换血治疗不同程度急性胆红素脑病患儿的成本-效果分析.docVIP

换血疗法治疗急性胆红素脑病的成本效益分析 李慧繁，何华云，刘开珍，华子瑜(重庆医科大学附属儿童医院 新生儿，重庆 400014Cost-benefit analysis of exchange transfusion for acute bilirubin encephalopathy LI Huifan, HE Huayun, LIU Kaizhen, HUA Ziyu（Department of Neonatology, Childrens Hospital of Chongqing Medical University, Chongqing 400014, China） ［Abstract］ Objective To assess the cost-benefit of exchange transfusion（ET) in the treatment of acute bilirubin encephalopathy(ABE). Methods Retrospective analysis was carried out on the clinical data of 137 ABE neonates admitted our department from January 2009 to December 2010. Results The enrolled neonates were divided into four groups by ABE severity and interventions: 40 neonates in Group SE (Subtle ABE with ET), 29 in Group SNE (Subtle ABE without ET), 49 in Group ME (Moderate to advanced ABE with ET), and 19 in Group MNE (Moderate to advanced ABE without ET). The Total Serum Bilirubin (TSB) levels, tSb:Albumin molar ratio(B/A), the proportion of blood group incompatibility and the hospitalization costs per capita in Group SE were obviously higher than those in Group SNE (P0.05). Without death in subtle ABE, the rate of poor outcomes in Group SE, 15.0% was similar to that of Group SNE, 13.8%. The maximum benefit-cost ratio of Group SE and Group SNE was 87.5 and 121.5, respectively. The TSB levels, B/A, the proportion of blood group incompatibility and the hospitalization costs per capita in Group ME significantly exceeded those in Group MNE (P0.05). Five neonates died in moderate to advanced ABE, and the incidence of poor outcomes in Group ME, 32.7% was 2.1 times to that of Group MNE, 5.8%. The maximum benefit-cost ratio of Group ME and Group MNE was 89.8 and 160.0, respectively. The TSB levels and B/A in Group ME exceeded those in Group SE (P0.05), the incidence of poor outcomes in Group ME was 2.2 times to that of Group SE, whereas the hospitalization costs per capita in Group ME were similar to those in Group SE (P0.05). Morbidity of the sever