Viljakka M, Nevalainen J, Isolauri J
Medical School, Dept. of Surgery, University of Tampere, Finland.
Scand J Gastroenterol. 1997 Aug;32(8):766-72. doi: 10.3109/00365529708996532.
Gastro-oesophageal reflux disease (GERD) can be effectively treated pharmacologically or surgically. As GERD is often a chronic condition, we compared the long-term costs of medical and surgical management.
The medical regimens were ranitidine (150 or 300 mg/day), omeprazole (20 or 40 mg/day), and lansoprazole (30 mg/day), with costs calculated for total life expectancy after diagnosis and for one-third of that time. Costs for open or laparoscopic surgery (Nissen fundoplication) included pre- and post-operative investigations, sick leave, and calculated financial loss due to fatal outcome.
Costs were lowest with ranitidine, 150 mg/day, for one-third of the patient's lifetime and highest with lifelong omeprazole, 40 mg/daily. The cost of open or laparoscopic operation was less than that of lifelong daily treatment with proton pump inhibitors or ranitidine, 300 mg daily.
In Finland, antireflux surgery for GERD is cheaper than lifetime treatment with proton pump inhibitors.
胃食管反流病（GERD）可通过药物或手术有效治疗。由于GERD通常是一种慢性病，我们比较了药物治疗和手术治疗的长期成本。
药物治疗方案为雷尼替丁（150或300毫克/天）、奥美拉唑（20或40毫克/天）和兰索拉唑（30毫克/天），计算诊断后的预期寿命总成本以及该时间的三分之一的成本。开放手术或腹腔镜手术（nissen胃底折叠术）的成本包括术前和术后检查、病假以及因致命结果计算的经济损失。
雷尼替丁150毫克/天治疗患者一生的三分之一时间成本最低，而奥美拉唑40毫克/天终身治疗成本最高。开放手术或腹腔镜手术的成本低于质子泵抑制剂或雷尼替丁300毫克/天终身每日治疗的成本。
在芬兰，GERD的抗反流手术比质子泵抑制剂终身治疗便宜。
