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选择性消化道去污染的成本效益,以减少结直肠癌手术中的传染性并发症:对SELECT试验的分析

J R D Reuvers¹, E Gaikhorst¹, Â Jornada Ben²

¹Department of Surgery, Spaarne Gasthuis, Spaarnepoort 1, 2134, TM, Hoofddorp, the Netherlands; Department of Surgery, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, De Boelelaan 1108, 1081, HZ, Amsterdam, the Netherlands; Department of Molecular Cell Biology and Immunology, Amsterdam University Medical Centers, De Boelelaan 1108, 1081, HZ, Amsterdam, the Netherlands.

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

|October 31, 2023

概括

消化道的选择性去污染 (SDD) 减少了结直肠癌手术中的传染性并发症,并且具有成本效益. 这种方法,当添加到标准预防时,应被认为是改善患者结果和降低医疗保健成本的标准护理.

科学领域:

手术瘤学手术瘤学
传染性疾病传染性疾病
卫生经济学卫生经济学

背景情况:

已知消化道的选择性去污染 (SDD) 可以减少结直肠癌 (CRC) 手术中的传染性并发症.
然而,与标准抗生素预防相比,其成本效益仍然不清楚.

研究的目的:

评估在选择性结肠直肠癌手术中将SDD添加到标准抗生素预防中的成本效益.

主要方法:

从医疗保健的角度进行了一项多中心随机对照试验 (SELECT-试验).
患者接受了SDD加标准预防或单独标准预防.
收集的数据包括术后感染性并发症,经质量调整的寿命年 (QALYs) 和医疗保健费用.

主要成果:

SDD显著减少了感染性并发症 (差异 = -0.13,95% CI -0.05至 -0.20).
没有观察到QALYs的显著差异 (差异=0.002,95%CI-0.002到0.005).
在SDD群体中,医疗费用明显较低 (差异=-1258欧元,95% CI-2751至-166).

结论:

将SDD添加到标准的手术前抗生素预防中是具有成本效益的.
从医疗保健的角度来看,SDD应该被认为是选择性结肠直肠癌手术的护理标准.

关键词:

解剖学上的泄漏.结肠直肠外科手术是什么意思经济效益性经济效益性传染性并发症感染性并发症口服抗生素口服抗生素手术部位感染的感染.

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