尖吻蝮蛇血凝酶与氨基己酸氯化钠防治围手术期出血的有效性和经济性比较:基于溯直医疗数据库的回顾性研究  

Comparison of the effectiveness and economic value between haemocoagulase agkistrodon and aminocaproic acid and sodium chloride in the prevention and treatment of perioperative bleeding:a retrospective study based on the SuValue®database

作　　者：李静 孙国庆 宣建伟 Jing LI;Guo-Qing SUN;Jian-Wei XUAN(Health Economic Research Institute,Sun Yat-Sen University,Guangzhou 510006,China)

机构地区：[1]中山大学药学院医药经济研究所,广州510006

出　　处：《药物流行病学杂志》2023年第7期737-744,共8页Chinese Journal of Pharmacoepidemiology

摘　　要：目的基于真实世界研究评价尖吻蝮蛇血凝酶和氨基己酸氯化钠应用于围手术期住院患者止血的有效性和经济性差异。方法回顾溯直医疗数据库(SuValue?)2016年1月1日—2020年12月31日三级医院围手术期使用尖吻蝮蛇血凝酶或氨基己酸氯化钠住院患者的临床疗效和直接医疗成本数据,按不同干预措施将患者分别纳入尖吻蝮蛇血凝酶组和氨基己酸组,进行倾向性评分匹配,比较两组的有效性和经济性差异。结果两组各纳入367例患者。有效性方面,与氨基己酸组相比,尖吻蝮蛇血凝酶组患者的估计总失血量和住院时间显著减少(P<0.01);两组患者的输血率和输血量差异均无统计学意义(P>0.05),术前和术后凝血酶原时间、凝血酶时间、活化部分凝血活酶时间、纤维蛋白原水平均在正常值范围,未影响患者凝血功能。经济性方面,尖吻蝮蛇血凝酶组住院总成本、止血总成本、止血药物成本和止血材料成本低于氨基己酸组(P<0.05)。结论尖吻蝮蛇血凝酶应用于围手术期住院患者防治出血症状的有效性和经济性优于氨基己酸氯化钠注射液。Objective To evaluate the effectiveness and economic value between haemocoagulase agkistrodon and aminocaproic acid and sodium chloride in perioperative inpatients.Methods A retrospective database study was conducted in which the clinical efficacy and direct medical cost of perioperative inpatient admitted to tertiary hospitals using haemocoagulase agkistrodon or aminocaproic acid and sodium chloride according to the SuValue®database from January 1st,2016 to December 31st,2020.The patients were divided into haemocoagulase agkistrodon group and aminocaproic acid group according to the different interventions.Aſter matching with propensity score,the effectiveness and economic differences between the two groups were compared.Results A total of 367 patients were included in each of the two groups.In terms of effectiveness,haemocoagulase agkistrodon significantly reduced estimated total blood loss and length of hospital stay compared with aminocaproic acid(P<0.01).There were no significant differences in transfusion rate and transfusion volume between the two groups(P>0.05),and the preoperative and postoperative prothrombin time,thrombin time,activated partial thrombin time,fibrinogen level were within the normal range,which did not affect the coagulation function of patients.In terms of economic value,the total cost of hospitalization and hemostasis,procoagulant drugs and hemostatic material cost per capita in haemocoagulase agkistrodon group were lower than those in aminocaproic acid group(P<0.05).Conclusion The effectiveness and hemostasis economic value of haemocoagulase agkistrodon in perioperative inpatients are superior to that of aminocaproic acid.

关 键 词：尖吻蝮蛇血凝酶 氨基己酸氯化钠 围手术期 出血 倾向性评分匹配 有效性 经济性 真实世界研究 

分 类 号：R969.3[医药卫生—药理学]