Braithwaite B D, Jones L, Heather B P, Birch P A, Earnshaw J J
Department of Surgery, Gloucestershire Royal Hospital, UK.
Br J Surg. 1996 Oct;83(10):1390-3. doi: 10.1002/bjs.1800831020.
The cost of attempting limb salvage in patients who presented with acute lower limb ischaemia was recorded prospectively for 20 months. Seventy-five patients were admitted during the study; 45 were treated primarily by radiological intervention and 18 had primary surgery. The remainder were treated conservatively. Patients who had primary surgery required fewer visits to the operating theatre than those who had primary thrombolysis, but there was no difference in the total time that the theatre or radiology suite was occupied: median 2.3 (10th centile range 1.5-5.0) h and 3.0 (2.0-5.0) h respectively. Median (range) cost of disposables for performing surgery was Pounds 82 (58-169) and for thrombolysis was Pounds 407 (252-596). When the costs of using the theatre or radiology suite were included, the costs of both treatments were similar: surgery Pounds 683 (309-1438) and lysis Pounds 861 (611-1244). Median (10th centile range) inpatient stay for surgical patients was 9 (3-18) days and for those having thrombolysis 11 (2-29) days. Median (10th centile range) costs for bed occupancy were similar in both groups: surgery Pounds 2497 (643-9115) and lysis Pounds 2189 (902-6020). Mean cost for attempting limb salvage by surgery was Pounds 3429 (1094-10065) compared with Pounds 3230 (1543-8353) for thrombolysis.
对75例急性下肢缺血患者进行肢体挽救治疗的费用进行了为期20个月的前瞻性记录。研究期间收治了75例患者；45例主要接受放射介入治疗，18例接受一期手术。其余患者接受保守治疗。接受一期手术的患者比接受一期溶栓治疗的患者需要更少的手术室就诊次数，但手术室或放射科占用的总时间没有差异：中位数分别为2.3（第10百分位数范围1.5 - 5.0）小时和3.0（2.0 - 5.0）小时。手术一次性用品的中位数（范围）成本为82英镑（58 - 169），溶栓治疗为407英镑（252 - 596）。当将手术室或放射科使用费用计算在内时，两种治疗的费用相似：手术683英镑（309 - 1438），溶栓861英镑（611 - 1244）。手术患者的住院中位数（第10百分位数范围）为9（3 - 18）天，溶栓治疗患者为11（2 - 29）天。两组床位占用的中位数（第10百分位数范围）成本相似：手术2497英镑（643 - 9115），溶栓2189英镑（902 - 6020）。手术进行肢体挽救的平均成本为3429英镑（1094 - 10065），而溶栓治疗为3230英镑（1543 - 8353）。
