概括
脏缺血有效降低血压在不受控制的高血压患者. 虽然比标准护理更昂贵,但它提供了一个有利的选择,特别是当其他治疗方法失败时.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 卫生技术评估 卫生技术评估
背景情况:
- 失控的高血压带来了心血管疾病,中风,功能衰竭和死亡的重大风险.
- 脏脱皮,一种微创手术,针对脏交感神经作为抗性高血压的辅助疗法.
- 本次卫生技术评估评估了皮剥皮的有效性,安全性,成本效益,预算影响以及患者/提供者的偏好.
研究的目的:
- 评估对未经控制的高血压进行脏缩的临床有效性和安全性.
- 确定公共资助脏损伤的成本效益和预算影响.
- 探索患者和医疗服务提供者的观点,以损为治疗选择.
主要方法:
- 随机对照试验和系统审查的系统文献搜索.
- 使用ROBIS工具进行偏差风险评估.
- 经济评估包括成本效益分析和预算影响建模.
- 通过采访对患者和提供者的偏好和价值观进行定性审查.
主要成果:
- 与标准护理相比,损伤显著降低了缩血压2.1-6.3 mmHg.
- 增量成本效益比为每获得的质量调整寿命年 (QALY) 为121,237美元.
- 在安大略省,公共资金预计将在5年内使年度成本增加0.42美元至378万美元.
- 大约30%的患者更喜欢脏缩,特别是年轻人和有药物坚持问题的患者.
结论:
- 脏变质是有效的降低血压的失控和耐药高血压.
- 虽然更昂贵,但它是一个有利的选择,特别是当传统治疗失败时.
- 患者和提供者反表明了积极的看法,突出了其作为辅助疗法的潜力.
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