上消化道出血急诊胃镜检查的经济学分析

目的上消化道出血急诊胃镜检查的经济学评价。方法将100例上消化道出血患者随机分为急诊胃镜组（A组）48例及非急诊胃镜组（B组）52例，两组患者的确诊率、再出血率、病死率、并发症发生率、平均住院日指标的观察及费用的统计，计算两组患者的成本效果比。结果A组确诊率（100．0％）高于B组（90．2％）（X2=4．01，P〈0．05）；A组胃镜检查费（714．78±263．54）元明显高于B组（383．57±251．72）元（t=2．778，P〈0．01）；再出血率A组（6．7％）明显低于B组26．8％（X2=4．13，P〈0．05）；A组总住院费为（2785．76±353．26）元明显低于B组（3527．76±555．62）元（t=2．898，P〈0．01）；成本效果比A组为2785．76元／人，低于B组3527．76元／人（t=2．239，P〈0．01）。结论上消化道出血急诊胃镜检查有临床价值且成本效果明显。

Economic analysis of emergency endoscopy in the diagnosis and treatment of massive upper gastrointestinal hemorrhage

Objective To value of economic with emergency endoscopy in the diagnosis and treatment of massive upper gastrointestinal hemorrhage. Methods I00 patients with upper gastrointestinal hemorrhage were ran-domly divided into emergency endoscopy group (group A) 48 cases and non emergency endoscopy group (group B) 52 cases. Then the correct diagnosis rates, rebleeding rates, complication rates, mean hospitalization days, the en-doscopy costs, the blood transfusion costs, the drugs costs and the total hospitalization costs of two groups were evalu-ated and the cost effect ratio (C/E) was calculated. Results Thecorrect diagnosis rates in A group (100. 0%) were higher than the B group(90. 2%)(x2 =4.01,P <0. 05) ;The endoscopy costs of group A (714. 78±263.54) yuan were higher than the group B (383.57 ±251.72) yuan(t = 2. 778, P < 0. 01) ; Rebleeding A group (6. 7%) were sig-nificantly lower than B group(26. 8%) (x2 = 4. 13 ,P < 0. 05) ; The total hospitalization costs in group A (2785.76 ± 353.26) yuan were lower than group B (3527. 76 ± 555.62) yuan (t = 2. 898, P < 0. 01) ; The C/E of group A (2785.76) yuan per patient were lower than the group B(3527.76) yuan per patient (t = 2. 239 ,P < 0. 01). Con-dusion Emergency endoscopy is economical in the diagnosis and treatment of massive upper gastrointestinal hereof-rhea.