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接受保留膀胱的泌尿外科重建手术的神经源性膀胱患者的生活质量评估

Quality of life evaluation of patients with neurogenic bladder submitted to reconstructive urological surgeries preserving the bladder.

作者信息

Lima Daniel Xavier, Pires Cleidismar Rosa, Santos Ana Clara Rezende Dos, Mendes Raphaela Gomes, Fonseca Carlos Eduardo Corradi, Zocratto Orlando Barreto

机构信息

Hospital of the Medical School of the Federal University of Minas Gerais.

出版信息

Int Braz J Urol. 2015 May-Jun;41(3):542-6. doi: 10.1590/S1677-5538.IBJU.2014.0150.

Abstract

Treatment of neurogenic bladder (BN) aims to upper urinary tract protection. When the conservative clinical measures are insufficient, surgical treatment is indicated. Though admittedly important, the quality of life (QoL) has been little studied in these patients, there are even contradictory results. The aim of this study was to evaluate QoL before and after bladder augmentation in patients with BN refractory to medical treatment. We analyzed, prospectively, the data of 67 patients who underwent surgical treatment for BN by questionnaire SF-36(®) and Qualiveen(®) QoL before and after six months of operation. Comparisons using paired t-tests and Wilcoxon and the assumption of normality was assessed using the Shapiro-Wilk test were made. According to the analysis of the SF-36(®) questionnaire, the patients had higher QoL indices in the postoperative period in the areas functional capacity, general state of health, vitality, social aspects, emotional aspects and mental health (n = 67; p <0.05). The questionnaire also revealed Qualiveen(®) best result in quality of life index in the postoperative period, and show lower specific negative impact by urinary problems (n = 36; p <0.05). The results show that, despite not being the main objective, the bladder augmentation results in significant improvement in QoL, probably related to the perception of better health and the resolution of urinary incontinence. Thus, the bladder augmentation associated with other urologic reconstruction techniques allows the upper urinary tract protection, and contribute to a better quality of life of patients with BN.

摘要

神经源性膀胱(BN)的治疗旨在保护上尿路。当保守的临床措施不足时,需进行手术治疗。尽管生活质量(QoL)无疑很重要,但在这些患者中对其研究较少,甚至存在相互矛盾的结果。本研究的目的是评估药物治疗无效的BN患者膀胱扩大术前后的生活质量。我们通过SF-36(®)问卷和Qualiveen(®)生活质量量表,前瞻性地分析了67例接受BN手术治疗患者术前及术后6个月的数据。采用配对t检验和Wilcoxon检验进行比较,并使用Shapiro-Wilk检验评估正态性假设。根据SF-36(®)问卷分析,患者在术后功能能力、总体健康状况、活力、社会方面、情感方面和心理健康等领域的生活质量指数更高(n = 67;p <0.05)。该问卷还显示Qualiveen(®)在术后生活质量指数方面结果最佳,且受泌尿问题的特定负面影响较低(n = 36;p <0.05)。结果表明,尽管不是主要目标,但膀胱扩大术可显著改善生活质量,这可能与对健康状况改善的感知以及尿失禁的解决有关。因此,膀胱扩大术与其他泌尿外科重建技术相结合可保护上尿路,并有助于提高BN患者的生活质量。

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