国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2020, Vol. 39 ›› Issue (5): 374-376.

• 论著 • 上一篇    下一篇

稽留流产治疗方法的最小成本分析

王彩燕，钱金凤，姚晓英   

  1. 200011  上海，复旦大学附属妇产科医院计划生育科
  • 收稿日期:2020-03-02 修回日期:2020-07-03 出版日期:2020-09-15 发布日期:2020-09-11
  • 通讯作者: 钱金凤，E-mail：qjf2003@163.com E-mail:qjf2003@163.com
  • 基金资助:
    上海市卫生和计划生育委员会科研课题（201540359）

Cost-Minimization Analysis of Different Treatments for Missed Abortion

WANG Cai-yan，QIAN Jin-feng，YAO Xiao-ying   

  1. Department of Family Planning，Obstetrics and Gynecology Hospital of Fudan University，Shanghai 200011，China
  • Received:2020-03-02 Revised:2020-07-03 Published:2020-09-15 Online:2020-09-11
  • Contact: QIAN Jin-feng，E-mail：qjf2003@163.com E-mail:qjf2003@163.com

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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。

关键词: 流产, 稽留；, 费用效益分析；, 米非司酮；, 米索前列醇；, 负压吸宫术

Abstract: 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. Cost-minimization 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 2 787.54 (2 474.29, 3 020.46)], and the total cost of Group A was highest [CNY 4 395.13 (4 175.16，4 627.63)]. The total cost of Group B was moderate [CNY 3 506.39 (3 151.22，3 974.91)]. 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.

Key words: Abortion, missed；, Cost-benefit analysis；, Mifepristone；, Misoprostol；, Vacuum aspiration