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目的分析胶囊内镜检查在小肠出血诊断中的效价,并与传统检查方法进行比较。方法将怀疑小肠出血住院患者分为两组:A组58例,为1998年至2005年间行传统检查患者;B组93例,为2002年5月至2005年1月间行胶囊内镜检查患者。通过统计两组的诊断率、特异性治疗率、检查费用和其他相关累计费用,分析传统检查和胶囊内镜检查的成本效果比及综合成本效果比情况,并进行敏感性检验。结果A组和B组对小肠出血病因的诊断率分别为22.4%(13/58)及86%(80/93),总检查费用分别为133 750元及790 500元。仅从检查成本效果比分析。B组(9881.3元/例)略优于A组(10 288.5元/例)。此外,由于B组的诊断率显著高于A组(P=0.001),而根据诊断结果指导的特异性治疗率B组高于A组(49.5%比12.1%),即B组能更有效终止和节省因病因不能明确而反复就诊、检查、支持治疗和住院等费用。故经调整后的综合成本效果比B组(9881.3元/例)明显优于A组(从1个月的16 361.5元至5年以上的97 424.0元/例),即随着时间的推移,A组比B组每例多花费6480.2～87 542.7元,是B组的1.7～9.9倍。结论对于经胃镜、结肠镜检查阴性而疑有小肠出血的患者,尽早选择胶囊内镜检查比反复进行传统检查更经济实用。
Objective To analyze the titer of capsule endoscopy in the diagnosis of small intestinal hemorrhage and compare it with the traditional method. Methods Inpatients with suspected intestinal bleeding were divided into two groups: group A (58 cases), patients undergoing traditional examination between 1998 and 2005; group B (93 cases), patients undergoing capsule endoscopy between May 2002 and January 2005 . Through the statistics of the diagnosis rate, specific treatment rate, examination cost and other related cumulative costs, the cost-effectiveness ratio and comprehensive cost-effectiveness ratio of traditional examination and capsule endoscopy were analyzed and the sensitivity test was conducted. Results The diagnostic rates of intestinal hemorrhage in group A and group B were 22.4% (13/58) and 86% (80/93) respectively. The total examination costs were 133 750 yuan and 790 500 yuan respectively. Only from checking the cost-effectiveness analysis. B group (9881.3 yuan / case) slightly better than A group (10 288.5 yuan / case). In addition, since the diagnostic rate of group B was significantly higher than that of group A (P = 0.001), the specific treatment rate according to the diagnosis was higher in group B than in group A (49.5% vs 12.1%), ie, group B could be terminated more effectively And save due to etiology can not be clear and repeated visits, check, support for treatment and hospitalization costs. Therefore, the adjusted overall cost-effectiveness was significantly better than that of Group B (RMB 9881.3 yuan / case) compared with that of Group A (from RMB 16 361.5 yuan in 1 month to 97 424.0 yuan / yuan over 5 years), that is, as time went by, A group than in group B spend 6480.2 ~ 87 542.7 yuan more per case, which is 1.7 to 9.9 times in group B. Conclusions For patients with suspected small intestinal bleeding who have been negative by endoscopy or colonoscopy, it is more economical and practical to choose capsule endoscopy earlier than repeated conventional tests.