CAJ | 학술논문

目的探讨长期家庭无创正压通气治疗慢性阻塞性肺疾病并发慢性呼吸衰竭的临床经济学意义.方法共选择34例慢性阻塞性肺疾病并发慢性呼吸衰竭患者,治疗组17例,应用长期家庭无创通气治疗;对照组17例,常规治疗.观察比较治疗组治疗后与治疗前及治疗组治疗后与对照组的年平均疾病急性发作次数、年平均住院次数、年平均住院天数及年平均医疗花费情况,将购买家用呼吸机的支出作为治疗组的额外成本,对治疗组治疗后与治疗前、治疗组治疗后与对照组的年平均花费进行成本效益分析.结果治疗组治疗后患者的年平均疾病急性发作次数、平均住院次数、平均住院天数、平均医疗费用较治疗前及对照组均显著减少(P＜0.01);治疗组治疗后较治疗前及对照组年平均节省的医疗费用(B)分别为5.51万元和5.48万元,购买呼吸机的平均费用(C)为2.3万元,B/C值分别为2.40和2.38,有明显的临床经济学意义.结论长期家庭无创正压通气治疗慢性阻塞性肺疾病并发慢性呼吸衰竭可明显降低总的医疗费用支出.
목적 탐토장기가정무창정압통기치료만성조새성폐질병병발만성호흡쇠갈적림상경제학의의.방법 공선택34례만성조새성폐질병병발만성호흡쇠갈환자,치료조17례,응용장기가정무창통기치료;대조조17례,상규치료.관찰비교치료조치료후여치료전급치료조치료후여대조조적년평균질병급성발작차수、년평균주원차수、년평균주원천수급년평균의료화비정황,장구매가용호흡궤적지출작위치료조적액외성본,대치료조치료후여치료전、치료조치료후여대조조적년평균화비진행성본효익분석.결과 치료조치료후환자적년평균질병급성발작차수、평균주원차수、평균주원천수、평균의료비용교치료전급대조조균현저감소(P＜0.01);치료조치료후교치료전급대조조년평균절성적의료비용(B)분별위5.51만원화5.48만원,구매호흡궤적평균비용(C)위2.3만원,B/C치분별위2.40화2.38,유명현적림상경제학의의.결론 장기가정무창정압통기치료만성조새성폐질병병발만성호흡쇠갈가명현강저총적의료비용지출.
Objective To study the clinical economy value of long-time domiciliary noninvasive positive pressure ventilation (LTDNIPPV) in the treatment of chronic obstructive pulmonary disease (COPD) complicated with chronic respiratory failure. Methods 34 COPD complicated with chronicrespiratory failure cases were selected, then divided into two groups randomly, one group treated with LTDNIPPV,the other with traditional therapy, the therapeutic course was a year. The overall incidence (person per year) for acute attack of COPD complicated with chronic respiratory failure, the hospitalization, the mean times of hospitalization and the mean medical cost including the expense of domiciliary respirator were compared before and after treatment in LTDNIPPV group and traditional group. The cost-benefit of both groups was figured out. Results After LTDNIPPV treatment, the incidence for acute attack, the hospitalization, the mean times of hospitalization and the mean medical cost decreased significantly in LTDNIPPV group( P ＜0.01 ), 51. 5 thousand yuan and 54.8 thousand yuan medical expenditure were saved after LTDNIPPV treatment compared with before LTDNIPPV treatment and traditional group, the cost of respirator is 23 thousand yuan, B/C is 2.40,2.38 respectively, which shows great clinical economy value. Conclusions LTDNIPPV is a good method to prevent acute attack and decrease overall medical expenditure in patient with COPD complicated with chronic respiratory failure.