中国药物经济学2024，Vol.19Issue(1)：27-34,8.DOI:10.12010/j.issn.1673-5846.2024.01.004
腹腔镜疝修补术与开放式疝修补术的真实世界研究
Laparoscopic hernia repair and open hernia repair in the real world
林敏 1韩剑秋 2宣建伟 3倪志颖 4施小宇 5陈吉彩 6翁惠芬 3陈政国 7陆星韡 3赵汪洋 3胡晓寒3
作者信息
- 1. 浙江大学医学院附属第二医院医保办,杭州 310009
- 2. 温州医科大学附属第一医院医保管理处,浙江温州 325000
- 3. 中山大学药学院医药经济研究所,广州 510006
- 4. 浙江大学医学院附属邵逸夫医院医保办,杭州 310009
- 5. 浙江大学医学院附属第二医院胃肠外科,杭州 310009
- 6. 温州医科大学附属第一医院胃肠外科,浙江温州 325000
- 7. 广州医科大学附属第三医院临床研究管理办公室,广州 510405
- 折叠
摘要
Abstract
Objective To evaluate the effectiveness,safety and economy of different kinds of inguinal hernia repair surgery(laparoscopic vs.open surgery)and different types of mesh(three-dimensional(3D)preformed mesh vs.self-fixation mesh)fixation for laparoscopic repair of inguinal hernia based on real-world data.Methods A multicenter,retrospective,real-world study was designed to collect clinical data of inguinal hernia patients admitted to 3 top Ⅲ hospitals in Zhejiang Province from March 2016 to March 2019.The time of operation and the length of hospital stay were taken as the effectiveness index.Intraoperative blood loss and postoperative complications(proportion of prescription of painkillers and proportion of prescription of anti-infective drugs)were used as safety indexes.Direct medical cost is used as the economic evaluation index.Based on real-world data and evaluation indicators,a retrospective study was conducted to evaluate the effectiveness,safety and economy of inguinal hernia patients using different surgical methods(laparoscopic repair versus open repair)and different types of mesh(three-dimensional preformed patch versus self-fixed patch).Results 1)Comparison of different operation methods:the operation time of laparoscopic group was longer than that of open group,and the length of hospital stay was shorter than that of open group,with statistical significance(P<0.05);The proportion of patients using painkillers after surgery in laparoscopic group was higher than that in open group,and the difference was statistically significant(P<0.05).Compared with the open group,the proportion of patients using anti-infective drugs after surgery in the laparoscopic group was lower,and the difference was statistically significant(P<0.05).The total cost was higher in the laparoscopic group than in the open group(P<0.05),mainly due to the higher operation cost and material cost(P<0.05).2)Comparison of different types of mesh:There was no statistical significance in operation time and hospital stay between the two groups(P>0.05);The proportion of patients using painkillers and anti-infective drugs in 3D preformed patch group was lower than that in self-fixed patch group,and the difference was statistically significant(P<0.05).The total cost of the three-dimensional preformed patch group was lower than that of the self-fixed patch group,with statistical significance(P<0.05).The analysis of the cost composition showed that compared with the self-fixed patch group,the cost of materials,patch,total drug,postoperative pain relief and anti-infection drugs were lower in the three-dimensional preformed patch group(P<0.05).Conclusion Compared with open surgery,laparoscopic surgery has better efficacy and safety with higher total cost.The analysis of the two mesh types commonly used in laparoscopic surgery showed that the three-dimensional preformed mesh had advantages of lower cost and better safety than the self-fixation mesh.关键词
腹股沟疝/疝修补术/腹腔镜/补片/有效性/安全性/经济性Key words
Inguinal hernia/Hernia repair/Laparoscopic/Mesh/Effectiveness/Safety/Economic分类
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林敏,韩剑秋,宣建伟,倪志颖,施小宇,陈吉彩,翁惠芬,陈政国,陆星韡,赵汪洋,胡晓寒..腹腔镜疝修补术与开放式疝修补术的真实世界研究[J].中国药物经济学,2024,19(1):27-34,8.
