摘要
目的:用成本最小分析法比较稽留流产的3种治疗方法,筛选成本最小的方案。方法:2017年1月—2018年12月在复旦大学附属妇产科医院计划生育科就诊的1 400例稽留流产患者随机分配至负压吸宫术组(A组,513例)、米非司酮配伍米索前列醇药物流产组(B组,328例)和单纯米索前列醇药物流产组(C组,559例),比较各组从随机分配入组至随访结束的所有就诊费用,包括术前检查、终止早期妊娠失败以及术后随访。结果:3组患者均无手术并发症,术后出血时间、转经时间、复诊次数和复诊费用比较,差异均无统计学意义(均P>0.05)。单用米索前列醇药物流产所需的成本最小,为2 787.54(2 474.29,3 020.46)元,负压吸宫术所需成本最高,为4 395.13(4 175.16,4 627.63)元,米非司酮配伍米索前列醇药物流产所需成本介于二者之间,为3 506.39(3 151.22,3 974.91)元,差异有统计学意义(Z=908.950,P<0.001)。结论:如果单纯从成本考虑,在无手术并发症的稽留流产患者中,单用米索前列醇药物流产可能是成本最低的治疗方案。
Objective:To compare the costs of three treatments for missed abortion,and to screen out the cost-minimization treatment.Methods:The patients diagnosed with missed abortion from January 2017 to December 2018 were divided into three groups randomly.Group A(n=513)was treated with vacuum aspiration,Group B(n=328)medical abortion with mifepristone and misoprostol,Group C(n=559)only misoprostol.Costminimization analysis was done.The direct medical costs were recorded and compared among 3 groups,including all tests before operation,termination of early pregnancy failure and the costs of follow-up.Results:There were no surgical complications in 3 groups.There were no significant differences in the duration of bleeding,days to onset of next menses,times and costs of follow-up among 3 groups.The total cost of Group C was least[CNY 2787.54(2474.29,3020.46)],and the total cost of Group A was highest[CNY 4395.13(4175.16,4627.63)].The total cost of Group B was moderate[CNY 3506.39(3151.22,3974.91)].There were significant differences in the groups(Z=908.950,P<0.001).Conclusions:In those missed abortion patients without surgical complications,the medical treatment with misoprostol without mifepristone may be cheapest if only considering the medical cost.
作者
王彩燕
钱金凤
姚晓英
WANG Cai-yan;QIAN Jin-feng;YAO Xiao-ying(Department of Family Planning,Obstetrics and Gynecology Hospital of Fudan University,Shanghai 200011,China)
出处
《国际生殖健康／计划生育杂志》
CAS
2020年第5期374-376,381,共4页
Journal of International Reproductive Health/Family Planning
基金
上海市卫生和计划生育委员会科研课题(201540359)。
作者简介
通信作者:钱金凤,E-mail:qjf2003@163.com。
