摘要
目的分析良性阵发性位置性眩晕（BPPV）的误诊情况，并评估由此导致的社会经济成本损耗。方法收集2015年10—12月，上海长征医院眩晕专病门诊确诊的80例BPPV患者，采集这些患者的临床资料、就诊史、辅助检查项目以及诊治费用等数据，分析研究BPPV的误诊数据及由此产生的经济成本。结果研究表明，BPPV的误诊率为60．O％（48／80），常见的非针对性的检查包括：头颅CT、MRI平扫、颈椎MRI检查、颈部及头颅血管检查等，上述误诊组患者（48例）和非误诊组患者（32例）在性别、年龄、症状持续时间、受累半规管、BPPV类型等方面没有显著差异。相较于非误诊组患者，误诊组患者的并发症发生概率显著增加[81．3％（39／48）比34．4％（11／32）]。单个误诊患者的误诊成本估计为8502．98元人民币，估算每年上海市由于BPPV误诊导致的相关经济负担为1318．47～7886．21万元人民币。结论本研究表明，BPPV的误诊率较高，而且因BPPV误诊误治给患者和社会带来了经济成本浪费。对于存在变位性眩晕的患者，在昂贵的医学检查之前，例行床旁Dix—Hallpike诱发试验和平卧侧头试验，可以有效地减少BPPV误诊误诊并避免医疗资源的浪费。
Objective The aims of this study were to investigate the misdiagnosis of benign paroxysmal positional vertigo （BPPV） and to estimate the associated costs. Methods During October 2015 to December 2015, eighty patients were diagnosed with BPPV in the outpatient dizziness clinic of Shanghai Changzheng Hospital and the clinical data of all the 80 patients were collected including the demographic and clinical characteristics, the history of diagnosis, inappropriate diagnostic tests, costs of the medical tests, transportation and accommodation. Al1 the data were investigated to estimate the misdiagnosis of benign paroxysmal positional vertigo and the associated costs in Shanghai, China. Results This study showed that the misdiagnosis rate of BPPV was 60. 0% （48/80） and the common inappropriate diagnostic tests for BPPV included Cranial CT and MRI test, cervical MRI, cervical and cerebrovascular investigations et al. There was no significant difference between the misdiagnosis patients （48） and patients without misdiagnosis （32） in gender, age, duration of symptom, involved canal and type of BPPV. Complications were significantly more frequent in the misdiagnosis group than for those without[81.3% （39/48） vs 34.4% （11/32） 1. The estimated costs for each misdiagnosed individual were 8 502. 98 China Yuan （CNY） and one-year economic burden associated with the misdiagnosis of BPPV in Shanghai was 13. 184 7 - 78. 862 1 million CNY. Conclusions Our study suggests that the misdiagnosis rate of BPPV is high and the financial impact on patients and society with this disease is huge. The cost-effective Dix-Hallpike or supine roll test maneuver should be used before applying other expensive medical tests in order to minimize misdiagnosis and the waste of health care resources.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2017年第14期1057-1060,共4页
National Medical Journal of China
