Cost-benefit analysis of different surgical methods in patients with trigeminal neuralgia / 重庆医学

ABSTRACT

Objective To analyze the cost-benefit ratio of primary trigeminal neuralgia patients with bad drug control and never accepted the surgical treatment through surgery [including microvascular decompression (MVD) ,percutaneous radiofrequency rhizotomy (RFR) ,stereotactic radiotherapy (SRS)] .Methods A total of 89 patients with primary trigeminal neuralgia who under-went surgical treatment for the first time from 2005 to 2013 were enrolled in this study ,including 27 patients with MVD ,23 patients with RFR and 39 patients with SRS .Evaluation criteria (effect factors) include facial pain (excellentno pain and no drug treat-ment ;goodno pain but medication ;worseless than 50% of patients with pain ;worsemore than 50% of patients with facial pain or need to undergo secondary surgery ) ,numbness ,cost and .Results The mean age of the patients treated with MVD was (50 .4 ± 14 .3)years old ,RFR was(73 .2 ± 13 .6) years old SRS was (72 .6 ± 11 .8) years old ,MVD group was younger than RFR and SRS group(P<0 .05);The average total cost of each surgical approach as followsMVD was 50274 yuan ,RFR was 4539 yuan ,SRS was 38512 yuan (P<0 .05);The postoperative facial numbness proportion of MVD was 1 .1% ,RFR was 52 .2% and SRS was 28 .2% (P<0 .05);The ratio of patients who needed recurrent surgery in two years was MVD 26 .0% ,RFR 73 .9% and SRS 30 .7% (P<0 .05);The mean remission rate of MVD was 1 .6 years ,the RFR was 2 .1 years ,and the SRS was 1 .0 year(P<0 .05);The cost-benefit ratio of MVD was 31618 yuan ,RFR was 1982 yuan ,SRS was 39297 yuan(P<0 .05) .Conclusion The cost-ben-efit ratio of the three surgical from low to high were RFR ,MVD ,SRS ,which means the unit cost of RFR gain the highest ,followed by M VD and SRS .