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经皮肾造瘘术与双猪尾输尿管支架治疗恶性输尿管梗阻的生活质量比较。

Quality of life with tandem ureteral stents compared to percutaneous nephrostomy for malignant ureteral obstruction.

机构信息

Department of Urology, Sheba Medical Center, Ramat-Gan, Israel.

Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

Support Care Cancer. 2022 Nov;30(11):9541-9548. doi: 10.1007/s00520-022-07354-2. Epub 2022 Sep 3.

Abstract

PURPOSE

Malignant ureteral obstruction (MUO) is treated with kidney decompression by a percutaneous nephrostomy (PCN) or internal ureteral stents. The objective of this study was to compare quality of life (QoL) with a PCN compared to tandem ureteral stents (TUS) in cases of MUO.

METHODS

We reviewed the medical records of patients with MUO who were treated by PCN/TUS in our institution between June 2019 and May 2020. Patients were asked to fill out a QoL questionnaire, a tube-symptoms questionnaire, report a general health scale, and asked for a drain preference if they had experience with both drains. Scores of both groups were compared and predictors of all QoL and tube-symptoms measures were searched using multivariate analysis.

RESULTS

Seventy-four patients with a PCN and 30 with TUS were included in the study. No statistically significant difference was found in all QoL and tube-symptoms measurements between the two drains. Type of drain was not found to be a predictor of QoL or tube-related symptoms. Eighty-four percent of patients (11/13) who have experience with both types of drains preferred TUS.

CONCLUSION

TUS and PCN for relief of MUO have a negative and similar effect on various areas of QoL and urinary symptoms. Most patients who had experience with both types of drains preferred TUS over PCN. In this patient population with a grim prognosis, this negative effect must be communicated to patients, and calculated against the potential benefits of drainage.

摘要

目的

通过经皮肾造口术 (PCN) 或内置输尿管支架治疗恶性输尿管梗阻 (MUO) 以实现肾脏减压。本研究的目的是比较 MUO 患者 PCN 与输尿管支架内引流 (TUS) 治疗的生活质量 (QoL)。

方法

我们回顾了 2019 年 6 月至 2020 年 5 月在我院接受 MUO 治疗的患者的病历。患者被要求填写 QoL 问卷、管症状问卷、报告一般健康状况量表,并在他们有两种引流管经验的情况下询问他们对引流管的偏好。比较两组的评分,并使用多变量分析搜索所有 QoL 和管症状测量的预测因子。

结果

本研究纳入了 74 例接受 PCN 和 30 例接受 TUS 治疗的患者。两种引流管在所有 QoL 和管症状测量方面均无统计学差异。引流管类型不是 QoL 或管相关症状的预测因子。有两种引流管经验的患者中有 84%(11/13)更喜欢 TUS。

结论

缓解 MUO 的 TUS 和 PCN 对 QoL 和尿路症状的各个方面都有负面且相似的影响。大多数有两种引流管经验的患者更喜欢 TUS 而不是 PCN。在这种预后不佳的患者人群中,必须将这种负面影响告知患者,并权衡引流的潜在益处。

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