国产和进口覆膜支架治疗非复杂Stanford B型主动脉夹层的疗效和成本比较  

Comparison of curative effect and cost between domestic and imported covered stents in the treatment of non-complex Stanford type B aortic dissection

作　　者：王诗驿 吴小冬 曹生军[1] Wang Shiyi;Wu Xiaodong;Cao Shengjun(Department of Vascular Surgery,Taizhou Second People's Hospital,Taizhou 225500,China)

机构地区：[1]江苏省泰州市第二人民医院血管外科,泰州225500

出　　处：《国际外科学杂志》2023年第3期175-179,共5页International Journal of Surgery

摘　　要：目的:比较国产和进口覆膜支架治疗非复杂Stanford B型主动脉夹层的疗效和成本。方法:采用回顾性病例对照研究的方法分析2016年9月—2021年9月泰州市第二人民医院行胸主动脉腔内修复术(TEVAR)治疗的93例非复杂Stanford B型主动脉夹层患者的临床数据,根据术中使用覆膜支架的不同分为两组,其中47例患者接受国产覆膜支架治疗(观察组),46例患者接受进口覆膜支架治疗(对照组)。比较两组患者的总有效率,并发症发生率,治疗成本和成本-效果比,并进行敏感性分析。符合正态分布的计量资料以均数±标准差(x±s)表示,组间比较采用t检验;计数资料组间比较采用χ^(2)检验或Fisher确切概率法。结果:观察组和对照组总有效率分别为93.62%、97.83%,差异无统计学意义(P>0.05);并发症发生率分别为6.38%、2.17%,差异无统计学意义(P>0.05)。观察组覆膜支架成本(62155.49±10231.08)元和总成本(95063.66±20042.34)元均低于对照组(93825.37±16577.04)元和(126035.89±26186.18)元,差异有统计学意义(P<0.05);其他直接成本观察组(32908.17±9811.26)元与对照组(32210.52±9609.14)元差异无统计学意义(P>0.05);观察组和对照组的成本-效果比分别为1015.42、1288.31,对照组的增量成本-效果比为7356.82;对两组成本-效果行敏感性分析,调整覆膜支架成本下降10%后,观察组和对照组的成本-效果比分别为949.03、1192.41,对照组的增量成本-效果比为6604.61。结论:国产与进口覆膜支架治疗非复杂Stanford B型主动脉夹层均具有较好疗效,并发症少。与进口覆膜支架相比,国产覆膜支架治疗成本更低,更具有成本-效果优势,更符合疾病诊断相关分组改革要求。Objective:To compare the curative effect and cost of domestic and imported covered stents in the treatment of non-complex Stanford type B aortic dissection.Methods:A retrospective case-control study was used to analyze the clinical data of 93 patients with non-complex Stanford B aortic dissection who underwent thoracic endovascular aortic repair(TEVAR)in Taizhou Second People's Hospital from September 2016 to September 2021.Ninty-three patients were divided into two groups according to the use of different covered stents during the operation,of which 47 patients were treated with domestic covered stents(observation group) and 46 patients were treated with imported covered stents(control group).Overall response rate,rate of complication,treatment cost and cost-effectiveness ratio of the two groups were compared and sensitivity analysis was performed in the two groups.The measurement datas conforming to the normal distribution were expressed as mean±standard deviation(x±s),and the inter-group comparison was conducted by t test.The comparison of counting datas between groups was conducted by Chi-square test or Fisher exact probability method.Results:The overall response rate of the observation group and the control group were 93.62% and 97.83%,with no significant difference(P>0.05);The incidence of complications was 6.38% and 2.17%,with no significant difference(P>0.05).The cost of covered stent[(62155.49±10231.08)yuan]and the total cost of treatment[(95063.66±20042.34)yuan]in the observation group were lower than those in the control group[(93825.37±16577.04) yuan and(126035.89±26186.18)yuan](P<0.05).There was no significant difference in other direct costs between the observation group[(32908.17±9811.26)yuan] and the control group[(32210.52±9609.14)yuan](P>0.05).The cost-effectiveness ratio of the observation group and the control group were 1015.42 and 1288.31,and the incremental cost-effectiveness ratio of the control group was 7356.82.After the cost-effectiveness sensitivity analysis and adjusting the c

关 键 词：支架 主动脉 胸 成本及成本分析 非复杂Stanford B型主动脉夹层 疗效 

分 类 号：R654.3[医药卫生—外科学]