中华消化内镜杂志
中華消化內鏡雜誌
중화소화내경잡지
CHINESE JOURNAL OF DIGESTIVE ENDOSCOPY
2013年
1期
15-17
,共3页
孙曦%张修礼%卢忠生%黄启阳%李延青%杨云生
孫晞%張脩禮%盧忠生%黃啟暘%李延青%楊雲生
손희%장수례%로충생%황계양%리연청%양운생
消化系统肿瘤%癌前状态%内镜黏膜下剥离术%传统外科手术%费用效益分析
消化繫統腫瘤%癌前狀態%內鏡黏膜下剝離術%傳統外科手術%費用效益分析
소화계통종류%암전상태%내경점막하박리술%전통외과수술%비용효익분석
Digestive system neoplasms%Precancerous conditions%Endoscopic submucosal dissection%Traditional surgery%Cost-Benefit analysis
目的 对比研究内镜黏膜下剥离术(ESD)与传统外科手术治疗消化道早癌或癌前病变的效价比.方法 选择2006年11月至2012年9月确诊的866位消化道早癌或癌前病变的住院患者,对其病历资料进行回顾性分析,根据治疗方法不同分为ESD组及传统外科手术组.记录和对比分析两组患者的基本信息、卫生经济学资料以及治疗情况.结果 ESD组共607例患者,外科组共259例患者；两组病变的完全切除率相当(93.1％比93.0％,P＞0.05)；ESD组和外科组的平均住院天数、住院费用分别为13.01 d比18.88 d(P ＜0.05),22932.17元比57993.88元(P ＜0.05)；ESD组中共有22例(1.98％)患者出现术中及术后出血,17例(2.80％)患者出现穿孔；传统外科手术组中,共有8例(3.01％)出血、3例(1.16％)穿孔.两组出血及穿孔率差异无统计学意义.结论 ESD术及传统外科手术均为治疗消化道早癌或癌前病变的有效手段,与传统外科手术治疗相比,ESD术在平均住院日、住院费用方面具有明显优势.
目的 對比研究內鏡黏膜下剝離術(ESD)與傳統外科手術治療消化道早癌或癌前病變的效價比.方法 選擇2006年11月至2012年9月確診的866位消化道早癌或癌前病變的住院患者,對其病歷資料進行迴顧性分析,根據治療方法不同分為ESD組及傳統外科手術組.記錄和對比分析兩組患者的基本信息、衛生經濟學資料以及治療情況.結果 ESD組共607例患者,外科組共259例患者；兩組病變的完全切除率相噹(93.1％比93.0％,P＞0.05)；ESD組和外科組的平均住院天數、住院費用分彆為13.01 d比18.88 d(P ＜0.05),22932.17元比57993.88元(P ＜0.05)；ESD組中共有22例(1.98％)患者齣現術中及術後齣血,17例(2.80％)患者齣現穿孔；傳統外科手術組中,共有8例(3.01％)齣血、3例(1.16％)穿孔.兩組齣血及穿孔率差異無統計學意義.結論 ESD術及傳統外科手術均為治療消化道早癌或癌前病變的有效手段,與傳統外科手術治療相比,ESD術在平均住院日、住院費用方麵具有明顯優勢.
목적 대비연구내경점막하박리술(ESD)여전통외과수술치료소화도조암혹암전병변적효개비.방법 선택2006년11월지2012년9월학진적866위소화도조암혹암전병변적주원환자,대기병력자료진행회고성분석,근거치료방법불동분위ESD조급전통외과수술조.기록화대비분석량조환자적기본신식、위생경제학자료이급치료정황.결과 ESD조공607례환자,외과조공259례환자；량조병변적완전절제솔상당(93.1％비93.0％,P＞0.05)；ESD조화외과조적평균주원천수、주원비용분별위13.01 d비18.88 d(P ＜0.05),22932.17원비57993.88원(P ＜0.05)；ESD조중공유22례(1.98％)환자출현술중급술후출혈,17례(2.80％)환자출현천공；전통외과수술조중,공유8례(3.01％)출혈、3례(1.16％)천공.량조출혈급천공솔차이무통계학의의.결론 ESD술급전통외과수술균위치료소화도조암혹암전병변적유효수단,여전통외과수술치료상비,ESD술재평균주원일、주원비용방면구유명현우세.
Objective To compare the cost-effectiveness between endoscopic submucosal dissection (ESD) procedure and traditional surgery for the treatment of early gastrointestinal cancer or precancerous lesions.Methods A total of 866 early GI cancer/precancerous patients who had been admitted to Chinese PLA General hospital and Qilu hospital were included in this study.The medical records of all 866 patients were reviewed.Patients were divided into ESD group and traditional surgery group.Parameters of each patient,such as time of hospitalization,total treatment cost and incidence of complications,were documented and later compared in detail.Results A total of 607 patients were included in the ESD group and 259 in the traditional surgery group.There was no statistical difference in complete resection rate between the two groups (93.1％ vs 93.0％,P ＞ 0.05).The ESD group showed a shorter mean hospitalization time (d)(13.01 vs 18.88,P ＜ 0.05) and lower treatment cost (RMB) than the traditional surgery group (22932.17 vs 57993.88,P ＜ 0.05).The incidence of hemorrhage and perforation for each group were 3.63％ and 3.10％ respectively,which were not significantly different (1.98％ vs 3.01％,P ＞ 0.05; 2.80％ vs 1.16％,P ＞ 0.05).Conclusion ESD and surgery are both effective for early gastrointestinal cancer/precancerous lesions therapy,but ESD procedure is superior to surgery in terms of hospitalization time and expediture.
