食管静脉曲张出血3种治疗方法的成本效果分析

目的　对比 3种疗法治疗食管静脉曲张出血 (EVB)的临床成本 /效果。方法　 98例EVB分为 3组 ,36例给予垂体后叶素 (0 .2～ 0 .4u·min-1,共 2d)联用硝苯啶 (垂体组 )、30例给予施他宁 (2 5 0 μg·h-1,共 2d) (施他宁组 ) ,32例给予硬化剂治疗 (硬化剂组 ) ,并对 3组成本和效果进行分析。结果　垂体组、施他宁组和硬化剂组 2 4h内有效止血分别为 32例 (88.89% )、2 7例 (90 .0 0 % )和 2 8例 (87.5 0 % ) ,各组间比较无显著差异 (P >0 .0 5 ) ;平均输血量垂体组与硬化剂组、施他宁组与硬化剂组间比较均差异性显著 (P <0 .0 5 ) ;3d和 7d再出血率各组间比较无明显差异 (P >0 .0 5 ) ;成本 /效果比值 (C/E)垂体组明显低于施他宁组和硬化剂组 (P <0 .0 5 )。结论　垂体后叶素联用硝苯啶不但安全有效 ,相比更经济 ,应为治疗EVB紧急止血的一线药物

A cost-effectiveness analysis on the treatment of esophageal varic es bleeding with 3 methods

Objective To compare the efficacy,economic cost of treatment of esophageal varices bleeding(EVB)with 3 methods.Methods Ninty-eight EVB patients divided into 3 groups:36 patients treated with pituitrin (0.2～0.4?u·min -1 ,for 2 days) combined with nifedipini(pituitrin group),30 patients treated with stilamin(250?μg·h -1 ,for 2 days) (stilamin group) and other 32 patients treated with esophageal variceal sclerotherapy (EVS group).Results The hemostatic rate within 24h maintained were 88.89% in pituitrin group,90% in stilamin group and 87.50% in EVS group(P>0.05).The rebleeding rate within 3 days and 7 days in three group were not significant difference(P>0.05).The quantity of everage blood transfusion was significant different between pituitrin group and EVS group,stilamin group and EVS group(P<0.05).The direct ratio of medical effects costs of pituitrin group were less than those of stilamin group(average 1899 yan vs 14162 yan,P<0.05),also less than those of EVS group(average 1899 yan vs 6142 yan,P<0.05).Conclusion Considering the effectiveness and the costs,large dose pituitrin combined with nifedipini was an effective,safe and economical method for emergency hemostasis of EVB.