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[输尿管镜碎石术后留置双J管相关疼痛的前瞻性评估]

[Prospective evaluation of pain associated with indwelling JJ stents following ureterorenoscopic lithotripsy].

作者信息

Dudek Przemysław, Gołabek Tomasz, Jaskulski Jarosław, Orłowski Paweł, Bukowczan Jakub, Szopiński Tomasz, Chłosta Piotr

出版信息

Przegl Lek. 2013;70(11):936-8.

PMID:24697033
Abstract

AIM

Routine placement of JJ ure teric stents, following uncomplicated endoscopic removal of a ureteral stone, still remains debatable. Indwelling JJ stents are not without any risks. They often can cause marked discomfort, or even pain. The aim of this study was to prospectively evaluate patient's perceived pain due to renal colic and indwelling JJ stent left following ure terorenoscopic lithotripsy (URSL).

MATERIAL AND METHODS

54 patients with colicky pain due to distal ureteric stone, and who underwent uncompli cated ureterorenoscopic lithotripsy, were included in the study. Follow ing URSL, patients were randomly selected to have either JJ stent left in situ (Group I), or remain without a stent (Group II). Among all study par ticipants levels of pain prior, as well as 14 days after the procedure were evalu ated with the use of a visual analogue pain scale.

RESULTS

Pain perception at the time of colic did not vary between men and women (6.30 +/- 1.33 and 6.38 +/- 1.11, respectively, p=0.293). Similarly, no differences in perceived pain were noted 14 days following URSL. Mean pain score in patients with indwelling JJ stent was 2.12 +/- 1.23 as compared to 2.15 +/- 0.67 in those without it (p=0.148).

CONCLUSIONS

No increase in pain levels due to indwelling JJ stent could be observed. Further research to allow for better assessment of discomfort and pain caused by an indwelling JJ stent on a larger cohort, and which could also discriminate patients' psy chosomatic symptoms, is needed.

摘要

目的

在输尿管结石经内镜简单取出后常规放置双J输尿管支架仍存在争议。留置双J支架并非没有风险。它们常常会引起明显不适,甚至疼痛。本研究的目的是前瞻性评估输尿管镜碎石术(URSL)后患者因肾绞痛和留置双J支架而感受到的疼痛。

材料与方法

纳入54例因远端输尿管结石引起绞痛且接受了简单输尿管镜碎石术的患者。URSL术后,患者被随机分为两组,一组留置双J支架(第一组),另一组不留置支架(第二组)。在所有研究参与者中,使用视觉模拟疼痛量表评估术前以及术后14天的疼痛程度。

结果

肾绞痛发作时的疼痛感受在男性和女性之间没有差异(分别为6.30±1.33和6.38±1.11,p = 0.293)。同样,URSL术后14天的疼痛感受也没有差异。留置双J支架患者的平均疼痛评分为2.12±1.23,而未留置支架患者的平均疼痛评分为2.15±0.67(p = 0.148)。

结论

未观察到因留置双J支架导致疼痛水平增加。需要进一步研究,以便在更大的队列中更好地评估留置双J支架引起的不适和疼痛,并且能够区分患者的身心症状。

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