宫颈锥切术围术期预防应用抗菌药物的成本-效果

Cost-effectiveness of Prophylactic Use of Antibiotics during Perioperative Period of Cervical Conization

目的探讨不同抗菌药物在宫颈锥切术围术期预防应用的成本-效果,为宫颈锥切术提供有效、经济的预防用药方案,减轻患者负担。方法选取2020年1月至2021年12月于克拉玛依市人民医院妇产科住院的子宫颈上皮内瘤变(CIN)患者100例作为研究对象,均拟执行宫颈锥切术,随机分为对照组和试验组,每组50例。对照组应用头孢呋辛联合甲硝唑预防感染,试验组采用头孢西丁作为预防用药,两组患者均在切皮前30 min开始静脉滴注,术后规律性应用48 h,比较两组方案预防感染效果、成本-效果,并进行敏感性分析。结果两组患者体温、白细胞计数、中性粒细胞百分比、C反应蛋白、降钙素原及围术期预防用药临床有效率比较差异无统计学意义(P>0.05);试验组预防用药方案的C/E低于对照组方案(P<0.05);扣除抗菌药物成本15%的药品加成后,结果显示,试验组方案的C/E依然低于对照组方案(P<0.05)。结论宫颈锥切术围术期应用抗菌药物可达到预防感染的效果,选择头孢西丁作为预防用药,有效性得以保证且经济性更佳,患者负担得到一定程度减轻。

Objective To explore the cost-effectiveness of preventive application of different antibiotics in the perioperative period of cervical conization,so as to provide effective and economic preventive medication scheme for cervical conization and reduce the burden of patients.Methods 100 CIN patients hospitalized in the department of obstetrics and gynecology of Karamay People's Hospital from January 2020 to December 2021 were selected as the study objects,and cervical conization was planned to be performed.They were randomly divided into control group and test group,with 50 patients in each group.The control group used cefuroxime combined with metronidazole to prevent infection,and the test group used cefoxitin as the preventive drug.The patients in both groups started intravenous drip 30 minutes before the skin incision,and regularly applied 48 hours after the operation.The effect,cost-effectiveness and sensitivity of the two groups were compared.Results There was no significant difference between the two groups in temperature,leukocyte count,percentage of neutrophils,C-reactive protein,procalcitonin and clinical efficacy of perioperative preventive drugs(P>0.05);The C/E of the preventive drug regimen in the test group was lower than that in the control group(P<0.05);After deducting the drug addition of 15%of the cost of antibacterial drugs,the results showed that the C/E of the test group was still lower than that of the control group(P<0.05).Conclusion Antibiotics application during the perioperative period of cervical conization could achieve the effect of preventing infection.Choosing cefoxitin as a preventive drug could ensure the effectiveness and better economy while reducing the burden of patients in a certain extent.