早期胃癌诊断中应用链霉蛋白酶颗粒经济价值

The Economic Efficacy of Using Pronase Particles in the Early Detection of Gastric Cancer

目的 :评价链霉蛋白酶颗粒在胃镜检查中的有效性、安全性和经济性。方法 :采用系统综述(Meta分析)的方法对链霉蛋白酶颗粒的有效性和安全性进行评价;采用成本效益分析对链霉蛋白酶颗粒经济性进行评价。结果 :以胃内视野清晰度显效率作为疗效指标,链霉蛋白酶颗粒组与对照组相比,RR值为3.36(95%CI:1.89,5.97),链霉蛋白酶颗粒组的显效率高于对照组(P<0.00001);以胃内视野清晰度总有效率作为疗效指标,RR值为1.67(95%CI:1.36,2.04),链霉蛋白酶颗粒组的总有效率高于对照组(P<0.00001)。链霉蛋白酶颗粒增加胃癌患者的早期检出率,减轻患者发展到进展期的疾病负担,平均每例患者可以节省380.97元(32.37元-1073.52元),按照70%的报销比例,接受胃镜检查的患者由于胃癌的早期诊断人均降低医保基金支出为266.68元(22.26元-751.46元)。结论 :链霉蛋白酶颗粒应用于早期胃癌诊断具有较好的疗效、安全性以及经济性。

Objectives： To evaluate the effi cacy, safety and economy of using pronase particle in gastroscopy examination. Methods： Systematic review（meta-analysis） was used to evaluate the effi cacy and safety of pronase using; and cost-benefi t analysis was conducted to evaluate the economical effi cacy. Results： the clarity rate of the view under gastroscopy was used to evaluate the effi cacy. Compared with the control group, the pronase using group has a higher signifi cant clarity rate, with RR being 3.36（95% CI： 1.89- 5.97）; while the RR of total clarity rate is 1.67（95% CI： 1.36-2.04）. Pronase using increases the probability of early detection of gastric cancer, and reduces the expenses caused by the advance of the disease. It is evaluated by this research that 380.97 yuan（32.37 yuan to 1073.52yuan） can be saved averagely by using pronase for every case of gastric cancer early detection. If health insurance reimbursement ratio is 70%, 266.68 yuan（22.26 yuan to 751.46 yuan） of health insurance expenditure can be saved in each case. Conclusions： Pronase using is eff ective, safe and economical, and can be used in gastroscopy examination for early detection of gastric cancer.