内镜鼻窦手术成本分析的范围综述：经济趋势、成本驱动因素与方法学空白

文献信息

中文摘要

目的： 内镜鼻窦手术（ESS）是慢性鼻窦炎（CRS）的标准手术干预方式，但其经济价值尚未被充分理解。本范围综述旨在综合ESS的经济学评价，重点关注成本驱动因素、方法学方法以及当前文献中的空白。
数据来源： 这是一项范围综述。
综述方法： 按照PRISMA-ScR指南开展范围综述。使用主要数据库（MEDLINE、Embase、Cochrane CENTRAL、Web of Science）进行文献检索，检索时间自建库至2025年7月。根据预先确定的纳入标准筛选和选择研究，并提取有关研究特征、经济学方法和报告成本组成部分的数据。
结果： 在筛选的1660条记录中，35项研究符合纳入标准。纳入研究在研究设计、经济学方法、成本定义和报告实践方面存在相当大的异质性。在各研究中，手术时间、手术范围和手术环境是与手术成本差异相关的因素。间接成本报告不一致，而患者自付费用未被明确评估。
结论： ESS的经济学评价高度异质，限制了研究之间的直接比较。尽管若干研究报告了有利的成本效果估计，但方法学异质性限制了对ESS长期经济价值的结论。需要标准化的经济学报告框架以提高可比性和临床适用性。

英文摘要

OBJECTIVE: Endoscopic sinus surgery (ESS) is the standard surgical intervention for chronic rhinosinusitis (CRS), yet its economic value is not fully understood. This scoping review aims to synthesize economic evaluation of ESS, with emphasis on cost drivers, methodological approaches, and gaps in current literature.
DATA SOURCES: This is a scoping review.
REVIEW METHODS: A scoping review was conducted in accordance with PRISMA-ScR guidelines. A literature search was done using major databases (MEDLINE, Embase, Cochrane CENTRAL, Web of Science) from inception to July 2025. Studies were screened and selected based on predetermined inclusion criteria, and the data regarding study characteristics, economic methodology, and reported cost components were extracted.
RESULTS: Of 1660 screened records, 35 studies met the inclusion criteria. Considerable heterogeneity was observed in study design, economic methodology, cost definitions, and reporting practices of the included studies. Across studies, operative time, surgical extent, and surgical setting were among the factors associated with variation in procedural costs. Indirect costs were inconsistently reported, while patient out-of-pocket costs were not explicitly evaluated.
CONCLUSION: Economic evaluations of ESS are highly heterogeneous, limiting direct comparison between studies. Although several studies reported favorable cost-effectiveness estimates for ESS, methodological heterogeneity limits conclusions regarding its long-term economic value. Standardized economic reporting frameworks are needed to improve comparability and clinical applicability.