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抗反流输尿管支架改善支架相关症状和生活质量:一项前瞻性随机对照试验。

Antireflux Ureteral Stent Improves Stent-Related Symptoms and Quality of Life: A Prospective Randomized Controlled Trial.

作者信息

Zhang Yuqing, Chen Changqing, Hu Wei, Li Simin, Li Yang, Zhu Rujian

机构信息

Department of Urology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China.

出版信息

J Endourol. 2023 Jul;37(7):761-767. doi: 10.1089/end.2022.0839. Epub 2023 Jun 14.

Abstract

To compare the effectiveness of antireflux ureteral stents on improving symptoms and quality of life of patients with ureteral stents. We randomized 120 patients with ureteral stone who required ureteral stent placement after ureteroscopic lithotripsy, of which 107 (56 in standard ureteral stent group and 51 in antireflux ureteral stent group) entered the final analysis. Severity of flank pain and suprapubic pain, visual analog scale (VAS), analgesic used after hospitalization, back soreness during micturition, gross hematuria, creatinine abnormality, hydronephrosis grade, symptomatic urinary tract infection (UTI), and quality of life were compared between the two groups. There were no serious complications after operation in all 107 cases. The antireflux ureteral stent group had less flank pain and suprapubic pain ( < 0.05), analgesic used after hospitalization ( < 0.05), back soreness during micturition ( < 0.05), and lower VAS ( < 0.05). The health status index scores ( < 0.05), dimensions of usual activities, and pain/discomfort ( < 0.05) in the antireflux ureteral stent group were statistically better than those in the standard ureteral stent group. There were no significant differences between the groups in creatinine abnormality, hydronephrosis grade, gross hematuria, and symptomatic UTI. The antireflux ureteral stent has the same safety and efficacy as the standard ureteral stent, and is significantly better than the standard ureteral stent in flank pain and suprapubic pain, VAS, analgesic used after hospitalization, back soreness during micturition, and quality of life.

摘要

比较抗反流输尿管支架在改善输尿管支架置入患者症状及生活质量方面的有效性。我们将120例输尿管结石患者随机分为两组,这些患者在输尿管镜碎石术后需要放置输尿管支架,最终107例患者(标准输尿管支架组56例,抗反流输尿管支架组51例)进入最终分析。比较两组患者的胁腹疼痛和耻骨上疼痛的严重程度、视觉模拟评分(VAS)、住院后使用的镇痛药、排尿时的腰酸、肉眼血尿、肌酐异常、肾积水分级、有症状的尿路感染(UTI)及生活质量。107例患者术后均无严重并发症。抗反流输尿管支架组的胁腹疼痛和耻骨上疼痛较少(P<0.05),住院后使用的镇痛药较少(P<0.05),排尿时的腰酸较少(P<0.05),VAS较低(P<0.05)。抗反流输尿管支架组的健康状况指数评分(P<0.05)、日常活动维度及疼痛/不适(P<0.05)在统计学上均优于标准输尿管支架组。两组在肌酐异常、肾积水分级、肉眼血尿及有症状的UTI方面无显著差异。抗反流输尿管支架与标准输尿管支架具有相同的安全性和有效性,在胁腹疼痛、耻骨上疼痛、VAS、住院后使用的镇痛药、排尿时的腰酸及生活质量方面明显优于标准输尿管支架。

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