头孢曲松-头孢克洛序贯疗法治疗儿童支气管肺炎的成本-效益分析

摘要

目的 分析头孢曲松-头孢克洛序贯疗法治疗儿童支气管肺炎的临床疗效及疾病成本负担.方法 选取2015年1月-2016年1月菏泽市牡丹人民医院收治的支气管肺炎患儿120例,采用随机数字表法分为对照组和试验组,每组60例.在常规治疗基础上,对照组患儿给予头孢曲松治疗7d,试验组患儿给予头孢曲松治疗3d后改用头孢克洛缓释片治疗4d.比较两组患儿临床疗效,治疗前后白细胞计数、中性粒细胞分数、淋巴细胞分数及C反应蛋白水平,治疗成本(包括抗生素治疗费用、治疗总费用、住院天数),观察两组患儿治疗期间不良反应发生情况.结果 两组患儿临床疗效比较,差异无统计学意义(P＞0.05).两组患儿治疗前后白细胞计数、中性粒细胞分数、淋巴细胞分数及C反应蛋白水平比较,差异均无统计学意义(P＞0.05).试验组患儿抗生素治疗费用、治疗总费用少于对照组,住院天数短于对照组(P＜0.05).两组患儿治疗期间均未出现严重不良反应.结论 头孢曲松-头孢克洛序贯疗法治疗儿童支气管肺炎的临床疗效与头孢曲松常规治疗相当,安全性相似,但头孢曲松-头孢克洛序贯疗法的成本-效益更优.%Objective To analyze the clinical effect and cost burden of disease of ceftriaxone-cefaclor sequential therapy in treating children with bronchopneumonia.Methods A total of 120 children with bronchopneumonia were selected in Peony People's Hospital of Heze from January 2015 to January 2016,and they were divided into control group and test group according to random number table,each of 60 cases.Based on conventional treatment,children of control group received ceftriaxone for 7 days,while children of test group received ceftriaxone for 3 days and cefaclor for 4 days.Clinical effect,WBC,neutrophil percentage,lymphocyte percentage and CRP before and after treatment,and treatment cost (including cost of antibiotics,total cost of treatment and hospital stays) were compared between the two groups,and incidence of adverse reactions was observed during the treatment.Results No statistically significant differences of clinical effect was found between the two groups (P ＞ 0.05).No statistically significant differences of WBC,neutrophil percentage,lymphocyte percentage or CRP was found between the two groups before or after treatment (P ＞ 0.05).Cost of antibiotics and total cost of treatment of test group were statistically significantly less than those of control group,meanwhile hospital stays of test group was statistically significantly shorter than that of control group (P ＜ 0.05).No one of two groups occurred any serious adverse reactions during the treatment.Conclusion Cefiriaxone-cefaclor sequential therapy has similar clinical effect and safety with routine treatment of cefiriaxone in treating children with bronchopneumonia,but the cost-effectiveness of ceftriaxone-cefaclor sequential therapy is better.