丙泊酚联合右美托咪定用于无痛人工流产术的成本-效果分析

目的:评价丙泊酚联合右美托咪定用于无痛人工流产术的成本-效果。方法:将我院孕早期自愿行人工流产术的患者240例随机均分为丙泊酚组和联合用药组。丙泊酚组患者仅采用丙泊酚进行麻醉;联合用药组采用丙泊酚复合右美托咪定麻醉。观察两组的镇痛效果及不良反应,记录两组患者术中体动反应次数及丙泊酚总药量,并采用成本-效果分析法进行评价。结果:联合用药组的镇痛总有效率(77.50%)显著高于丙泊酚组(56.67%),且其除头晕外的不良反应发生率、术中体动反应次数和丙泊酚总药量均低于丙泊酚组,两组比较差异均有统计学意义(P<0.05)。丙泊酚组和联合用药组的成本-效果比分别为2.27、3.93元;联合用药组相对于丙泊酚组的增量成本-效果比为8.45。经敏感度分析结果不变。结论:丙泊酚联合右美托咪定用于无痛人工流产术的镇痛效果较好,治疗费用高于单用丙泊酚,但每提高一个单位的效果仅需多支付8.45元,因此条件允许时采用联合用药方案更佳。

Cost-effectiveness Analysis of Propofol Combined with Dexmedetomidine for Painless Artificial Abortion

OBJECTIVE： To evaluate cost-effectiveness of propofol combined with dexmedetomidine for painless artificial abortion. METHODS ： 240 patients who voluntarily terminated first trimester pregnancy in our hospital were divided into propofol group and drug combination group. Propofol group was only given anesthesia using propofol, and drug combination group was given anesthesia using propofol combined with dexmedetomidine. Analgesic effects and adverse drug reactions were observed in 2 groups. The times of body movement reaction and the dose of propofol were recorded in 2 groups, and cost-effectiveness analysis was carded out. RESULTS： The analgesic total effective of drug combination group （77.50%） was significantly better than propofol group （56.67%） ; the incidence of adverse drug reaction beside dizziness, the times of intraoperative body movement and the amount of propofol in drug combination group were lower than in propofol group; there was statistical significance （P〈0.05）. The cost-effectiveness ratio of propofol group and drug combination group were 2.27 yuan and 3.93 yuan. The incremental cost-effectiveness ratio of drug combination group to propofol group was 8.45. Through sensitivity analysis, the result was not changed. CONCLUSIONS： Propofol combined with dexmedetomidine is effective for the analgesia of painless artificial abortion; the cost of it is higher than that of propofol alone; with the increase of one unit of anesthetic effect, just 8.45 yuan should be paid. Therefore, combination therapy program is better anesthetic solution.