肝硬化食管静脉曲张出血硬化治疗的成本-效益分析

目的对肝硬化食管静脉曲张出血硬化治疗的成本-效益情况进行分析。方法以患者硬化治疗直接医疗费用作为硬化治疗的成本,以无出血生存时间作为效益。直接医疗费用除以无出血生存时间作为硬化治疗的本益比。不同硬化剂本益比差别进行t检验,不同肝功能病例间进行方差分析。结果硬化治疗平均本益比为3708元/年。乙氧硬化醇组本益比高于鱼肝油酸钠组(P<0.001)。肝功ChildA级与B级间本益比无统计学差异(P=0.17),肝功C级患者总直接费用和生存时间均低于肝功B级患者(P=0.002,P=0.008),其本益比则高于肝功B级患者(P=0.04)。结论乙氧硬化醇组本益比高于鱼肝油酸钠组。肝功较差患者食管静脉曲张出血硬化治疗的本益比高于肝功较好患者。

Cost-effectiveness Analysis of Esophagogastric Varicial Sclerotherapy on Cirrhotic Patients

Objective To analyze the cost-effectiveness of esophagogastric varicial sclerotherpy (EVS) on cirrhotic patients.Methods T test was used to find the difference between different sclerosant on cost-effective ratio,and anova analysis was used to find the difference between different hepatic functions.Results Mean cost-effectiveness ratio was $3708/year.The mean cost- effectiveness ratio of aethoxysklerol group was higher than that of the sodium morrhuate group ( P <0.001).Among 3 groups of different hepatic function,there was no difference on mean cost-effectiveness ratio between group of Child A hepatic function and Child B hepatic function ( P =0.17) while the mean non-bleeding survival time,mean direct cost of group of Child C hepatic function was lower than that of Child B hepatic function ( P=0.002,P =0.008) and the mean cost-effectiveness ratio of group of Child C hepatic function was higher than that of Child B hepatic function( P =0.04).Conclusion Higher cost-effectiveness ratio was found in aethoxysklerol group.Cost-effectiveness ratio of EVS on patients of worse hepatic function was higher than on patients of better hepatic function.