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目的对剖宫产瘢痕妊娠(cesarean scar pregnancy,CSP)介入治疗医疗费用及分布特征进行分析,为临床治疗决策提供依据。方法选择2011年11月至2014年9月在九江市妇幼保健院住院诊治的CSP患者56例,36例行双侧子宫动脉化疗栓塞+病灶清除为研究组,20例甲氨蝶呤+甲酰四氢叶酸+病灶清除为对照组,比较两组医疗费用分布及差异。结果 1医疗总费用分布特征:最大值、最小值、25%分位、75%分位、<10 000元占比、10 000~15 000元占比、>15 000元占比,研究组为26 926.35元、8 913.97元、19 584.03元、15 446.36元、2.78%、13.89%、83.33%;对照组为30 823.37元、5 859.33元、18 908.12元、10 601.96元、20%、35%、45%;研究组医疗总费用>15 000元占83.33%。2医疗费用差异:研究组住院费用高,但误工交通费用少,与对照组比较差异有统计学意义(P<0.05);研究组门诊费用少,医疗总费用高,与对照组比较差异有统计学意义(P<0.05)。结论子宫动脉栓塞费用相对昂贵,用于治疗CSP主要体现住院费用高,门诊费用及误工交通费用少;由于介入治疗能迅速控制和预防子宫出血,仍是临床首选方案。
Objective To analyze the medical expenses and distribution characteristics of cesarean scar pregnancy (CSP) interventional therapy and provide the basis for clinical treatment decision-making. Methods 56 cases of CSP patients diagnosed and treated in Jiujiang MCH from November 2011 to September 2014 were selected. Twenty-six patients underwent bilateral uterine artery chemoembolization and lesion clearance, 20 methotrexate + formyl Tetrahydrofolic acid + lesions were cleared as the control group, the distribution and differences of medical expenses between the two groups were compared. Results 1 The distribution of total medical costs: maximum, minimum, 25% quantile, 75% quantile, <10 000 yuan, accounting for 10 000 ~ 15 000 yuan, accounting for> 15 000 yuan, the research group was 26926.35 yuan, 8 913.97 yuan, 19 584.03 yuan, 15 446.36 yuan, 2.78%, 13.89% and 83.33% respectively. The control group was 30 823.37 yuan, 5 859.33 yuan, 18 908.12 yuan, 10 601.96 yuan, 20%, 35% 45%; study group medical total cost> 15 000 yuan accounted for 83.33%. (2) The difference of medical expenses: The research group had higher hospitalization expense but less transportation expense for lost work, which was significantly different from that of the control group (P <0.05). There was less outpatient expense and high total medical cost in the study group with statistical difference Significance (P <0.05). Conclusion The cost of uterine artery embolization is relatively expensive. It is mainly used in the treatment of CSP, which has the characteristics of high cost of hospitalization, outpatient service and less lost traffic. As the interventional treatment can control and prevent uterine bleeding quickly, it is still the first choice of clinical practice.