Ucer Oktay, Ceylan Yasin, Ekren Fatih, Ozan Erol, Muezzinoglu Talha
Department of Urology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey.
Department of Urology, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey.
Urolithiasis. 2016 Nov;44(6):559-564. doi: 10.1007/s00240-016-0879-4. Epub 2016 Apr 4.
The aim of this study is to evaluate the impact of anxiety and pain on success of shockwave lithotripsy (SWL) for treatment of proximal ureteral and renal pelvic stones smaller than 15 mm. One hundred thirty-two patients with proximal ureteral or renal pelvic stones <15 mm who were treated by a SWL and forty controls were enrolled in the study. State-trait anxiety inventory (STAI) was used to assess anxiety of the controls and patients (before every SWL session). Pains of the patients were measured by a visual analog scale (VAS) at three times (T) of the sessions (T11 at 11 kV, T15 at 15 kV and T end of treatment). The mean STAI scores of the patients at the first SWL session and controls were 40.61 ± 8.71 and 36.11 ± 8.18, respectively (p < 0.05). There was statistically positive moderate relationship between STAI and VAS scores at the first SWL session. The mean size of stone in men and women were 11.16 ± 2.88 and 11.00 ± 3.41, respectively (p = 0.88). In the first session, the mean STAI and VAS scores of the men were significantly lower than the women. The stone-free rate (SFR) of SWL was 72.7 % in this study. The SFR of SWL in the men and women were 78 and 64 %, respectively (p < 0.05). Our data showed that the severity of anxiety and pain in the women were higher than the men. SFR of SWL in the men was higher than the women. The severity of anxiety and pain in the patients may affect SFR of SWL.
本研究旨在评估焦虑和疼痛对冲击波碎石术（SWL）治疗直径小于15毫米的近端输尿管和肾盂结石成功率的影响。132例接受SWL治疗的直径小于15毫米的近端输尿管或肾盂结石患者及40名对照者纳入本研究。采用状态-特质焦虑量表（STAI）评估对照者和患者的焦虑程度（每次SWL治疗前）。通过视觉模拟量表（VAS）在治疗的三个时间点（T）测量患者的疼痛程度（11 kV时的T11、15 kV时的T15以及治疗结束时的T）。首次SWL治疗时患者和对照者的STAI平均得分分别为40.61±8.71和36.11±8.18（p<0.05）。首次SWL治疗时STAI与VAS得分之间存在统计学上的正性中度关系。男性和女性结石的平均大小分别为11.16±2.88和11.00±3.41（p=0.88）。在首次治疗中，男性的STAI和VAS平均得分显著低于女性。本研究中SWL的结石清除率（SFR）为72.7%。男性和女性SWL的SFR分别为78%和64%（p<0.05）。我们的数据表明，女性的焦虑和疼痛严重程度高于男性。男性SWL的SFR高于女性。患者的焦虑和疼痛严重程度可能会影响SWL的SFR。
