两种中心静脉血管通路应用于神经外科重症监护病房患者中的卫生经济学比较  

Health Economics Comparison of Two Central Venous Vascular Access in Neurosurgical Intensive Care Unit Patients

作　　者：邓瑛瑛[1] 殷春梅[1] 徐飞[1] 包贇 邱炳辉[1] DENG Ying-Ying;YIN Chun-Mei;XU Fei;BAO Yun;QIU Bing-Hui(Department of Neurosurgery,South Hospital Affiliated to Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院神经外科,广州510515

出　　处：《中国药物经济学》2023年第7期29-34,45,共7页China Journal of Pharmaceutical Economics

基　　金：南方医科大学护理科研专项(Y2021011)。

摘　　要：目的 比较经外周静脉置入的中心静脉导管(PICC)和中心静脉导管(CVC)两种中心静脉血管通路应用于神经外科重症监护病房(ICU)患者中的经济性差异,评估其临床应用的可负担性。方法 收集2018年7月至2022年4月入住南方医院神经外科ICU后行中心静脉置管的患者401例(PICC组280例,CVC组121例)的临床资料,采用预算影响分析法(BIA)对两组患者的置管、维护和拔管情况以及各项费用、并发症发生率及其相关处理费用等指标进行统计学分析和评价。结果 相较于CVC组患者,PICC组患者平均ICU滞留天数和平均导管留置天数更长(P<0.05),1次置管成功率更高(96.1%vs.87.6%,P=0.002),相同置管时长条件下置管总费用更节约(114 341.85 vs.174 858.00元/千导管日),并发症发生率显著减少(0.81 vs.21.74例/千导管日,P=0.000),并发症处理费用更少(1 369.86 vs.97 840.79元/千导管日)。结论 与CVC置管相比,在神经外科ICU患者中使用PICC置管能够减少日均置管所产生的费用,降低导管相关并发症发生率,节约并发症相关治疗费用,从而使临床患者获益,减轻患者家庭经济负担,具有良好的临床应用价值。Objective To compare the economics of peripherally inserted central catheter(PICC)and central venous catheter(CVC)in neurosurgical intensive care unit(ICU)patients,and evaluate the affordability of their clinical use.Methods The data of total 401 patients(280 patients in PICC group and 121 patients in CVC group)who underwent central venous cannulation from neurosurgical ICU of South Hospital Affiliated to Southern Medical University were retrospectively collected from July 2018 to April 2022,and then statistically analyzed by using BIA(Budget Impact Analysis)to compare the situation and costs about cannulation,catheter maintenance and removal,as well as the incidence and treatment costs of catheter related complications.Results Compared with the patients in CVC group,the average length of ICU admission and catheter retention were longer(P<0.05),the first inserted success rate was higher(96.1%vs.87.6%,P=0.002),the incidence of complications(0.81 vs.21.74 per 1000 catheter days,P=0.000)were significantly reduced,and the total costs of cannulation(114341.85 vs.174858.00 Yuan per 1000 catheter days)and complications treatment(1369.86 vs.97840.79 Yuan per 1000 catheter days)were lower in the patients in PICC group.Conclusion Compared with CVC cannulation,PICC cannulation for neurosurgical ICU patients could decrease the daily cannulation cost,the incidence and treatment costs of catheter-related complications,so as to good benefits and lower burden forclinical application.

关 键 词：中心静脉血管通路 神经外科 重症监护病房 经外周静脉置入的中心静脉导管 中心静脉导管 卫生经济学 预算影响分析 临床获益 

分 类 号：R473.6[医药卫生—护理学] R956[医药卫生—临床医学]