Sagmeister M, Amann F W, Follath F
Abteilung Gastroenterologie und Hepatologie, Universitätsspital Zürich.
Schweiz Med Wochenschr. 2000 Aug 19;130(33):1146-51.
Clinical studies have shown a favourable outcome for primary PTCA compared with thrombolysis in the treatment of acute myocardial infarction. No data are available in Switzerland on the logistic and economic implications of treating more acute myocardial infarction patients by PTCA. The present paper sets out to assess all published studies comparing the cost-effectiveness of the two treatment modalities. A Medline search identified seven original cost and cost-effectiveness studies conducted between 1989 and 1999. According to these studies emergency PTCA generates costs similar to thrombolysis in the treatment of acute myocardial infarction if the infrastructure is available and there is high volume output. Better clinical results, as suggested by the literature, would result in a favourable cost-effectiveness ratio for primary PTCA.
临床研究表明，在急性心肌梗死的治疗中，与溶栓治疗相比，直接经皮冠状动脉腔内血管成形术（PTCA）具有更好的疗效。瑞士尚无关于采用PTCA治疗更多急性心肌梗死患者的后勤保障及经济影响的数据。本文旨在评估所有已发表的比较这两种治疗方式成本效益的研究。通过医学文献数据库（Medline）检索，确定了1989年至1999年间开展的七项关于成本及成本效益的原始研究。根据这些研究，如果具备相应基础设施且产出量高，在急性心肌梗死治疗中，急诊PTCA产生的成本与溶栓治疗相近。正如文献所表明的，更好的临床效果将使直接PTCA具有良好的成本效益比。
