评估Volar手腕的最佳治疗途径:一个成本最小化分析
Miranda J Rogers1, Hernan Roca2, Minkyoung Yoo3
1University of Michigan, Department of Orthopaedics, 2912 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109.
Plastic and reconstructive surgery
|December 23, 2025
概括
在开放性手术前尝试一次超声波导向吸收是对飞手腕 (VWG) 最具成本效益的治疗方法. 这种方法与即时手术切除相比,最大限度地降低了成本,最大限度地提高了护理价值.
科学领域:
- 整形外科 整形外科 整形外科
- 卫生经济学 卫生经济学
- 医疗技术 医疗技术 医学技术
背景情况:
- 背手腕瘤治疗通常涉及最初的愿望,以降低成本.
- 对于飞手腕 (VWG) 的初始吸血的成本效益不太清楚,可能需要超声波指导以避免辐射动脉损伤.
- 这项研究调查了这样的假设,即手术切除前的一次吸血对于VWG来说比立即手术更具成本效益.
研究的目的:
- 为了确定最具成本效益的治疗途径飞手腕 (VWG).
- 为了比较不同VWG治疗策略的成本,包括吸收和外科切除 (开放式与关节镜).
- 评估初始愿望对VWG的整体治疗成本的影响.
主要方法:
- 开发了一个微模拟决策分析模型来分析VWG的四个治疗途径.
- 该模型结合了文献中的解决率和来自机构数据库和劳工和统计局的直接/间接成本.
- 对关键变量进行了单向敏感性分析 (OWSA) 和值分析.
主要成果:
- 在开放切除前的超声导向吸收是最不昂贵的途径 (每例解决病例2,106美元±2,233美元).
- 复发率为42%±8%的吸收,27%±2%的开放切除,和2%±2%的关节镜切除.
- 最初的关节镜切除术是最昂贵的策略 (7293美元±521美元).
结论:
- 为了最大限度地提高VWG的护理价值,需要在开放切除之前尝试一次吸收.
- 手部外科医生执行自己的超声波导向愿望可以进一步降低成本.
- 对于VWG的立即开放或关节镜切除术的成本效益是可疑的.
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