丙泊酚中/长链脂肪乳联合舒芬太尼用于颅脑损伤镇静镇痛的成本-效果分析

目的探讨丙泊酚中/长链脂肪乳联合舒芬太尼用于颅脑损伤镇静镇痛的成本-效果。方法选择余姚市人民医院重症监护病房收治的60例颅脑损伤患者,随机分成观察组和对照组。所有患者在舒芬太尼镇痛治疗的基础上,观察组给予丙泊酚中/长链脂肪乳,对照组给予丙泊酚,比较2种镇静镇痛方案的成本-效果。结果与对照组比较,观察组的重症监护病房住院天数、住院总天数、昏迷天数和机械通气天数,镇静镇痛药物成本、住院药物成本以及住院成本无统计学差异(均P>0.05)。观察组存活率(77.78%)明显高于对照组(73.33%),但差异无统计学意义(P>0.05),而观察组出院时格拉斯哥昏迷评分(Glasgow Coma Scale,GCS)(10.38±4.15)分显著高于对照组(8.17±3.93)分,差异有统计学意义(P<0.05)。以出院时GCS评分和存活率作为疗效指标时,观察组的平均成本-效果比和增量成本-效果比均显著低于对照组,差异有统计学意义(均P<0.05)。结论丙泊酚中/长链脂肪乳联合舒芬太尼是颅脑损伤患者较为经济、有效的镇静镇痛方案。

Cost-effectiveness analysis of medium/long chain propofol combined with sufentanil for sedation and analgesia in patients with craniocerebral injury

Objective To investigate the cost-effectiveness of sedation and analgesia with medium/long chain propofol combined with sufentanil in the treatment of craniocerebral injury.Method Sixty patients with craniocerebral injury admitted to ICU were randomly divided into observation group and control group according to the admission time.Based on sufentanil analgesic therapy,all patients in the observation group were administered medium/long chain propofol,while those in the control group were given propofol.The cost-effectiveness of the two sedative and analgesic regimens was compared.Results In comparison with the control group,there was no statistical difference in the ICU hospitalization days,total hospitalization days,coma days and mechanical ventilation days,the cost of sedative and analgesic drugs,the cost of inpatient drugs and the total cost of hospitalization in the observation group(all P>0.05).The survival rate of the observation group(77.78%)was higher than that of the control group(73.33%),but the difference was not statistically significant(P>0.05),while the GCS score of the observation group(10.38±4.15)was statistically significantly higher than that of the control group(8.17±3.93)(P<0.05).When the GCS score and the survival rate were taken as therapeutic indicators at discharge,the average cost-effectiveness ratio and incremental cost-effectiveness ratio of the observation group were significantly lower than those of the control group(all P<0.05).Conclusion Medium/long chain propofol combined with sufentanil is an economical and effective sedative and analgesic therapeutic regimen for craniocerebral injury.