伽玛刀的医学技术评估

Medical technology assessment on ‘gamma knife’

伽玛刀是世界上最昂贵的医疗设备之一，我国从１９９２年开始引进。１９９５年卫生部等联合发文暂缓装备。为了规范提供方和患方的行为，以及为卫生行政部门提供决策依据，我们开展了伽玛刀的技术评估。在评估前拟定评估步骤，然后确定评估内容与方法。评估结果，国外１９９４年有５６台伽玛刀，平均每台治疗１９０例，治疗病种是：动静脉畸型病人占３２％，肿瘤病人占６５％，功能性疾病占２％。我国１３台伽玛刀到１９９５年底共治病人７０００例，前６位病种是转移瘤等，虽然比例和顺位与世界有差异，但病例分析结果完全一致。

Gamma Knife is one of the most expensive medical equipment in the world, and was introduced into our country in 1992. In 1995, it was suspended by a joint mandate of the Ministry of Health and other governmental agencies. In order to regulate behaviors of both providers and patients and to provide policy basis for health authorities, the authors conducted medical technology assessment on ‘gamma knife’. Prior to assessment, the evaluation steps were scheduled and then evaluation contents and methods were determined. The assessment results show that there were 56 sets of ‘gamma knives’ in foreign countries in 1994. Average work load of a single ‘gamma knife’ was one hundred and ninety patients. The diseases treated include artery and vein deformity as 32%, cancers as 65%, and functional diseases as 2%. By 1995, about 7 000 patients were treated by 13 domestic ‘gamma knives’. The top six diseases were metastasis of cancers. Despite the disease proportion and sequence discrepancy from international profile, the case analysis results are completely identical.