肝细粒棘球蚴病4种手术方式的成本-效果评价

Cost effectiveness evaluation of four kinds of surgical methods for hepatic echinococcosis

目的分析4种手术方式(A、B、C、D)治疗肝包虫病的成本-效果,比较其有效性和经济性。方法收集2005-2013年新疆9家医院住院的757例肝包虫手术患者临床资料和费用信息,比较4种手术方式的临床疗效、成本-效果比和增量成本-效果比。结果 4种手术方式总并发症发生率依次为15.8%、9.2%、0、2.9%;复发率依次为7.3%、6.2%、0、0;治愈率依次为77.8%、84.6%、100.0%和97.1%;成本依次为11947.3元、18543.6元、25510.7元和18877.4元;C/E依次为153.6、219.1、255.1和194.3;△C/△E依次为964.4、610.4和358.0;进行物价因素调整后,与原成本-效果分析结果一致。结论外膜内外囊完整切除术(D法)是既有效又经济的最理想手术方式,值得实施推广。

We analyzed the cost effectiveness of four different surgical methods（A,B,C and D）in treatment of hepatic echinococcosis.Totally 757 cases of hepatic echinococcosis surgery clinical data and cost information of hospitalized cases were collected from nine hospitals in Xinjiang during 2005-2013.The clinical effects,cost effectiveness ratio and incremental costeffectiveness ratio were analyzed and compared.The total complication rates were 15.8%,9.2%,0% and 2.9%;the recurrence rates were 7.3%,6.2%,0%and 0%;the cure rates were 77.8%,84.6%,100.0%and 97.1%;the cost（RMB）were11 947.3,18 543.6,25 510.7and 18 877.4,cost-effectiveness ratio were 153.6,219.1,255.1and 194.3,incremental cost-effectiveness ratio△C/△E were 964.4,610.4and 358.0respectively for group A,B,C and D.The results after adjusting of price factor were consistent with original cost effectiveness analysis.The complete resection of inner and outer capsule（D）is the most effective and economical way of clinical operation and may worthy be promoted in treatment of hepatic echinococcosis.