小球囊预扩张治疗布加综合征合并混合性下腔静脉血栓一期和分期治疗方案的疗效和成本效益对比  

Comparative analysis of the efficacy and cost-effectiveness of single-stage and two-stage treatment strategy using small-diameter balloon pre-dilation for Budd-Chiari syndrome complicated by mixed inferior vena cava thrombosis

作　　者：史芳[1] 周文 李磊[2] 刘超[2] 王博[1] 张驰[1] 丁鹏绪[2] SHI Fang;ZHOU Wen;LI Lei;LIU Chao;WANG Bo;ZHANG Chi;DING Pengxu(Medical Insurance Office,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052;Department of Interventional Radiology,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052)

机构地区：[1]郑州大学第一附属医院医保办,郑州450052 [2]郑州大学第一附属医院放射介入科,郑州450052

出　　处：《郑州大学学报（医学版）》2024年第1期113-117,共5页Journal of Zhengzhou University(Medical Sciences)

基　　金：中原医创基金会医院管理研究项目(23YCG1002)。

摘　　要：目的:对比分析小球囊预扩张治疗布加综合征(BCS)合并混合性下腔静脉血栓(IVCT)一期和分期治疗方案的疗效和成本效益。方法:回顾性收集2011年1月至2020年12月郑州大学第一附属医院收治的BCS合并混合性IVCT、行小球囊预扩张治疗的患者116例,其中,一期治疗方案49例,分期治疗方案67例。对比分析两种治疗方案的血栓溶解率、技术成功率、住院时间、住院费用、医保补偿率。结果:两种治疗方案中位总住院时间(22.0 d vs 22.5 d,P=0.303)和医保补偿率(58.92%vs 55.75%,P=0.965)差异无统计学意义,而一期治疗方案血栓溶解率(100.0%vs 87.5%,P=0.012)、技术成功率(100.0%vs 62.7%,P=0.001)和中位人均住院费用(45676.51元vs 61283.21元,P<0.001)均优于分期治疗方案。结论:一期治疗方案具有更高的溶栓效率和技术成功率,以及更低的住院费用,应被临床优先选择。Aim:To compare the efficacy and cost-effectiveness of single-stage and two-stage treatment strategy using small-diameter balloon pre-dilation for Budd-Chiari syndrome(BCS)complicated by mixed inferior vena cava thrombosis(IVCT).Methods:From January 2011 to December 2020,116 patients with BCS complicated by mixed IVCT who underwent small-diameter balloon pre-dilation at the First Affiliated Hospital of Zhengzhou University were included in this retrospective study.Out of them,49 patients underwent single-stage treatment strategy while 67 underwent two-stage treatment strategy.The differences of thrombolysis rate,technical success rate,hospital stay,insurance reimbursement rate,and hospitalization cost were analyzed between the 2 groups.Results:There were no significant differences between the 2 groups in median hospital stay(22.0 days vs 22.5 days,P=0.303)or insurance reimbursement rate(58.92%vs 55.75%,P=0.965).However,the single-stage group exhibited significantly higher thrombolysis rate(100.0%vs 87.5%,P=0.012),technical success rate(100.0%vs 62.7%,P=0.001),and median per capita hospitalization cost(45676.51 CNY vs 61283.21 CNY,P<0.001)compared with the two-stage group.Conclusion:In comparison with two-stage treatment strategy,single-stage treatment strategy exhibits higher thrombolytic efficiency and technical success rate,and lower hospitalization costs,and thus should be given clinical priority.

关 键 词：布加综合征 下腔静脉 血栓 溶栓 介入治疗 

分 类 号：R605[医药卫生—外科学]