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水凝胶栓塞物在CT引导下肺活检中的成本效益

Cost-effectiveness of hydrogel plugs in CT-guided lung biopsies.

作者信息

Marco-Doménech S F, Fernández-García P, Navarro-Ballester A, Cifrián-Pérez M, Escobar-Valero Á, Ibáñez-Gual M V

机构信息

Servicio de Radiología Diagnóstica y Terapéutica, Hospital General Universitario de Castellón, Castellón de la Plana, España; Unidad Predepartamental de Medicina, Universidad Jaume I (UJI), Castellón de la Plana, España.

Servicio de Radiología Diagnóstica y Terapéutica, Hospital General Universitario de Castellón, Castellón de la Plana, España; Unidad Predepartamental de Medicina, Universidad Jaume I (UJI), Castellón de la Plana, España.

出版信息

Radiologia (Engl Ed). 2019 Mar-Apr;61(2):153-160. doi: 10.1016/j.rx.2019.01.001. Epub 2019 Feb 14.

Abstract

OBJECTIVE

Using a hydrogel plug decreases the number of cases of pneumothorax and reduces the need for pleural drainage tubes in CT-guided lung biopsies. We aimed to analyze the cost-effectiveness of using hydrogel plugs.

MATERIAL AND METHODS

We analyzed 171 lung biopsies divided into three groups: Group 1 (n=22): fine-needle aspiration cytology (FNAC) without hydrogel plugs; Group 2 (n=89): FNAC with hydrogel plugs; and Group 3 (n=60): FNAC plus core-needle biopsy (CNB) with hydrogel plugs. We calculated the total costs (direct and indirect) in the three groups. We analyzed the percentage of correct diagnoses, the average and incremental rations, and the most cost-effective option.

RESULTS

Total costs: Group 1 = 1,261.28 + 52.65 = € 1,313.93; Group 2 = 1,201.36 + 67.25 = € 1,268.61; Group 3 = 1,220.22 + 47.20 = € 1,267.42. Percentage of correct diagnoses: Group 1 = 77.3%, Group 2 = 85.4%, and Group 3 = 95% (p = 0.04). Average cost-effectiveness ratio: Group 1 = 16.99; Group 2 = 14.85; and Group 3 = 13.34.

CONCLUSIONS

Group 3 was the best option, with the lowest average cost-effectiveness ratio; therefore, the most cost-effective approach is to do FNAC and CNB using a dehydrated hydrogel plug at the end of the procedure.

摘要

目的

使用水凝胶塞可减少气胸病例数量,并减少CT引导下肺活检中胸腔引流管的使用需求。我们旨在分析使用水凝胶塞的成本效益。

材料与方法

我们分析了171例肺活检病例,分为三组:第1组(n = 22):未使用水凝胶塞的细针穿刺细胞学检查(FNAC);第2组(n = 89):使用水凝胶塞的FNAC;第3组(n = 60):使用水凝胶塞的FNAC加粗针活检(CNB)。我们计算了三组的总成本(直接成本和间接成本)。我们分析了正确诊断的百分比、平均和增量比率,以及最具成本效益的方案。

结果

总成本:第1组 = 1,261.28 + 52.65 = 1,313.93欧元;第2组 = 1,201.36 + 67.25 = 1,268.61欧元;第3组 = 1,220.22 + 47.20 = 1,267.42欧元。正确诊断的百分比:第1组 = 77.3%,第2组 = 85.4%,第3组 = 95%(p = 0.04)。平均成本效益比:第1组 = 16.99;第2组 = 14.85;第3组 = 13.34。

结论

第3组是最佳选择,平均成本效益比最低;因此,最具成本效益的方法是在操作结束时使用脱水水凝胶塞进行FNAC和CNB。

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