本文選題：消化性潰瘍伴出血　切入點(diǎn)：住院費(fèi)用　出處：《蘇州大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的： 研究消化性潰瘍伴出血住院患者的診治現(xiàn)狀及治療費(fèi)用，分析住院費(fèi)用的主要影響因素。 方法： 2009年8月至2013年12月期間，收錄因消化性潰瘍出血住院的患者進(jìn)行研究。記錄并分析患者人口學(xué)特征、既往病史、臨床表現(xiàn)、住院期間的診治、住院費(fèi)用、合并癥等，同時(shí)對患者住院費(fèi)用的構(gòu)成及影響因素進(jìn)行統(tǒng)計(jì)分析。 結(jié)果： 患者平均住院費(fèi)用為￥6338.8，其中西藥費(fèi)占55.6%，實(shí)驗(yàn)室檢查費(fèi)用占14.4%，診療護(hù)理費(fèi)用及床位費(fèi)用占9.3%，器械檢查費(fèi)用占7.4%，，其他費(fèi)用如內(nèi)鏡下止血、輸血費(fèi)用等約占13.3%。而西藥費(fèi)用中，質(zhì)子泵抑制劑占41.5%�；颊呷朐簳r(shí)Rockall評分為2.47±1.31。平均住院天數(shù)為7.5天。所有的患者在72小時(shí)內(nèi)進(jìn)行了胃鏡檢查。其中，十二指腸球部潰瘍伴出血占63.1%，胃潰瘍伴出血占29.4%，復(fù)合潰瘍伴出血占6.0%，吻合口潰瘍伴出血占1.3%，食管潰瘍伴出血0.1%。住院總費(fèi)用與住院天數(shù)、患者年齡、入院時(shí)患者血紅蛋白水平、胃鏡下潰瘍Forrest分級、有服用非甾體類抗炎藥（NSAIDs）藥物史明顯相關(guān)。 結(jié)論： 影響患者住院費(fèi)用的主要因素為住院天數(shù)、患者年齡、入院時(shí)患者血紅蛋白水平、胃鏡下潰瘍Forrest分級、有服用NSAIDs藥物史，而嘔血、黑便及幽門螺旋桿菌（Hp）感染并不獨(dú)立影響患者的住院費(fèi)用，同樣的，潰瘍類型、潰瘍直徑、糖尿病等與患者的住院費(fèi)用無明顯相關(guān)。文中，質(zhì)子泵抑制劑占了西藥總費(fèi)用的較大部分，合理的治療方案有助于降低患者住院費(fèi)用，同時(shí)可優(yōu)化患者的費(fèi)用構(gòu)成。上述影響患者住院費(fèi)用的因素只能解釋患者住院費(fèi)用的53.3%，說明還有其他影響患者住院總費(fèi)用的因素，還需要醫(yī)學(xué)工作者進(jìn)一步探討。
[Abstract]:Objective:. To study the present situation of diagnosis and treatment of peptic ulcer patients with hemorrhage and the cost of treatment, and to analyze the main influencing factors of hospitalization cost. Methods:. From August 2009 to December 2013, patients with peptic ulcer bleeding were studied. The demographic characteristics, past medical history, clinical manifestations, diagnosis and treatment during hospitalization, hospital expenses, complications, and so on were recorded and analyzed. At the same time, the composition and influencing factors of patients' hospitalization expenses were analyzed statistically. Results:. The average cost of hospitalization was 6338.8, of which western medicine accounted for 55.6, laboratory examination 14.4, consultation and nursing and bed cost 9.3, instrument examination 7.4, other expenses such as endoscopy hemostasis, blood transfusion, etc. Proton pump inhibitors accounted for 41.5% of the patients. The Rockall score at admission was 2.47 鹵1.31. The average length of stay was 7.5 days. All patients underwent gastroscopy within 72 hours. Duodenal ulcer with bleeding accounted for 63.1%, gastric ulcer with bleeding accounted for 29.4%, compound ulcer with bleeding accounted for 6.0%, anastomotic ulcer with bleeding 1.3%, esophageal ulcer with bleeding 0.1%. Total hospitalization cost and hospitalization days, patient age, hemoglobin level at admission. The Forrest grade of ulcer under gastroscopy had a history of NSAIDstaking non-steroidal anti-inflammatory drugs (NSAIDs). Conclusion:. The main factors influencing the cost of hospitalization were length of stay, age of patients, hemoglobin level at admission, Forrest grade of ulcer under gastroscopy, history of taking NSAIDs drugs, and hematemesis. Black stool and Helicobacter pylori (HP) infection did not independently affect the cost of hospitalization. Similarly, the types of ulcers, the diameter of ulcers and diabetes were not significantly related to the cost of hospitalization. Proton pump inhibitors account for a large part of the total cost of western medicine. A reasonable treatment plan can help reduce the cost of hospitalization of patients. At the same time, the cost composition of patients can be optimized. The factors mentioned above can only explain 53.3% of the total cost of hospitalization of patients, indicating that there are other factors that affect the total cost of hospitalization of patients, and need to be further explored by medical workers.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R573.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前2條

1 Michael Hobsley;Frank I Tovey;John Holton;;Precise role of H pylori in duodenal ulceration[J];World Journal of Gastroenterology;2006年40期

2 Kang-Moon Lee;Chang-Nyol Paik;Woo Chul Chung;Jin Mo Yang;;Association between acute pancreatitis and peptic ulcer disease[J];World Journal of Gastroenterology;2011年08期

本文編號：1639949