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四种常用输尿管结石治疗技术对患者日常身体机能影响的比较:一项观察性随机对照研究。

Comparison of the Effects of Four Treatment Techniques Commonly Used in Ureteral Stone Treatment on Patients' Daily Physical Functioning: An Observational Randomized-Controlled Study.

机构信息

Department of Urology, Erciyes University, Kayseri, Turkey.

Department of Urology, Kayseri City Hospital, Kayseri, Turkey.

出版信息

J Endourol. 2021 Jan;35(1):8-13. doi: 10.1089/end.2020.0659. Epub 2020 Oct 21.

DOI:10.1089/end.2020.0659
PMID:32935564
Abstract

To investigate the effect of four different techniques used in the treatment of ureteral stones on patients' daily physical functioning (PF) and quality of life (QoL). Patients who underwent ureterorenoscopy (URS)-with or without Double-J stenting (DJS)-and extracorporeal shock wave lithotripsy (SWL) were divided into four groups: Group I: SWL ( = 29), Group II: URS ( = 43), Group III: URS +4.8F DJS ( = 39), Group IV: URS +6F DJS ( = 42), and Group V: Control ( = 30). Short Form-36 (SF-36) was administered to each participant both preoperatively and 14 days after operation. Based on the SF-36 results, the changes in patients' PF and QoL were evaluated. Ureteral stone treatment was performed in 202 patients. Of these, 153 patients who underwent an effective SWL or URS procedure in the first attempt were included in the study. Success rates in the first session were 53.7% (29/54) and 83.8% (124/148) for SWL and URS, respectively ( < 0.001). All the four groups were similar with regard to age, gender, body mass index, stone size, preoperative PF, and QoL. However, although postoperative PF, role limitations due to physical health, and energy/fatigue scores were similar in Group I, III, and IV, they were significantly higher in Group II. No major complication associated with SWL or URS occurred in any patient. However, in Group 2, DJS was inserted in three (7.7%) patients in the early postoperative period (within the first 48 hours) due to renal colic attacks secondary to ureterovesical junction mucosal edema. URS without DJS seems to be the most advantageous technique in the treatment of ureteral stones in terms of daily PF and QoL. However, it should be noted that patients undergoing URS may require postoperative emergency stenting, although rarely.

摘要

探讨治疗输尿管结石的四种不同技术对患者日常身体机能(PF)和生活质量(QoL)的影响。接受输尿管镜检查(URS)-伴或不伴双 J 支架(DJS)-和体外冲击波碎石术(SWL)的患者分为四组:组 I:SWL( = 29),组 II:URS( = 43),组 III:URS +4.8F DJS( = 39),组 IV:URS +6F DJS( = 42),组 V:对照组( = 30)。每位参与者在术前和术后 14 天均接受简短形式 36 项健康调查(SF-36)。根据 SF-36 结果,评估患者 PF 和 QoL 的变化。对 202 例输尿管结石患者进行了治疗。其中,153 例首次成功进行有效 SWL 或 URS 治疗的患者被纳入研究。首次治疗的成功率分别为 SWL 组 53.7%(29/54)和 URS 组 83.8%(124/148)( < 0.001)。在年龄、性别、体重指数、结石大小、术前 PF 和 QoL 方面,所有四组均相似。然而,尽管 I 组、III 组和 IV 组的术后 PF、因身体健康受限的角色和精力/疲劳评分相似,但 II 组的评分明显更高。SWL 或 URS 无任何主要并发症。然而,在第 2 组中,由于输尿管膀胱连接处粘膜水肿引起的肾绞痛,在术后早期(48 小时内)有 3 名(7.7%)患者需要插入 DJS。在治疗输尿管结石方面,URS 无 DJS 似乎是最有利的技术,因为它可以提高日常 PF 和 QoL。然而,应该注意的是,接受 URS 的患者可能需要术后紧急支架置入,尽管很少见。

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