Department of Urology, Medical University of Vienna, Vienna, Austria.
Urology. 2013 Sep;82(3):521-5. doi: 10.1016/j.urology.2013.04.031. Epub 2013 Jun 14.
To investigate the perception of colicky pain due to ureteral stones and double-J (DJ)-associated discomfort and to evaluate the role of clinical parameters that might influence the perception of pain.
From November 2011 to May 2012, 124 consecutive patients with colicky pain due to ureteral stones and ureteroscopic stone extraction underwent DJ stent placement. A visual analog scale (VAS) was used to assess the pain at ureteral colic, during indwelling DJ stent, and at DJ stent removal. The association of clinical data with pain scores was also analyzed.
Pain perception at the time of colic did not vary according to sex (P = .804), age (P = .674), or DJ stent length (P = .389). Stone size (<4 mm) was a predictor of a high VAS score (P = .001). Patients with recurrent stone formation had significantly less pain at the time of colic (P = .004), and DJ stent removal (P = .004) than those with the first instance of stone formation. The clinical experience at cystoscopic DJ stent removal influenced pain perception (P <.001).
Using a VAS for the evaluation of pain perception is a valid method for the objectification of subjective discomfort. The VAS is an easy to administer scale and provides accurate information on the patients' status. Additional studies with larger cohorts focusing on pain perception using the VAS and other validated questionnaires are recommended to produce more consistent data.
研究输尿管结石绞痛和双 J（DJ）相关不适的感知，并评估可能影响疼痛感知的临床参数的作用。
2011 年 11 月至 2012 年 5 月，124 例因输尿管结石和输尿管镜取石术而出现绞痛的连续患者接受了 DJ 支架置入术。采用视觉模拟评分（VAS）评估输尿管绞痛时、DJ 支架留置时和 DJ 支架取出时的疼痛。还分析了临床数据与疼痛评分的相关性。
绞痛时的疼痛感知与性别（P =.804）、年龄（P =.674）或 DJ 支架长度（P =.389）无关。结石大小（<4mm）是 VAS 评分高的预测因素（P =.001）。复发性结石形成的患者在绞痛时（P =.004）和 DJ 支架取出时（P =.004）疼痛明显减轻。膀胱镜 DJ 支架取出时的临床经验影响疼痛感知（P <.001）。
使用 VAS 评估疼痛感知是对主观不适进行客观评估的有效方法。VAS 是一种易于管理的量表，可提供患者状况的准确信息。建议进行更多使用 VAS 和其他经过验证的问卷评估疼痛感知的研究，以产生更一致的数据。
