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经皮冠状动脉腔内血管成形术与冠状动脉旁路移植术的长期临床结果及成本效益比较

[Comparison of long-term clinical results and cost-effectiveness of percutaneous coronary angioplasty and coronary artery bypass grafting].

作者信息

Ohashi H, Tsutsumi Y, Murakami A, Ueyama K, Fukahara K, Yamashita A, Ohnaka M

机构信息

Department of Surgery, Fukui Cardiovascular Center, Japan.

出版信息

Nihon Kyobu Geka Gakkai Zasshi. 1994 Feb;42(2):222-7.

PMID:8138690
Abstract

Cost-effectiveness was studied in 313 cases who had PTCA and 161 cases who had CABG as a first measure of interventional therapy for their coronary heart disease. Follow-up time ranged from 2 years to 5 years and 9 months with a mean interval of 3 years and 10 months. In the PTCA group a mean of 1.33 successfully dilated vessels/patient was obtained, but a total of 100 additional PTCA or bypass surgery procedure was necessary in the follow-up period. In the CABG group a mean of 2.60 patent grafts/patient was obtained. Mean length of hospital stay and charge was 21.9 days and 2,071 thousand yen in the PTCA group, and 82.2 days and 5,122 thousand yen in the CABG group through the entire follow up period. Cardiac event-free survival rate was significantly worse in the PTCA group. In the subgroup of two vessel disease, mean number of successfully dilated targets or patent grafts was 1.32 in the PTCA group and 1.88 in the CABG group. Total length of hospital stay and charge was 24.1 days and 2,352 thousand yen in the PTCA group and 86.2 days and 4,903 thousand yen in the CABG group. Cardiac event-free survival rate was significantly worse in the PTCA group. In the subgroup of three vessel disease, PTCA yielded 1.34 dilated target vessels, whereas CABG 2.66 patent grafts, which was two times more than the former one. Total length of hospital stay and charge was 32.7 days and 2,612 thousand yen in the PTCA group, and 82.4 days and 5,225 thousand yen in the CABG group.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

对313例行经皮冠状动脉腔内血管成形术(PTCA)和161例行冠状动脉旁路移植术(CABG)作为冠心病介入治疗首选措施的患者进行了成本效益研究。随访时间为2年至5年9个月,平均间隔为3年10个月。PTCA组患者平均成功扩张血管数为1.33个/患者,但随访期间共需额外进行100次PTCA或搭桥手术。CABG组患者平均有2.60个通畅的移植血管/患者。在整个随访期间,PTCA组的平均住院时间和费用分别为21.9天和207.1万日元,CABG组分别为82.2天和512.2万日元。PTCA组无心脏事件生存率明显较差。在双支血管病变亚组中,PTCA组成功扩张靶点或通畅移植血管的平均数为1.32个,CABG组为1.88个。PTCA组的总住院时间和费用分别为24.1天和235.2万日元,CABG组分别为86.2天和490.3万日元。PTCA组无心脏事件生存率明显较差。在三支血管病变亚组中,PTCA扩张了1.34个目标血管,而CABG有2.66个通畅的移植血管,是前者的两倍。PTCA组的总住院时间和费用分别为32.7天和261.2万日元,CABG组分别为82.4天和522.5万日元。(摘要截断于250字)

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