2种磨牙根管预备方法的成本-效果分析

Cost effectiveness analysis of two methods of preparing molar root canals

目的:比较不锈钢K锉常规根管预备(SSPT)法与镍钛机用根管器械逐步深入预备(NRPT)法在磨牙根管治疗中的近期临床效果和成本/效果(C/E)值。方法:入选患者随机分为SSPT法(49例)和NRPT法(45例)2组,记录治疗后不良反应、补救治疗措施和所花费用,评价近期疗效并进行成本-效果分析,用SPSS11.5统计分析软件进行数据统计。结果:NRPT组治疗满意率优于SSPT组(P=0.034),但前者人均治疗成本显著高于后者(P=0.001)。对重度弯曲根管,NRPT组治疗满意率优于SSPT组(P=0.007);前者的C/E值较后者低394.52元;轻中度弯曲根管前者的C/E值较后者高192.04元。根尖正常患者,NRPT组治疗满意率高于SSPT(P=0.012),但前者C/E值比后者高32.32元;而根尖阴影患者NRPT组的C/E值较SSPT组高376.47元。结论:NRPT法的疗效优于SSPT法,但治疗成本较高;对重度弯曲根管患牙,NRPT法可使患者受益;对中轻度弯曲根管患牙,应选用SSPT法。对根尖正常的患者,NRPT法近期疗效更高,而治疗前有根尖病变的患者,SSPT法可节约治疗成本。

PURPOSE： To evaluate the short-term clinical curative effects, cost effective ratio between ProFile nickeltitanium rotary preparation technique and stainless steel hand K-files preparation technique in molar root canal therapy. METHODS： All patients were randomly divided into two groups： 49 cases were prepared with stainless steel hand K-files in routine preparation technique; 45 cases were prepared with ProFile nickel-titanium rotary instruments in step-down technique. The clinical symptoms and cost were recorded. The data was analyzed by SPSS11.5 software package. RESULTS： The satisfactory rate of clinical effect of the NRPT group was significantly higher than SSPT（P=0.034）;The mean cost of the NRPT was significantly higher than SSPT （P=0.001）,the satisfactory rate of NRPT in severe curve subgroup was significantly higher than that of SSPT （P=0.007）, however,the C/E of NRPT was 394.52 Yuan less than SSPT. The former was 192.04 Yuan more than the latter in light curve subgroup. When it was classified by periapical condition before treatment, the satisfactory rate of NRPT was significantly higher than SSPT in negative subgroup yet （P=0.012） ,the C/E of the former was 32.32 Yuan more than the latter; nevertheless, the C/E of the former was 376.47 Yuan more than the latter in positive subgroup; CONCLUSIONS： It is better to prepare with ProFile nickel-titanium rotary preparation technique in severe curve subgroup, however, the light curve subgroup should be prepared with stainless steel hand K-files preparation technique. To patients with positive periodontopathy, SSPT would save the cost of treatments, nevertheless, NRPT group have a higher short-term recent effect.