不同麻醉方法用于剖宫产术的成本分析

目的：比较分析剖宫产中应用椎管内麻醉或全身麻醉的成本消耗，为医疗成本运作和医疗政策制定提供临床参考数据。方法回顾我院择期行子宫下段剖宫产术的患者（212例），按其接受的麻醉方法分为椎管内麻醉组（连续硬膜外麻醉，SA组，106例）及全身麻醉组（喉罩下全麻，GA组，106例），对麻醉的直接成本进行了评估。从麻醉数据库中统计麻醉中使用的药品及耗材，根据麻醉相关时间及麻醉人员薪酬计算人员成本，并计算相关比例。结果剖宫产中应用全身麻醉直接麻醉成本及非人员麻醉成本均高于连续硬膜外麻醉（P＜0．05），人员成本则是连续硬膜外麻醉高于全身麻醉（P＜0．05），全身麻醉的药品及耗材成本明显高于连续硬膜外麻醉（P＜0．05），连续硬膜外麻醉的诱导时间及持续时间较长（P＜0．05），两组患者术后住院天数差异无统计学意义（P＞0．05）。结论椎管内麻醉的直接成本较低，但是人员成本相对较高。麻醉方法的选择并不影响患者术后住院天数。

Cost of continuous epidural anesthesia and general anesthesia for caesarean section

Objective To analyze the costs of continuous epidural anesthesia and general anesthesia for caesarean section and pro-vide clinical reference data for health behaviors and health policy makers.Methods The clinical data of 212 patients （aged 22~35 years） who received elective cesarean section surgery from to July to December in 2012 in our hospital were retrospectively analysed.The patients were divided into the spinal anesthesia group（continuous epidural anesthesia,SA group,n=106）and the general anesthesia group（LMA un-der general anesthesia,GA group,n=106 ）according to their method of anesthesia.Direct costs were measured on detailed data of the re-sources used during anaesthetic procedures from the anesthesia record.Costs related to anaesthetic staff work were calculated based on per ca-pita remuneration and duration of anaesthesia.Results Direct costs of general anaesthesia for caesarean section were higher than those of continuous epidural anaesthesia （P〈0.05）.Personnel costs of continuous epidural anaesthesia were found to be higher than those of general anaesthesia （P〈0.05）.Costs of pharmaceuticals and medical materials for general anaesthesia were higher than those of continuous epidural anaesthesia（P〈0.05）.The postoperative duration of hospitalization was not statistically different between the two groups （P＆gt;0.05）.Con-clusion The duration of epidural anaesthesia is longer than that of general anaesthesia,which results in higher costs of medical staff work. The postoperative days of hospitalization are not associated with anesthesia approaches.