胰十二指肠切除术后肠内营养与肠外营养治疗费用的比较

Cost-effectiveness analysis of early enteral nutrition after pancreatoduodenectomy.

目的 从临床经济学角度比较胰十二指肠切除术后肠内营养与肠外营养治疗费用的差别 ,评价早期肠内营养支持作用。方法 回顾分析 1999年 7月至 2 0 0 1年 6月间 32例胰十二指肠切除术后早期营养支持临床资料 ,其中早期肠内营养 (EEN)组 11例 ,术后第 1天开始EEN支持 ;肠外营养组 (TPN) 2 1例。结果 术后平均住院日EEN组较TPN组为短 (2 5 0天vs 36 3天 ,P <0 0 1) ,且平均费用明显少于TPN组 (2 836 8元vs 40 494元 ,P<0 0 1)。并发症发生率EEN组虽少于TPN组 ,但无统计学差异 (P >0 0 5 )。费用效果分析及敏感性分析提示EEN较TPN优越。结论 胰十二指肠切除术后EEN支持可减少并发症 。

Objective To analysis the cost-effectiveness of early enteral nutrition after pancreaticoduodenectomy.Methods An outcome-based retrospective review of 32 patients who had undergone pancreaticoduodenectomy between July 1999 and June 2001 was performed. There were 11 patients in the EEN group, and 21 in the TPN group.Results The mean cost of the EEN group was significantly less than that of the TPN group ($28368 vs $40494 per patient, P<0.01). In addition, the mean postoperative hospitalization days of the EEN group was significantly less than that of the TPN group either (25 days vs 36.3 days, P <0.01). Though the complication rates of the EEN group were less than the TPN group, the differences were statistically insignificant (P>0.05). Cost-effectiveness analysis showed that EEN was better than TPN.Conclusion Early postoperative enteral nutrition after pancreaticoduodenectomy is safe,cheap and effective.