部分脾栓塞与脾切除术治疗血吸虫性肝硬化并发脾功能亢进的成本效果分析  

Cost-effectiveness Analysis of Partial Splenic Embolization and Splenectomy in the Treatment of Schistosomiasis Induced Liver Cirrhosis Complicated with Hypersplenism

作　　者：张红梅 ZHANG Hongmei(Department of Inpatient,Xinjian District Schistosomiasis Control Station of Nanchang City,Nanchang 330100,China)

机构地区：[1]江西省南昌市新建区血吸虫病防治站住院部,江西南昌330100

出　　处：《中国医药指南》2023年第20期111-113,共3页Guide of China Medicine

摘　　要：目的探讨部分脾栓塞与脾切除术治疗血吸虫性肝硬化并发脾功能亢进的成本效果。方法选取我院2021年1~12月血吸虫性肝硬化并发脾功能亢进患者60例,采用随机数字表法将其分为对照组30例与研究组30例。对照组患者行脾切除术,研究组行部分脾栓塞术。比较两组手术前后的机体炎症指标水平、补体C_(3)和补体C_(4)水平、手术时间、出血量、住院时间、成本、疗效、手术并发症发生率等情况。结果手术前两组机体炎症指标水平、补体C_(3)和补体C_(4)水平比较,P>0.05,手术后两组机体炎症指标水平均显著降低,补体C_(3)和补体C_(4)水平均升高,其中研究组机体炎症指标水平显著低于对照组,补体C_(3)和补体C_(4)水平显著高于对照组,P<0.05。研究组的疗效显著率93.33%比对照组76.67%高(P<0.05)。研究组手术时间、出血量、住院时间、成本短或低于对照组,P<0.05。研究组手术并发症发生率低于对照组(P<0.05)。结论血吸虫性肝硬化并发脾功能亢进患者实施部分脾栓塞效果确切,能够有效减少创伤,更好控制机体炎症和提高免疫力,减少手术并发症的发生,其成本低,效果好。Objective To investigate the cost effectiveness of partial splenic embolization and splenectomy in the treatment of schistosomiasis induced liver cirrhosis with hypersplenism.Methods From January 2021 to December 2021,60 patients with schistosomiasis induced liver cirrhosis complicated by hypersplenism in our hospital were selected and divided into a control group of 30 cases and a study group of 30 cases using a random number table method.Patients in the control group underwent splenectomy,while patients in the study group underwent partial splenic embolization.The levels of inflammation indicators,complement C_(3) and C_(4) levels,surgical time,bleeding volume,hospital stay,cost,significant rate of efficacy,and incidence of surgical complications were compared between the two groups before and after surgery.Results Before surgery,the levels of inflammatory indicators,complement C_(3),and complement C_(4) in the two groups were compared,P>0.05.After surgery,the levels of inflammatory indicators in the two groups were significantly reduced,while the levels of complement C_(3) and complement C_(4) were both increased.Among them,the levels of inflammatory indicators in the study group were significantly lower than those in the control group,while the levels of complement C_(3) and complement C_(4) were significantly higher than those in the control group,P<0.05.The significant rate of efficacy in the study group was 93.33%higher than 76.67%in the control group(P<0.05).The operation time,bleeding volume,hospitalization time,and cost in the study group were lower than those in the control group(P<0.05).The incidence of surgical complications in the study group was lower than that in the control group(P<0.05).Conclusion Partial splenic embolization is effective for patients with schistosomiasis induced liver cirrhosis and hypersplenism,which can effectively reduce trauma,better control inflammation,improve immunity,and reduce the occurrence of surgical complications.It has low cost and good effect.

关 键 词：血吸虫性肝硬化并发脾功能亢进 部分脾栓塞 脾切除术 成本效果 

分 类 号：R657.63[医药卫生—外科学] R657.31[医药卫生—临床医学]