多发性肋骨骨折内固定术与保守治疗的成本-效果分析

目的探讨镍钛记忆合金环抱器内固定手术与保守治疗多发性肋骨骨折的疗效,并对其成本-效果进行比较。方法选择2008年3月至2012年6月河北北方学院附属第二医院收治的多发肋骨骨折患者120例,按照随机数字表法分为手术组及非手术组,每组各60例。比较两组患者的疗效,疼痛时间、住院时间、治疗成本等。结果两组患者的治疗效果比较差异有统计学意义(H=5.290,P<0.001);手术组患者的疼痛时间、住院时间、无工作能力天数显著地少于非手术组(t=10.836,14.431,6.382,P<0.001);虽然手术组治疗的总成本显著地高于非手术组(t=27.235,P<0.001),在成本-效果比方面每治愈1例肋骨骨折患者,手术比非手术节省355元。结论镍钛记忆合金环抱器内固定治疗多发肋骨骨折是安全、可行的手术方式,更适合在经济条件良好的患者中推广应用。

Cost-effectiveness Analysis on Internal Fixation Surgery and Conservative Treatment for Multiple Rib Fracture

Objective To discuss the effect of internal＂ fixation surgery using Ni-Ti shape memory alloy embracing fixator and the conservative treatment for multiple rib fracture, and compare the cost-effectiveness. Methods A total of 120 cases of patients with multiple rib fractures admitted in the Second Affiliated Hospital of Hebei North University from Mar. 2008 to Jun. 2012 were collected, and divided into internal fixation operation group and the non-operation group according to the random number table method, with 60 cases in each group. The clinical curative effect, duration of pain, hospitalization time, and treatment cost of the two groups were compared. Results The currative effect of the two groups had significant statistical difference（ H = 5. 290, P 〈 0. 001 ）. The duration of pain, hospitalization time, days of disability of the internal fixation operation group were significantly less than those of the non-operation group （t = 10. 836,14.431,6. 382, P 〈 0. 001 ）, while the total treatment cost of the internal fixation operation group was significantly higher than that of non-operation group （t = 27. 235,P 〈 0. 001 ）. BUt concerning the cost-effectiveness ratio, the cost for curing each rib fraction patient of the internal fixation operation group was 355 yuan less than that of non- operation group. Conclusion Internal fixation surgery using Ni-Ti shape memory alloy embracing fixator in the treatment for multiple rib fractures is safe and feasible, and is more suitable for patients with good economic conditions.