| 朱晓芸,马如超,于红刚.我国不同手术方式治疗早期胃癌的经济学指标评价[J].中国肿瘤,2019,28(1):74-80. |
| 我国不同手术方式治疗早期胃癌的经济学指标评价 |
| Health Economic Analysis of Endoscopic Submucosal Dissection Versus Open Surgery for Early Gastric Cancer in China：a Meta-analysis |
| 投稿时间：2018-05-08 |
| DOI：10.11735/j.issn.1004-0242.2019.01.A011 |
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| 中文关键词: 胃癌 内镜黏膜下剥离术 外科手术 卫生经济学 系统评价 Meta分析 中国 |
| 英文关键词:gastric cancer endoscopic submucosal dissection surgery health economics systematic review Meta-analysis China |
| 基金项目:国家自然科学基金资助项目（81272693） |
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| 摘要点击次数: 1981 |
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| 中文摘要: |
| 摘 要：［目的］ 对内镜黏膜下剥离术（endoscopic submucosal dissection，ESD）与外科手术两种不同手术方式治疗早期胃癌的卫生经济学指标进行系统评价。［方法］ 计算机检索Pubmed、Embase、the Cochrane Library（2018年4期）、中国生物医学文献数据库、中国知网学术总库、万方数据库和维普中文科技期刊数据库，获得关于ESD与外科手术治疗早期胃癌的队列研究、随机对照研究，检索时限均为建库至2018年4月。由2位评价员根据纳入及排除标准独立筛选文献、提取资料并评价纳入研究的偏倚风险，应用Stata 12.0软件进行Meta 分析。［结果］ 共纳入14项研究，其中回顾性队列研究12项，随机对照研究2项，共涉及2087个研究对象，其中ESD组919例，外科手术组1168例。Meta 分析结果显示：与外科手术组相比，ESD组的手术时间［标准化均数差（SMD）=-2.26，95%可信区间（95%CI）：-2.94～-1.58，P<0.05］和住院时间（SMD=-1.97，95%CI：-2.32～-1.61，P<0.05］缩短，且住院费用低（SMD=-3.01，95%CI：-3.78～-2.24，P<0.05］。［结论］ ESD与外科手术相比，具有手术时间短、住院天数少、住院费用低等优势。若临床能够在严格把握适应证的前提下推广应用ESD治疗早期胃癌，或可节约部分医疗资源。 |
| 英文摘要: |
| Abstract：［Purpose］ To perform a health economic analysis of endoscopic submucosal dissection(ESD) versus open surgery for early gastric cancer(EGC) in China. ［Methods］ Pubmed，Embase，the Cochrane Library(4th issue of 2018)，Chinese Biomedical Literature Database，CNKI，Wanfang Database and VIP were searched for randomized controlled clinical trials and cohort studies that assessed the health economics of ESD and open surgery for treatment of early gastric cancer in China. All studies published prior to April 2018，and were assessed the risk of bias by two reviewers independently. Meta-analysis was performed with Stata 12.0 software. ［Results］ Fourteen studies were included in the analysis，including 12 retrospective cohort studies and 2 randomized controlled trials involving 2087 study subjects，of whom 919 received ESD and 1168 received open surgery. The operation time and the length of hospital stay in the ESD group were shorter than those in the surgery group ［standard mean difference(SMD)=-2.26，95%CI：-2.94～-1.58，P<0.05 and SMD=-1.97，95%CI：-2.32～-1.61，P<0.05，respectively］. Compared with the surgery group，the hospitalization costs were lower(SMD=-3.01，95%CI：-3.78～-2.24，P<0.05) in ESD group. ［Conclusion］ Compared with open surgery，ESD has the advantages in shorter operation time and length of hospital stay，and lower hospitalization cost for treatment of early gastric cancer. |
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