医疗成本和治疗效果,做出成本-效果比较。结果术式1单眼成本最低(4000元),但考虑到治疗效果时,则术式1平均成本最高(13628.6元),术式3平均成本最低(7346.9元)。结论积极开展和推广单纯超声乳化白内障吸除人工晶状体植入术治疗闭角型青光眼的临床研究和应用,对于闭角型青光眼合并白内障的治疗,不仅可以简化术式,提高临床疗效,而且对于节约医疗成本,提高社会整体医疗资源的利用效率有着重要的经济学意义。

Objective Cost-effect analysis is used to make a clinical economics evaluation for three surgery methods of angle - closure glaucoma combined cataract. The three method include （ 1 ） extracapsular cataract extraction （ EC- CE） combined IOL implantation and trabulaeetomy; （2） Phacoemasification combined IOL implantation and trabulaectomy; （3） Phacoemusification combined IOL implantation. Method Original articls about angle-closure glaucoma combined cataract surgery was coUigated and adopted to as an evidence for calculation. The cost and therapy effect of every method was calculated respectively, and the three methods were compared by cost -effect, Results the lowest single eyes cost is the first method, but when preferring effect, then the first method average cost is the highest （ 13628, 60RMB）, the lowest cost is the third method. Conclusion Projecting clinical research and application of phacoemusification combined IOL implantation to managing angle-closure glaucoma combined cataract can not only simpify the surgery operation but also induce cost, Using this method to managing angle-closure glaucoma combined cataract can greatly improve national health resource.