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基于日本威斯康星州结石生活质量问卷的尿石症手术后生活质量:来自 SMART 研究组的多中心分析。

Quality of life after urinary stone surgery based on Japanese Wisconsin Stone Quality of Life questionnaire: multicenter analysis from SMART study group.

机构信息

Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.

Department of Urology, Gyotoku General Hospital, Chiba, Japan.

出版信息

Urolithiasis. 2023 Sep 14;51(1):113. doi: 10.1007/s00240-023-01486-8.

Abstract

We aimed to evaluate the impact of surgical treatment for urinary stones on perioperative health-related quality of life (HRQOL) using the Japanese Wisconsin Stone Quality of Life questionnaire (J-WISQOL), an HRQOL measure designed for patients with urinary stones. This study prospectively enrolled 123 patients with urinary stones who visited three academic hospitals for stone treatment. The participants completed the J-WISQOL within 4 weeks before and after the urinary stone treatment. Treatments included shock wave lithotripsy (SWL), ureteroscopy lithotripsy, and endoscopic combined intrarenal surgery. J-WISQOL was assessed for age, stone size and location, type of treatment, stone-free status, postoperative ureteral stent placement, hospital stay, and complications in all patients. Patients with stones in the ureter had significantly greater social impact D1 and disease impact D3 than those with stones in the kidney. In a comparison of pre- and postoperative J-WISQOL, patients without postoperative ureteral stent placement scored significantly higher on social impact D1 and disease impact D3. Patients with shorter hospital stays had significantly higher social impact D1 and disease impact D3 (p < 0.001) than those with longer hospital stays. SWL significantly improved the total score, social impact D1, and disease impact D3 compared with other treatments. Perioperative HRQOL in patients with urinary stones is particularly affected by the type of treatment, ureteral stent placement, and hospital stay, which should be considered in surgical selection and patient decision-making.

摘要

本研究旨在使用专为尿路结石患者设计的健康相关生活质量(HRQOL)评估工具——日本威斯康星结石生活质量问卷(J-WISQOL),评估手术治疗尿路结石对围手术期 HRQOL 的影响。这项前瞻性研究纳入了 123 名因结石治疗而就诊于三家学术医院的尿路结石患者。参与者在尿路结石治疗前 4 周内和治疗后完成 J-WISQOL 评估。治疗方法包括体外冲击波碎石术(SWL)、输尿管镜碎石术和内镜下联合肾内手术。在所有患者中,根据年龄、结石大小和位置、治疗类型、结石清除状态、术后输尿管支架放置、住院时间和并发症评估 J-WISQOL。与肾结石患者相比,输尿管结石患者的社会影响 D1 和疾病影响 D3 显著更大。在 J-WISQOL 术前和术后比较中,无术后输尿管支架放置的患者在社会影响 D1 和疾病影响 D3 方面的评分显著更高。与住院时间较长的患者相比,住院时间较短的患者在社会影响 D1 和疾病影响 D3 方面的评分显著更高(p<0.001)。SWL 与其他治疗方法相比,显著改善了总评分、社会影响 D1 和疾病影响 D3。尿路结石患者的围手术期 HRQOL 尤其受到治疗方法、输尿管支架放置和住院时间的影响,在手术选择和患者决策时应考虑这些因素。

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