| 微创保守在老年骨质疏松性脊柱骨折的成本效果评估 |
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投稿时间：2015-12-19
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| 作者 | Author | 单位 | Address | E-Mail |
| 陈琛 |
CHEN Chen |
山西医科大学, 山西 太原 030001 |
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| 李大伟 |
LI Da-wei |
中国人民解放军第309医院骨科, 北京 100091 |
Department of Orthopaedics, the 309th Hospital of China People's Liberation Army, Beijing 100091, China |
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| 王琦 |
WANG Qi |
中国人民解放军第309医院骨科, 北京 100091
解放军陆军航空兵学院门诊部, 北京 101116 |
Department of Orthopaedics, the 309th Hospital of China People's Liberation Army, Beijing 100091, China |
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| 徐小文 |
XU Xiao-wen |
中国人民解放军第309医院骨科, 北京 100091 |
Department of Orthopaedics, the 309th Hospital of China People's Liberation Army, Beijing 100091, China |
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| 马远征 |
MA Yuan-zheng |
中国人民解放军第309医院骨科, 北京 100091 |
Department of Orthopaedics, the 309th Hospital of China People's Liberation Army, Beijing 100091, China |
myzzxq@sina.com |
| 李祯 |
LI Zhen |
中国人民解放军第309医院骨科, 北京 100091 |
Department of Orthopaedics, the 309th Hospital of China People's Liberation Army, Beijing 100091, China |
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| 邹伟龙 |
ZOU Wei-long |
中国人民解放军第309医院骨科, 北京 100091 |
Department of Orthopaedics, the 309th Hospital of China People's Liberation Army, Beijing 100091, China |
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| 期刊信息：《中国骨伤》2016年，第29卷，第7期，第614-618页 |
| DOI：10.3969/j.issn.1003-0034.2016.07.006 |
| 基金项目:全军青年培育项目（编号：13QNP087） |
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中文摘要:
目的：评价保守治疗、经皮椎体成形术（PVP）及经皮椎体后凸成形术（PKP）治疗老年骨质疏松性脊柱骨折的成本-效果。
方法：回顾性分析2013年10月至2014年7月就诊于解放军第309医院骨科且符合纳入标准的152例患者，根据治疗方法不同，分为保守组（51例）、PVP组（50例）、PKP组（51例）.统计患者住院期间、出院后1年内的平均医疗成本（C）及患者VAS评分达到“治愈”（VAS评分≤2分）或“好转”（VAS评分3~8分）标准时的治疗效果（E）,则C/E值表示不同标准下患者的成本-效果。
结果：保守组患者住院时间为12~15 d,平均（14.0±0.6） d,PVP组及PKP组患者住院时间为3~5 d,平均（3.4±0.6） d.住院期间以“治愈”为评价标准时，保守组、PVP组、PKP组的成本-效果分别为RMB 1 253.88、935.75、983.99元，PVP组优于PKP组，PKP组优于保守组；以“好转”为评价标准时，3组成本-效果分别为RMB 97.80、449.16、501.84元，保守组优于PVP组，PVP组优于PKP组。出院后以“治愈”为评价标准，3组成本-效果分别为RMB 3 834.05、1 878.41、1 916.11元；PVP组优于PKP组，PKP组优于保守组。
结论：住院期间，如以“治愈”为评价标准，PVP为最佳选择；若仅以“好转”为评价标准，保守为最佳选择；出院后PVP为最佳选择。 |
| 【关键词】骨质疏松 脊柱骨折 保守治疗 经皮椎体成形术 经皮椎体后凸成形术 成本-效果 |
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| The cost-effectiveness analysis of minimally invasive surgery and conservative treatment in elderly osteoporotic spinal fracture |
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ABSTRACT
Objective: To evaluate the cost-effectiveness of conservative treatment, percutaneous vertebroplasty(PVP)and percutaneous kyphoplasty(PKP)for elderly osteoporotic vertebral compression fracture(OVCF).
Methods: The clinical data of 152 patients with osteoporotic vertebral compression fractures, collected in the orthopedic department of 309th Hospital of PLA from October 2013 to July 2014, was retrospectively analyzed. According to the therapeutic methods, the patients who met the inclusion criteria were divided into conservative treatment group (51 cases), percutaneous vertebroplasty group (50 cases) and percutaneous kyphoplasty group(51 cases). The average medical cost (C) in hospital period and 1 year after discharging, and the treatment effect (E) according to standard of “cure” (VAS score less than or equal to 2) or “improvement” (VAS score was 3 to 8) was recorded. Then the C/E value indicated the cost-effectiveness in different standards.
Results: The average hospitalization days of the PVP and PKP group was 3 to 5 days with an average of(3.4±0.6) days. The conservative group was 12 to 15 days with an average of (14.0±0.6) days. During the hospitalization period, the cost-effectiveness of the conservative group, PVP group and PKP group were RMB 1 253.88, 935.75, 983.99 yuan, respectively, according to the standard of “cure”. The PVP group was superior to the PKP group and the latter was superior to the conservative group. If “improvement” was used as the standard of evaluation, the results were RMB 97.80, 449.16, 501.84 yuan, respectively, suggesting that the conservative group was better than the PVP group and the latter was better than the PKP group. After hospital discharge, the cost-effectiveness of the conservative group, PVP group and PKP group were RMB 3 834.05, 1 878.41 and 1 916.11 yuan, respectively, according to the standard of “cure”. The PVP group was superior to the PKP group and the latter exceeded the conservative group.
Conclusion: The study showed that the PVP was the best choice at the evaluation criterion of “cure”, while taking “improvement” as the evaluation criterion, the conservative treatment was the best one. Either way, the PVP was the best choice after hospital discharge. |
| KEY WORDS Osteoporosis Spinal fracture Conservative treatment Percutaneous vertebroplasty Percutaneous kyphoplasty Cost-effectiveness |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 陈琛,李大伟,王琦,徐小文,马远征,李祯,邹伟龙.微创保守在老年骨质疏松性脊柱骨折的成本效果评估[J].中国骨伤,2016,29(7):614~618 |
| 英文格式: | CHEN Chen,LI Da-wei,WANG Qi,XU Xiao-wen,MA Yuan-zheng,LI Zhen,ZOU Wei-long.The cost-effectiveness analysis of minimally invasive surgery and conservative treatment in elderly osteoporotic spinal fracture[J].zhongguo gu shang / China J Orthop Trauma ,2016,29(7):614~618 |
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