食管静脉曲张套扎术前应用奥曲肽降低门脉压的临床效果及经济学效应

Clinical and economic effects of octreotide administered before esophageal variceal ligation on reducing portal pressure

目的探讨食管静脉曲张套扎术前应用奥曲肽降低门脉压的临床效果及经济学效应。方法选取我院收治的86例门脉高压伴食管静脉曲张患者,根据食管静脉曲张套扎术前是否应用奥曲肽分为奥曲肽组(n=45)和常规组(n=41)。采用成本-效果分析法对药物经济学效应进行分析。结果奥曲肽组的术后出血率低于常规组,静脉曲张消除率高于常规组,住院时间短于常规组(P<0.05);两组的治疗成本比较,差异无统计学意义(P>0.05)。奥曲肽组的成本-效果比(C/E)小于常规组;以常规组作为参照,奥曲肽组比常规组多增加一个单位的未出血效果和静脉曲张消除效果需分别多支付36.06、31.71元。治疗后,两组的RBC、Hb水平均升高,且奥曲肽组高于常规组(P<0.05)。结论食管静脉曲张套扎术前应用奥曲肽可有效降低出血率,提高静脉曲张消除率,且不会增加患者的经济负担。

Objective To investigate the clinical and economic effects of octreotide administered before esophageal variceal ligation on reducing portal pressure.Methods A total of 86 patients with portal hypertension and esophageal varices treated in our hospital were selected and divided into octreotide group(n=45)and routine group(n=41)according to whether octreotide was administered before esophageal variceal ligation.The pharmacoeconomic effects were analyzed by cost-effectiveness analysis method.Results The postoperative bleeding rate in the octreotide group was lower than that in the routine group,the varicose elimination rate was higher than that in the routine group,and the hospital stay was shorter than that in the routine group(P<0.05);there was no significant difference in treatment cost between the two groups(P>0.05).The cost-effectiveness ratio(C/E)in the octreotide group was lower than that in the routine group;taking the routine group as a reference,when the non-bleeding effect and varicose elimination effect in the octreotide group increased by one unit more than the routine group,and the patients needed to pay 36.06 and 31.71 Yuan more respectively.After treatment,the RBC and Hb level in the two groups increased,and those in the octreotide group were higher than the routine group(P<0.05).Conclusion Octreotide administered before esophageal variceal ligation can effectively reduce the bleeding rate,increase the varicose elimination rate,and don't increase the economic burden of patients.