阴式与横切口开腹子宫切除术的卫生经济学评价

Cost-effectiveness analysis of transvaginal hysterectomy vs minilaporotomy hysterectomy

目的:比较阴式子宫切除术(transvaginal hysterectomy,TVH)和横切口开腹子宫切除术(minilaporotomy hysterectomy,MiniLPT)两种手术的费用以及卫生资源利用率。方法:将35例行TVH(阴式组)与43例行MiniLPT(腹式组)的患者治疗前后花费时间、住院费及医疗总费用(包括直接医疗费用、直接非医疗费用和间接费用)进行比较。结果:阴式组直接医疗费、间接医疗费均低于腹式组(P<0.01);阴式组恢复工作时间和误工时间明显短于腹式组(P<0.01)。两种术式住院时间、术前和术后时间及药品费差异均无统计学意义(P>0.05)。结论:相对于MiniLPT,TVH术后恢复快,并通过减少住院费、手术费及非手术费用,降低间接医疗费用从而提高卫生资源利用率,降低手术成本。

Objective：To compare the cost and effectiveness of transvaginal hysterectomy versus minilaporotomy hysterectomy.Methods：From Oct.2008 to Oct.2009,35 patients were undergone transvaginal hysterectomy（TVH）,while 43 cases were submitted to minilaporotomy hysterectomy（MiniLPT）.The off-work day,hospital charge,total cost（including direct and indirect cost） were analyzed and compared.Results：The direct cost and indirect cost of TVH were significantly lower than those of MiniLPT（P〈0.01）.The return-work and off-work days were significantly shorter in TVH group than in MiniLPT group（P〈0.01）.But the hospitalization time and drug cost in the two groups had no statistical difference（P〉0.05）.Conclusions：Compared to MiniLPT,TVH can recover quickly and improve cost-effectiveness utilization and decreasing operation cost through decreasing direct and indirect cost.