目的 比较宫腔镜监测下诊刮术(HC)与宫腔镜电切术(HPE)诊治子宫内膜息肉的卫生经济学状况.方法 收集我院2007年1月-2008年10月确诊为子宫内膜息肉且实施宫腔镜检查及诊刮术者80例(HC组),同期住院行HPE的患者55例(HPE组),比较两组的卫生经济学指标.结果 HC组和HPE组的宫腔镜手术费用分别为(629±237)元和(1 394±205)元,两组总的医疗费用分别为(1 097±263)元和(5 562±425)元,差异均有统计学意义(P＜0.01＝.两组患者的误工时间分别为(2.6±0.5)d和(8.6±1.1)d,差异有统计学意义(P＜0.01＝.患者家属的误工时间分别为(0.4±0.1)d和(2.4±0.5)d,差异有统计学意义(P＜0.01＝.两组术中需要医护人员为2人和5人,两组患者在医院时间分别为(3.8±0.5)h和(132±5.6)h,差异有统计学意义(P＜0.01).结论 HC和HPE两种治疗子宫内膜息肉的手术方法均安全、有效,HC较HPE更经济、所需人力资源少、在院时间短、不需住院、更方便患者及家属,符合卫生经济学的要求,使子宫内膜息肉的诊治简单化、大众化,值得普及和推广.%Objective To evaluate the health economics of hysteroscopy with curettage ( HC ) and hysteroscopic polypectomy ( HPE ) applied for endometrial polyps. Methods Eighty patients with endometrial polyps who underwent HC ( the HC group ) and 55 patients who underwent HPE ( the HPE group ) from January 2007 to October 2008 were enrolled with the indices of health economics evaluated. Results The cost of HC was lower than that of HPE [ ( 629 ± 237 ) yuan vs ( 1394 ± 205 ) yuan, P ＜0. 01 ]. The total cost of HC was also lower than that of HPE [ ( 1097 ± 263 ) yuan vs ( 5562 ± 425 ) yuan, P ＜ 0. 01 ] , the time off work of both the patients and their family members in the HC group [ (2. 6 ±0. 5 ) d and ( 0. 4 ±0. 1 ) d, respectively ] were shorter than those in the HPE group [ (8. 6 ± 1. 1 ) d and ( 2. 4 ±0. 5 ) d, respectively ] ( P ＜0. 01 ). The number of doctors and nurses during the operation in two group was respectively two and five. The time of hospital stay in group HC was even less than that in group HPE [ ( 3. 8 ±0. 5 ) h vs ( 132 ±5. 6 ) h, P ＜0. 01 ], and the cases in group HC engross less health manpower than the cases in group HPE. Conclusion HC and HPE are both safe and effective methods in treating endometrial polyps. HC is less expensive, less engrossing of health manpower, less time consuming, and more convenient for both the patients and their families, which makes it highly consistent with the requirements of health economics. HC is worth popularization for treating endometrial polyps.
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