前列腺增生症激光治疗及开放手术的经济学分析

A comparative study and economic analysis of suprapubic transvesical prostatectomy and TULVP for BPH patients

目的 以社会经济学指标评估BPH开放手术及腔内激光手术费用及意义。 方法 93例患者分为两组 :经尿道激光前列腺切除术组 48例 (激光组 ) ,同期前列腺开放手术组 45例 (开放组 )。两组临床资料及结果无显著差别 ,就住院日、术后拔管日、疗效、费用及分布特征与手术方式间关系进行成本 效益分析。 结果 两种手术方式与住院日明显相关 ,激光组平均缩短术后拔管日4.6d(P <0 .0 0 1)。费用总额激光组低于开放组 (t =2 .934,P =0 .0 4) ,其中手术费用激光组平均为人民币 2 2 2 6 .99元 ,开放组为 710 .2 2元 ,而药费及输血费开放组均明显高于激光组 (P <0 .0 1,P <0 .0 0 1)。 结论 腔内技术能缩短术后拔管及住院日 ,降低医疗费用。成本 效益分析提示微创新技术包含着新医疗模式的可行性潜力。

Objective To evaluate the cost differences in two groups of BPH patients undergone suprapubic transvesical prostatectomy or TULVP. Methods A comparison of the cost-effectiveness was undertaken,including days of catheter indwelling and hospitaliztion,follow-up results,cost financial expense as related to different operative procedures. Results In TULVP group,the days of catheter indwelling and hospitalization were significantly shortened and the total expenditure was decreased (P<0.01～ 0.001 ).Although the apparatus charge was higher in laser group whereas the medicine and blood transfusion costed more in open operative group (P<0.01～0.001). Conclusions By means of cost-effectiveness analysis of the two groups,it is shown that endourologic technique is able to shorten hospitalization stay,save financial expense and utilize the medical resources more reasonably,implying that new healthcare model is potential in minimally invasive surgery.