目的:研究子宮腺肌病局部病灶切除術的可行性,方法及手術療效的評價。方法:對2002年3月至2006年3月97例子宮腺肌病保留子宮僅作局部病灶切除術的患者進行隨訪觀察。結果:97例子宮腺肌病手術后痛經治愈率:輕度,100%,中度37.8%,重度36%,痛經緩解率,中度及重度分別為62.2%及64%。月經過多治愈率為100%。妊娠分娩率原發不孕57.6%,繼發不孕52.9%。結論:子宮腺肌病局部病灶切除術既治愈和改善了患者的臨床癥狀又保留生殖器官的完整性及生理生殖功能可且有助于妊娠率的提高,是值得使用的方法。
ObjectivesTo review the pharmacoeconomic evaluation of rheumatoid arthritis patients with an inadequate efficacy or intolerance with conventional synthetic disease modifying antirheumatic drugs (csDMARDs).MethodsCNKI, WanFang Data, VIP, PubMed, EMbase, Web of Science and The Cochrane Library were electronically searched to collect pharmacoeconomic studies about rheumatoid arthritis patients with an inadequate efficacy or intolerance with csDMARDs from inception to February 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of the included studies, then, descriptive analysis was performed.ResultsA total of 16 studies were included, where most compared the economics of different treatment methods from the perspective of the payer by cohort or individual model. The economic costs in the studies were primarily on direct cost. Sensitivity analyses were used to prove the robustness of the main analysis in each study. Biological disease-modifying antirheumatic drugs (bDMARDs) might be more cost-effective than csDMARDs. In addition, compared with the bDMARDs, new-marketed targeted synthetic disease-modifying antirheumatic drugs (tsDMARDs) might be more cost-effective.ConclusionsIt could be considered to implement more new marketed tsDMARDs to improve patients’ condition to reduce the economic burden and optimize the allocation of health care resources.