摘要
目的:评价肝硬化上消化道出血的3种药物治疗方案。方法:肝硬化上消化道出血患者共132例,分别选用奥曲肽(善得定)、施他宁和垂体后叶素治疗,运用药物经济学成本-效果分析法进行分析。结果:善得定、施他宁、垂体后叶素3组治疗肝硬化食道静脉曲张破裂出血的有效率分别为88.89％、80％和46.15％;治疗肝硬化消化性溃疡出血的有效率分别为88.89％、87.50％和50.00％;治疗肝硬化急性胃粘膜病损出血的有效率分别为100.00％、94.44％和68.18％。善得定、施他宁、垂体后叶素3组治疗的总费用分别为2 242.8元、3 294元和996.2元;成本-效果比分别为25.63～22.43、41.18～34.88和21.59～14.61。结论:在肝硬化上消化道出血的药物选择上应首先考虑应用成本-效果比最低的垂体后叶素治疗,效果不佳可及时更换生长抑素类药物,而对食道胃底静脉出血等较严重的病例在经济条件允许的情况下可优先选用成本-效果比较低的善得定治疗。
OBJECTIVE: To evaluate the cost and effectiveness of three pharmacotherapeutic schemes for hemorrhage of upper digestive tract caused by liver cirrhosis. METHODS: 132 patients with hemorrhage of upper digestive tract were treated by different drugs:octreotide(49),somatostatin(42),pituitrin(41).Evaluation was carried out with pharmacoeconomic cost-effectiveness analysis. RESULTS: The hemostatic rates of octreotide, somatostatin and pituitrin for rupture of esophageal vari-cosis were 88. 89% , 80% and 46.15% ; for peptic ulcer bleeding associated with liver cirrhosis 88. 89% , 87. 50% and 50. 00% and for hemorrhage from acute gastric mucosa erosion combined with liver cirrhosis 100.00% , 94.44% and 68.18% , respectively. The costs of octreotide, somatostatin and pituitrin schemes were RMB 2 242.8,3 294 and 996.2 yuans, respectively. CONCLUSION: According to the evaluation with pharmacoeconomic cost-effectiveness analysis, the therapeutic scheme of pituitrin seems to be the best one for treating hemorrhage of upper digestive tract resulting from liver cirrhosis.
出处
《中国医院用药评价与分析》
2001年第5期278-280,共3页
Evaluation and Analysis of Drug-use in Hospitals of China
关键词
肝硬化
上消化道出血
药物治疗
成本-效果分析
奥曲肽
施他宁
垂体后叶素
hemorrhage of upper digestive tract caused by Liver cirrhosis
octreotide
somatostatin
pituitrin
cost-effectiveness analysis
