丙泊酚复合右美托咪定用于无痛人工流产术的成本－效果分析

目的观察丙泊酚复合右美托咪定用于无痛人工流产术的临床效果及安全性，并采用药物经济学评价方法对无痛人工流产的两种麻醉方案进行成本－效果研究。方法选择孕早期自愿人工流产患者200例．随机分为丙泊酚组（A组）和丙泊酚＋有美托咪定组（B组）各100例。观察其镇痛效果及不良反应，记录术中体动反应及丙泊酚总用药量，应用药物经济学的成本－效果分析方法进行评价。结果B组的镇痛效果优于A组（P〈0．05），且其不良反应及术中体动反应和丙泊酚总用药量较少（P〈0．05）；利用药物经济学理论，经C／E分析，A组和B组的单位镇痛效果成本分别为1．84、3．42元，经△C／△E分析，B组在A组的基础上每增加一个镇痛单位，多花费成本7.33元。结论右美托咪定复合丙泊酚用于无痛人工流产安全有效，但单用丙泊酚在药物经济学上优于B组。

Cost-effectiveness analysis of propofol combined with dexmedetomidine on painless artificial abortion

Objective To observe the clinical efficacy and safety of using propofol combined with dexmedetomidine in painless artificial abortion and evaluate the cost-effectiveness. Methods Two hundred early pregnancy women were randomly divided into 2 groups （n = 100 each） ： Group A （only propofol）, Group B （propofol plus dexmedetomidine）. Two groups were injected by intravenous anesthesia. The analgesic effect, adverse reaction, body movement and the total dosage of propofol were recorded. Cost-effectiveness ratio was evaluated by a pharmacoeconomics method. Results Group B had better analgesic effect and less adverse reaction than Group A （P 〈 0.05）. Compared with Group A, the total dosage of propofol was obviously reduced in Group B （P 〈 0.05）. The cost-effectiveness ratio was 1.84 yuan in Group A and 3.42 yuan in Group B. The cost-effectiveness analysis showed that the cost of an analgesic unit induced by adding of dexmedetomidine was more than 7.33 yuan. Conclusion Propofol combined with dexmedetomidine for painless artificial abortion is safe and effective, but only propofol is preferable to requirement of phannacoeconomic evaluation.