摘要
目的 :观察急诊胃镜诊治上消化道大出血的应用价值 ;通过卫生经济学评价 ,探讨急诊胃镜的安全性及医疗费用。方法 :将 91例患急诊上消化道大出血患者随机分为急诊胃镜组 (A组 )及非急诊胃镜组 (B组 ) ,A组患者在血压正常后立即行胃镜检查 ,B组患者在入院后 2 4～ 4 8h行胃镜检查 ,两组均酌情进行胃镜下治疗 ;评价两组患者的确诊率、再出血率、病死率、并发症发生率、平均住院日、胃镜检查费、输血费、药费及总住院费 ,计算两组患者的成本效果比。结果 :A组确诊率 (1 0 0 .0 % )及胃镜检查费 (71 4 .78± 2 6 3.5 4 )元明显高于 B组〔分别为 90 .2 %和 (383.5 7± 2 5 1 .72 )元 ,P<0 .0 5 ,P <0 .0 1〕;再出血率 A组 (6 .7% )明显低于 B组 2 6 .8%(P<0 .0 5 ) ;A组平均住院日为 (5 .4 2± 1 .70 ) d,输血费为 (791 .80± 2 5 8.35 )元 ,药费为 (94 5 .2 2± 1 2 5 .82 )元 ,总住院费为 (2 785 .76± 35 3.2 6 )元 ,明显低于 B组 (8.5 1± 2 .30 ) d(P<0 .0 1 ) ,(1 2 70 .2 9± 5 6 9.2 1 )元 (P<0 .0 1 ) ,(1 2 2 3.81± 2 5 4 .4 4 )元 (P<0 .0 1 ) ,(35 2 7.76± 5 5 5 .6 2 )元 (P<0 .0 1 )。成本效果比 A组为 2 785 .76元 /人 ,低于 B组 35 2 7.76元 /人。结论 :急诊胃镜诊治上消化道大出血不仅安?
Objective: To study the application value of emergency endoscopy in the diagnosis and treatment of massive upper gastrointestinal hemorrhage, and to evaluated by the economic analysis whether the emergency endoscopy was safe and effective,or shorten the hospitalization days and reduced the medical costs. Methods: Nintyone patients with massive upper gastrointestinal hemorrhage were randomly divided into emergency endoscopy group (group A) and nonemergency endoscopy group (group B).The patients in group A were endoscopied as soon as the blood pressures were normal and the patients of group B were endoscopied at 2448 hours after hospitalization. They would be treated depending on the conditions by endoscopy. Then the correct diagnosis rates, rebleeding rates, complication rates, mean hospitalization days, the endoscopy costs, the blood transfusion costs, the drugs costs and the total hospitalization costs of two groups were evaluated and the costeffect ratio(C/E) was calculated. Results: The correct diagnosis rates and the endoscopy costs of group A were higher than the group B 〔100 0 percent vs.90 2 percent, P <0 05;(714 78± 263 54)yuan vs. (383 57±251 72)yuan, P <0 01〕 , and the rebleeding rates, the mean hospitalizations days, the blood transfusion costs and the drugs costs and the total hospitalization costs were all lower compared to the group B 〔6 1 percent vs. 26 8 percent, P <0 05; (5 42±1 70)days vs. (8 51±2 30)days, P <0 01;(791 80±258 35)yuan vs. (1 270 29±569 21)yuan, P <0 01;(945 22±125 82)yuan vs. (1 223 81 ±254 44)yuan, P <0 01;(2 785 76±353 26)yuan vs. (3 527 76±555 62)yuan, P <0 01. The C/E of group A was lower than the group B〔2 785 76 yuan per patient vs. 3 527 76 yuan per patient, P <0 01〕 . Conclusion: Emergency endoscopy is not only safe and effective but also economical in the diagnosis and treatment of massive upper gastrointestinal hemorrhage.
出处
《中国危重病急救医学》
CAS
CSCD
2003年第12期758-761,共4页
Chinese Critical Care Medicine
关键词
急诊胃镜
上消化道大出血
经济学分析
成本-效果比
emergency endoscopy
massive upper gastrointestinal hemorrhage
economic analysis
costeffect ratio
