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[目的]以河南林州开展的食管癌早诊早治项目为背景,分析河南林州食管癌早诊早治项目筛查组和对照组的各项治疗成本,比较两组治疗成本的差异,为今后不同诊疗方案卫生经济学评价提供基础数据。[方法]选取应用内镜和病理活检筛查出的食管重度不典型增生/原位癌以上并进行治疗的患者作为筛查组,与筛查组经济条件等基本情况接近、因重度不典型增生/原位癌以上食管疾病自然就医的患者作为对照组。采用调查表的形式对患者的直接成本和间接成本进行调查,分析比较两组成本的差异和原因。[结果]筛查组平均每例重度不典型增生/原位癌和黏膜内癌的总治疗成本为10408元,明显低于对照组的21508元(t=-7.987,P﹤0.01);筛查组内平均每例黏膜下癌和浸润癌的总治疗成本为8124元,低于组内黏膜下癌和浸润癌的14919元(t=-7.922,P﹤0.01),而筛查组平均每例黏膜下癌和浸润癌的总治疗成本低于对照组浸润癌的21424元(t=-4.747,P﹤0.01)。重度不典型增生/原位癌患者采用黏膜切除术的总治疗成本为5233元,低于其他治疗方法的13732元(t=-7.506,P﹤0.01)。[结论]在食管癌高发区对高危人群开展筛查及早诊早治,筛查组治疗成本远低于自然就医人群。对早期癌使用黏膜切除术,治疗成本较低,可推广使用。
[Objective] Based on the early diagnosis and treatment of esophageal cancer in Linzhou, Henan Province, the treatment costs of screening and control groups in early diagnosis and treatment of esophageal cancer in Linzhou were analyzed. The differences of treatment costs between the two groups were compared. Provide the basic data for the evaluation of health economics of different treatment programs in the future. [Methods] Patients who were screened by endoscopy and pathological biopsy for esophageal atypical hyperplasia / carcinoma in situ were selected as the screening group, which were close to the basic conditions such as the economic conditions of the screening group. Because of severe dysplasia / Cancer in situ above the natural medical treatment of esophageal disease as a control group. The questionnaire was used to investigate the patients ’direct costs and indirect costs, and the differences and causes of the two groups’ costs were analyzed and compared. [Results] The average treatment cost of each severe atypical hyperplasia / carcinoma in situ and mucosal carcinoma in the screening group was 10408 yuan, significantly lower than 21508 yuan in the control group (t = -7.987, P <0.01). Screening The average cost of submucosal cancer and invasive cancer in each group was 8,124 yuan, which was lower than 14,919 yuan (t = -7.922, P <0.01) of submucosal and infiltrating cancers in the group. On average, every group The total cost of submucosal and invasive cancer was 21,424 yuan (t = -4.747, P <0.01) lower than that of the control group. The total cost of mucosal resection in patients with severe atypical hyperplasia / carcinoma in situ was 5233 yuan, which was 13.732 yuan less than other treatments (t = -7.506, P <0.01). [Conclusion] The screening and early diagnosis and early diagnosis and early diagnosis and treatment of high risk population in the high risk area of esophageal cancer are much lower than those of the natural treatment group. Mucosal resection for early cancer, the treatment of low cost, can be promoted.