离体肝切除和自体肝移植术治疗终末期肝多房棘球蚴病的住院医疗费用分析

doi:10.12140/j.issn.1000-7423.2020.01.021

中国寄生虫学与寄生虫病杂志 ›› 2020, Vol. 38 ›› Issue (1): 53-57.doi: 10.12140/j.issn.1000-7423.2020.01.021

离体肝切除和自体肝移植术治疗终末期肝多房棘球蚴病的住院医疗费用分析

喀斯木·艾海提^1,2, 阿卜杜萨拉木·艾尼^1,2, 吐尔干艾力·阿吉^1,2,*, 邵英梅^1,3, 张瑞青^1,2, 塔来提·吐尔干^1,2, 蒋铁民^1,2, 冉博^1,2, 阿卜杜艾尼·啊卜力孜^1,2, 米尔阿迪力·艾尔肯⁴, 温浩⁵

1新疆医科大学第一附属医院,肝胆包虫外科;
2 新疆维吾尔自治区包虫及肝胆疾病临床医学研究中心;
3 消化血管外科中心;
4 急救创伤中心,乌鲁木齐 830054;
5新疆医科大学中亚高发病成因与防治国家重点实验室,乌鲁木齐 830011

收稿日期:2019-08-22 出版日期:2020-02-28 发布日期:2020-03-19
通讯作者: 吐尔干艾力·阿吉,E-mail: tuergan78@sina.com
作者简介:喀斯木·艾海提（1992-）,男,硕士研究生,从事棘球蚴病及自体肝移植研究。E-mail：10193673346@qq.com
基金资助:
新疆维吾尔自治区重点实验室开放课题（No. 2017D04004）

Analysis of hospital expenses for patients with end-stage hepatic alveolar echinococcosis receiving ex vivo liver resection and autotransplantation

KASIMU Aihaiti^1,2, ABUDUSALAMU Aini^1,2, TUERGANAILI Aji^1,2,*, SHAO Ying-mei^1,3, ZHANG Rui-qing^1,2, TALAITI Tuergan^1,2, JIANG Tie-min^1,2, RAN Bo^1,2, ABUDUAINI Abulizi^1,2, MIERADILI Aierken⁴, WEN Hao⁵

1 Department of Hepatobiliary and Hydatid Disease;
2 Xinjiang Uyghur Autonomous Region Clinical Research Center for Echinococcosis and Hepatobiliary Diseases;
3 Digestive and Vascular Surgery Center;
4 Emergency and Trauma Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China;
5 State Key Laboratory of High Incidence Disease in Central Asia, Xinjiang Medical University, Urumqi 830011, China

Received:2019-08-22 Online:2020-02-28 Published:2020-03-19
Contact: E-mail: tuergan78@sina.com
Supported by:
Supported by Xinjiang Uyghur Autonomous Region Key Laboratory Open Research Program (No. 2017D04004)

摘要/Abstract

摘要： 收集2010-2018年新疆医科大学第一附属医院因终末期肝多房棘球蚴病实施离体肝切除和自体肝移植术（ELRA）治疗的患者人口学信息和相关临床病历资料数据,根据ELRA术前是否接受相应的诊疗分为6个组,无相关病史（A组）、抗虫化疗史（B组）、抗虫化疗 + 药物保肝史（C组）、穿刺或内镜减黄 + 药物保肝史（D组）、肝血管介入治疗 + 抗虫化疗史（E组）、肝切除 + 抗虫化疗史（F组）。采用Mann-Whinty检验比较分析各组之间医疗费用差异。共82例患者接受ELRA手术,男、女性别比为39 ∶ 43,平均年龄（36.1 ± 11.8）岁,主要民族有藏族、哈萨克族和汉族,患者主要来自新疆、西藏和四川。肝多房棘球蚴病患者接受ELRA治疗的医疗费用主要包括西药费、检查类费、材料费、手术费和特殊材料费等。82例患者平均总费用为（241 155.0 ± 119 746.5）元,其中西药费占比最高（41.1%）,其次是检查费（15.7%）、材料费（13.4%）、手术费（9.6%）、特殊材料费（7.5%）。C、D组总费用高于其他4组（P < 0.01）;西药费、检查费、护理费和治疗费C、D组高于其他4组（P < 0.05）;特殊材料费、血费、抢救费和床位费C、D组高于A组（P < 0.05）。术前无相关病史者总体费用和各项费用均比有其他相关病史者低;术前有黄疸/肝功能不全因素可增加总体费用及大部分子项费用。

关键词: 肝多房棘球蚴病, 离体肝切除和自体肝移植术, 住院费用

Abstract: We retrospectively collected demographic information as well as relevant clinical data of patients with end-stage hepatic alveolar echinococcosis (AE) treated with ex vivo liver resection and autotransplantation (ELRA) in the First Affiliated Hospital of Xinjiang Medical University during 2010-2018. The patients were divided into six groups based on their medical history prior to ELRA: group A patients having no relevant disease history record; group B having anti-parasitic chemotherapy history; group C having the history of anti-parasitic chemotherapy plus hepatoprotective medication; group D having the record of alleviating jaundice by percutaneous or endoscopic approach plus hepatoprotective medication; group E experienced interventional treatment via liver blood vessel plus anti-parasitic chemotherapy; and group F experienced hepatectomy and anti-parasitic chemotherapy. The medical expenses of different groups were compared by the Mann-Whinty test. A total of 82 patients receiving ELRA were included in this study, with a male/female ratio of 39 : 43 and an average age of (36.12 ± 11.84) years. Most of them were of Zang, Kazakh and Han ethnity, and came from Xinjiang, Tibet and Sichuan. The medical expenses for the hepatic AE patients receiving ELRA treatment included the costs of western medicine, medical examinations, consumable material, ELRA surgery and special material. The average total expense of the 82 patients was (241 155.0 ± 119 746.5) yuan, of which the cost of western medicine accounting the highest proportion (41.1%), followed by the cost of medical examinations (15.7%), consumable material (13.4%), surgery (9.6%) and special material (7.5%). The groups C and D had significantly higher total expenses (P < 0.01) than the other 4 groups. When compared with itemized cost, the group C and D expensed significantly higher for western medicine, medical examinations, nursing, and treatment (P < 0.05), compared with other 4 groups. The group C and D also expensed significantly higher for special material, blood supply, emergency aid, and ward bed than those of group A (P < 0.05). The total and itemized expenses of the patients with no relevant disease history prior to surgery were lower than those with these history records. In addition, occurrence of jaundice or liver dysfunction may increase the total expense and the costs of most items.

Key words: Hepatic alveolar echinococcosis, Ex vivo liver resection and autotransplantation, Hospital cost

中图分类号:

R532.32

喀斯木·艾海提, 阿卜杜萨拉木·艾尼, 吐尔干艾力·阿吉, 邵英梅, 张瑞青, 塔来提·吐尔干, 蒋铁民, 冉博, 阿卜杜艾尼·啊卜力孜, 米尔阿迪力·艾尔肯, 温浩. 离体肝切除和自体肝移植术治疗终末期肝多房棘球蚴病的住院医疗费用分析[J]. 中国寄生虫学与寄生虫病杂志, 2020, 38(1): 53-57.

KASIMU Aihaiti, ABUDUSALAMU Aini, TUERGANAILI Aji, SHAO Ying-mei, ZHANG Rui-qing, TALAITI Tuergan, JIANG Tie-min, RAN Bo, ABUDUAINI Abulizi, MIERADILI Aierken, WEN Hao. Analysis of hospital expenses for patients with end-stage hepatic alveolar echinococcosis receiving ex vivo liver resection and autotransplantation[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2020, 38(1): 53-57.

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离体肝切除和自体肝移植术治疗终末期肝多房棘球蚴病的住院医疗费用分析

Analysis of hospital expenses for patients with end-stage hepatic alveolar echinococcosis receiving ex vivo liver resection and autotransplantation

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