高强度聚焦超声和子宫切除手术治疗子宫腺肌瘤的有效性及其成本效用分析

High intensity focused ultrasound and hysterectomy for endometrioma women:effect on quality of life and cost-utility analysis

目的探讨高强度聚焦超声(HIFU)和子宫切除手术治疗子宫腺肌瘤有效性,并进行成本效用分析。方法将40例子宫腺肌瘤的患者均分为HIFU组和子宫切除组,于治疗后1、3、6个月随访患者治疗前后生活质量(QOL)改善率,并采用等级尺度法提取效用值进行成本效用分析。结果两组治疗后各时间点的QOL评分差异无统计学意义(P>0.05);但各组内QOL在治疗6个月后均较前升高(P<0.05),HIFU组和手术组的质量调整生命年成本分别为20388.76元/年和34507.68元/年,增量成本效用分析和敏感性分析表明手术组的花费高于HIFU组。结论 HIFU和手术治疗均可有效改善子宫腺肌瘤患者的生存质量,6个月内手术治疗成本较高。

Objective To explore the efficacy of high intensity focused uhrasound （HIFU） and hysterectomy for endometrioma women, and to analyze the cost-utility. Methods Forty women with endometrioma were devided into HIFU group （n=20） and hysterectomy group （n =20）.They were followed up in the first, third, sixth month after therapy. The quality of life （QOL） of the patients was evaluated and the utility scores were obtained from rating scale to conduct a cost-utility analysis （CUA）. Results At each follow-up examination, there were no significant differences in QOL between the tow groups（P〉0.05 ）. The QOL increased obviously after therapy in two groups （P〈0.05）. The cost-utility ratio of HIFU group and hysterectomy group were 20388.76 yuan/QALY （quality adjusted life year） and 34507.68 yuan/QALY ,respectily. Both incremental cost and sensitivity analysis showed that HIFU was less than hysterectomy in cost. Conclusion The QOL of women with endometrioma can be significantly improved by HIFU and hysterectomy, but HIFU is less in cost.