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Sex differences in the incidence of severe pain events following surgery: a review of 333,000 pain scores.手术后严重疼痛事件发生率的性别差异:对333,000个疼痛评分的回顾
Pain Med. 2014 Aug;15(8):1390-404. doi: 10.1111/pme.12498. Epub 2014 Jul 8.
2
Role of emergency ureteroscopy in the management of ureteric stones: analysis of 394 cases.急诊输尿管镜检查在输尿管结石治疗中的作用:394例分析
BJU Int. 2015 Jun;115(6):946-50. doi: 10.1111/bju.12841. Epub 2014 Oct 22.
3
Retrograde intrarenal surgery vs extracorporeal shock wave lithotripsy for intermediate size inferior pole calculi: a prospective assessment of objective and subjective outcomes.逆行肾内手术与体外冲击波碎石术治疗中等大小下极结石:客观和主观结局的前瞻性评估。
Urology. 2014 May;83(5):1016-22. doi: 10.1016/j.urology.2013.12.026. Epub 2014 Feb 21.
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Categorizing intraoperative complications of retrograde intrarenal surgery.逆行性肾内手术术中并发症的分类
Urol Int. 2014;92(2):164-8. doi: 10.1159/000354623. Epub 2014 Feb 6.
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Pain and analgesic use after robot-assisted radical prostatectomy.机器人辅助根治性前列腺切除术后的疼痛和镇痛药物使用。
J Endourol. 2014 May;28(5):544-8. doi: 10.1089/end.2013.0783. Epub 2014 Jan 30.
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Flexible ureteroscopy with a ureteral access sheath: when to stent?输尿管软镜联合输尿管鞘:何时需要置管?
Urology. 2014 Feb;83(2):278-81. doi: 10.1016/j.urology.2013.10.002. Epub 2013 Nov 12.
7
Retrograde intrarenal surgery in patients with horseshoe kidneys.马蹄肾患者的逆行性肾内手术。
Urolithiasis. 2013 Feb;41(1):79-83. doi: 10.1007/s00240-012-0534-7. Epub 2012 Dec 21.
8
Prediction of postoperative pain after percutaneous nephrolithotomy: can preoperative experimental pain assessment identify patients at risk?经皮肾镜取石术后疼痛预测:术前实验性疼痛评估能否识别出高危患者?
Urolithiasis. 2013 Apr;41(2):169-77. doi: 10.1007/s00240-013-0547-x. Epub 2013 Feb 8.
9
Prospective evaluation and classification of ureteral wall injuries resulting from insertion of a ureteral access sheath during retrograde intrarenal surgery.逆行性肾内手术中输尿管导入鞘插入导致的输尿管壁损伤的前瞻性评估和分类。
J Urol. 2013 Feb;189(2):580-4. doi: 10.1016/j.juro.2012.08.197. Epub 2012 Oct 8.
10
A new scoring system for predicting stone-free rate after retrograde intrarenal surgery: the "resorlu-unsal stone score".一种用于预测逆行肾内手术后结石清除率的新评分系统:“resorlu-unsal 结石评分”。
Urology. 2012 Sep;80(3):512-8. doi: 10.1016/j.urology.2012.02.072. Epub 2012 Jul 26.

肾结石逆行性肾内手术后与术后疼痛相关的因素。

Factors associated with postoperative pain after retrograde intrarenal surgery for kidney stones.

作者信息

Oğuz Ural, Şahin Tolga, Şenocak Çağrı, Özyuvalı Ekrem, Bozkurt Ömer Faruk, Reşorlu Berkan, Ünsal Ali

机构信息

Department of Urology, Giresun University School of Medicine, Giresun, Turkey.

Clinic of Urology, Keçiören Training and Research Hospital, Ankara, Turkey.

出版信息

Turk J Urol. 2017 Sep;43(3):303-308. doi: 10.5152/tud.2017.58997. Epub 2017 Jul 31.

DOI:10.5152/tud.2017.58997
PMID:28861302
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5562249/
Abstract

OBJECTIVE

We aimed to investigate factors related to early postoperative pain after retrograde intrarenal surgery (RIRS).

MATERIAL AND METHODS

A prospective data analysis of 250 patients who underwent RIRS due to kidney stones was performed. Postoperative pain was evaluated in all patients by using visual analogue scale (VAS). Patients with severe pain (VAS score ≥7) were separated and included in Group I (n=46). While patients without pain or with insignificant pain were included in Group II (n=204). The impact of patient-related (age, gender, renal anomalies, shock wave lithotripsy history, preoperative hydronephrosis) stone-related (stone number, side, size, location and opacity) and operation-related (preoperative and postoperative ureteral J-stenting, ureteral injury, postoperative bleeding and fever, stone-free rates, size of access sheath, and sheath indwelling time) factors on early stage postoperative pain (if any) were investigated.

RESULTS

Female gender increased the risk for pain 3.6-fold (p<0.05). One millimeter increase in stone diameter increased the risk for postoperative pain 1.15-fold. Prolonged sheath time was another important factor which increased the risk for pain (p<0.05). Patients with high residual fragments were also prone to early postoperative pain.

CONCLUSION

According to our results, patient-, stone-and operation-related factors associated with postoperative pain after RIRS were female gender, stone size and sheath time.

摘要

目的

我们旨在研究逆行性肾内手术(RIRS)术后早期疼痛的相关因素。

材料与方法

对250例因肾结石接受RIRS手术的患者进行前瞻性数据分析。采用视觉模拟评分法(VAS)对所有患者的术后疼痛进行评估。将疼痛严重(VAS评分≥7)的患者分离出来纳入第一组(n = 46)。而无疼痛或疼痛不明显的患者纳入第二组(n = 204)。研究患者相关因素(年龄、性别、肾脏异常、冲击波碎石病史、术前肾积水)、结石相关因素(结石数量、侧别、大小、位置和不透光性)以及手术相关因素(术前和术后输尿管支架置入、输尿管损伤、术后出血和发热、结石清除率、穿刺鞘大小和鞘留置时间)对术后早期疼痛(如有)的影响。

结果

女性使疼痛风险增加3.6倍(p < 0.05)。结石直径每增加1毫米,术后疼痛风险增加1.15倍。鞘留置时间延长是增加疼痛风险的另一个重要因素(p < 0.05)。残留碎片多的患者也容易出现术后早期疼痛。

结论

根据我们的结果,RIRS术后与疼痛相关的患者、结石和手术相关因素为女性、结石大小和鞘留置时间。