腹腔镜子宫肌瘤剔除术的卫生经济学研究

目的：对腹腔镜及开腹子宫肌瘤剔除的手术效果和成本进行比较分析。方法：回顾性分析了乌鲁木齐总医院107例子宫肌瘤剔除术患者的一般资料、手术效果、总成本及其构成。其中腹腔镜54例，开腹53例。结果：①腹腔镜子宫肌瘤剔除手术时间短，术中出血少，术后恢复快；与开腹组比较具有显著差异（P〈0．01）；②腹腔镜组直接医疗费用为（6255．99±739．55）元，高于开腹组（5675．55±569．64）元（P〈0．01）；腹腔镜组直接非医疗费用为（475．76±126．94）元，低于开腹组（559．09±128．97）元（P〈0．05）；腹腔镜组误工费为（1358．57±257．68）元，低于开腹组（2158．34±274．52）元（P〈0．01）；腹腔镜组总计费用为（8090．32±968．75）元，与开腹组（8410．45±684．98）元差异未达显著性水平（P〉0．05）。结论：腹腔镜子宫肌瘤剔除术后恢复快，成本并不比开腹手术高。

Health economics of myomectomy via laparoscopy and laparotomy

Objective：To compare the effects and costs of myomectomy via laparoscopy and laparotomy. Methods： Patients who underwent myomectomy via laparoscopy or laparotomy in Urumqi General Hospital were enrolled to perform a retrospective cohort study. Results：The patients who underwent laparoscopic myomectomy experienced a shorter operation, a less blood loss and a better recovery （P 〈 0.01 ）. The cost of hospitalization was higher in laparoscopy group （6 255. 99 ±739.55 vs 5 675.55 ±569. 64 Yuan, P 〈0.01）. But the nonmedical expenditure and the salary loss of sick leave were significantly lower in the laparoscopy group. The total cost of laparoscopic myomectomy （8 090.32 ± 968.75 Yuan） seems to be lower than that of laparotomy （8 410.45 ± 684.98 Yuan）. But there was no significant difference （P 〉 0.05 ）. Conclusion：The patients who underwent laparoseopic myomectomy enjoyed a better recovery. There was no significant difference in the total cost between the two groups.