CAJ | 학술논문

目的：比较分析剖宫产中应用椎管内麻醉或全身麻醉的成本消耗，为医疗成本运作和医疗政策制定提供临床参考数据。方法回顾我院择期行子宫下段剖宫产术的患者（212例），按其接受的麻醉方法分为椎管内麻醉组（连续硬膜外麻醉，SA组，106例）及全身麻醉组（喉罩下全麻，GA组，106例），对麻醉的直接成本进行了评估。从麻醉数据库中统计麻醉中使用的药品及耗材，根据麻醉相关时间及麻醉人员薪酬计算人员成本，并计算相关比例。结果剖宫产中应用全身麻醉直接麻醉成本及非人员麻醉成本均高于连续硬膜外麻醉（P＜0．05），人员成本则是连续硬膜外麻醉高于全身麻醉（P＜0．05），全身麻醉的药品及耗材成本明显高于连续硬膜外麻醉（P＜0．05），连续硬膜外麻醉的诱导时间及持续时间较长（P＜0．05），两组患者术后住院天数差异无统计学意义（P＞0．05）。结论椎管内麻醉的直接成本较低，但是人员成本相对较高。麻醉方法的选择并不影响患者术后住院天数。
목적：비교분석부궁산중응용추관내마취혹전신마취적성본소모，위의료성본운작화의료정책제정제공림상삼고수거。방법회고아원택기행자궁하단부궁산술적환자（212례），안기접수적마취방법분위추관내마취조（련속경막외마취，SA조，106례）급전신마취조（후조하전마，GA조，106례），대마취적직접성본진행료평고。종마취수거고중통계마취중사용적약품급모재，근거마취상관시간급마취인원신수계산인원성본，병계산상관비례。결과부궁산중응용전신마취직접마취성본급비인원마취성본균고우련속경막외마취（P＜0．05），인원성본칙시련속경막외마취고우전신마취（P＜0．05），전신마취적약품급모재성본명현고우련속경막외마취（P＜0．05），련속경막외마취적유도시간급지속시간교장（P＜0．05），량조환자술후주원천수차이무통계학의의（P＞0．05）。결론추관내마취적직접성본교저，단시인원성본상대교고。마취방법적선택병불영향환자술후주원천수。
Objective To analyze the costs of continuous epidural anesthesia and general anesthesia for caesarean section and pro-vide clinical reference data for health behaviors and health policy makers.Methods The clinical data of 212 patients (aged 22~35 years) who received elective cesarean section surgery from to July to December in 2012 in our hospital were retrospectively analysed.The patients were divided into the spinal anesthesia group(continuous epidural anesthesia,SA group,n=106)and the general anesthesia group(LMA un-der general anesthesia,GA group,n=106 )according to their method of anesthesia.Direct costs were measured on detailed data of the re-sources used during anaesthetic procedures from the anesthesia record.Costs related to anaesthetic staff work were calculated based on per ca-pita remuneration and duration of anaesthesia.Results Direct costs of general anaesthesia for caesarean section were higher than those of continuous epidural anaesthesia (P<0.05).Personnel costs of continuous epidural anaesthesia were found to be higher than those of general anaesthesia (P<0.05).Costs of pharmaceuticals and medical materials for general anaesthesia were higher than those of continuous epidural anaesthesia(P<0.05).The postoperative duration of hospitalization was not statistically different between the two groups (P>0.05).Con-clusion The duration of epidural anaesthesia is longer than that of general anaesthesia,which results in higher costs of medical staff work. The postoperative days of hospitalization are not associated with anesthesia approaches.