腹腔镜与开腹直肠癌Dixon术的卫生经济学评价  

Cost-effectiveness analysis of laparoscopic versus open anterior resection for rectal cancer

作　　者：刘勤[1] 周少波[2] 刘蔚东[3] 齐玉龙[1] 

机构地区：[1]安徽蚌埠医学院,安徽蚌埠233000 [2]蚌埠医学院附属医院肝胆外科,安徽蚌埠233004 [3]卫生部肝胆肠外科研究中心,湖南长沙410008

出　　处：《中国现代医学杂志》2009年第10期1566-1568,共3页China Journal of Modern Medicine

摘　　要：目的比较腹腔镜和开腹直肠癌Dixon术的近期疗效及两种手术技术的费用以及卫生资源利用率。方法自2006年7月～2008年12月,选择直肠癌患者87例,其中腹腔镜手术组46例,开腹手术组41例。比较2组的手术资料、直接与间接医疗费用以及总医疗成本。结果腹腔镜手术组切口长度、术中出血量、术后肛门排气时间、术后下床活动时间和住院天数明显少于开腹手术组,而2组手术耗时相差不大。腹腔镜组与开腹组直接医疗费用分别为(18166.99±1573.46)元和(17319.24±1250.22)元,2组差异无显著性;其中手术费用腹腔镜组为(11526.22±915.00)元。显著高于开腹组的(8682.08±693.65)元(P<0.01);药物治疗费用腹腔镜组(2714.37±267.62)元,显著低于开腹组的(4106.52±412.55)元(P<0.01);间接医疗费用腹腔镜组为(845.23±134.37)元,显著低于开腹组的(1584.47±213.61)元(P<0.01)。总的医疗成本2组无显著差别。结论相对于开腹直肠癌Dixon术,腹腔镜手术具有创伤小,患者恢复快的优势,且不增加总的医疗成本。[Objectives] To compare the early outcomes of laparoscopic Dixon procedure versus traditional procedure and evaluate the cost-effectiveness of the two methods for rectal cancer. [Methods] From July 2006 to Dee 2008, 46 patients With rectal cancer underwent laparoseopic Dixon procedure, while 41 eases were submitted to open procedure. The early outcomes as well as the direct, indirect and the total costs of two groups were compared. [Resuits] The laparoscopie group was better than open group when compare the early outcomes. The direct east of laparoscopic group was similar to that of open group [（18166.99±1573.46） RMB vs （17319.24±1250.22） RMB; P 〉 0.05].The operation related cost of the laparoseopic group was significantly higher than that of the open group [（11526.22±915.00） RMB vs （8682.08±693.65） RMB; P 〈0.05]. The medicine cost and indirect cost of laparoseopie group wassignificant lower than that of open group [（2714.37±267.62） RMB vs （4106.52±412.55） RMB and （845.23±134.37） RMB vs （1584.47±213.61） RMB respectively; P 〈0.05]. The total cost was not signilicandy different between two groups. [ Condusiorts] Laparoseopie Dixon for rectal cancer was minor invasiveness. The total economical burden for the patients were not significantly different between the laparoseopie and open groups.

关 键 词：腹腔镜 DIXON术 直肠癌 成本效果分析 

分 类 号：R735.37[医药卫生—肿瘤] R195[医药卫生—临床医学]