新型包皮环切缝合器治疗小儿包茎包皮过长的成本效果

目的观察新型包皮环切缝合器配合复方利多卡因乳膏局部浸润麻醉治疗小儿包茎及包皮过长的效果和安全性,并探讨其成本效果。方法遵循临床流行病学与卫生经济学的原理和方法,选择2012年5月-2014年8月四川省隆昌县人民医院236例包茎及包皮过长患者为研究对象,将其中118例接受新型包皮环切缝合器治疗（治疗组）与118例接受传统环切术治疗（对照组）的患儿进行对比,记录两组患儿的临床疗效和费用,计算并比较两组的成本效果。结果治疗组患儿麻醉疼痛、手术时间、家长满意度、术中出血量、术后愈合时间、术后并发症、切口外观、医疗费用、总体评价得分情况均优于对照组,差异均有高度统计学意义（P〈0.01）。两组的成本效果比（C/E）分别为999.88和1267.61,在获得相同的总体评价得分时,治疗组比对照组节省267.73元,所需医疗费用仅为对照组的78.9%;以对照组为基准,增量C/E为519.01,治疗组每增加1%的总体评价得分率仅比对照组多用5.19元。结论新型包皮环切缝合器配合复方利多卡因乳膏局部浸润麻醉治疗小儿包茎及包皮过长在临床疗效、治疗成本等方面均令人满意,值得在临床上推广应用。

Cost-effectiveness of disposable circumcision suture device for treatment of children with phimosis and redundant prepuce

Objective To observe the efficacy and safety of disposable circumcision suture device and compound lidocaine cream local infiltration anesthesia for treatment of children with phimosis and redundant prepuce, and explore the cost-effectiveness. Methods The principles and methods of clinical epidemiology and health economics were followed,and 236 cases of children with phimosis and redundant prepuce from May 2012 to August 2014 in the People＇s Hospital of Longchang County in Sichuan Province were selected, 118 children of which received disposable circumcision suture device treatment（treatment group） were compared with 118 children of which received traditional circumcision surgery（control group）. The clinical efficacy and cost records of two groups were recorded, cost-effectiveness of the two groups was compared. Results The narcotic pain, time of operation, parents satisfaction, intraoperatve blood soss, postoperative healing time, postoperative complications, appearance of the incision, hospitalization costs, overall evaluation score of the treatment group were better than those of the control group, the differences were statistically significant（P 0.05）. The cost-effectiveness ratio of the two groups were 999.88 and 1267.61; when achieve the same effect, the treatment group saved 267.73 yuan compared with the control group, the drug cost in the control group was only 78.9%.The control group was a reference, incremental cost effectiveness ratio was 519.01, in the treatment group, each 1%overall evaluation scoring rate only cost less than the control group about 5.19 yuan. Conclusion The disposable circumcision suture device and compound lidocaine cream local infiltration anesthesia for treatment of children phimosis and redundant prepuce is good effect, worthy of clinical application.