摘要
目的 探讨输尿管留置双J管对患者生活质量的影响因素.方法 60例留置输尿管双J管患者,平均年龄53岁.平均置管时间（21.4±3.8）d.患者门诊膀胱镜下拔管时应用输尿管支架管特殊调查问卷调查,包括泌尿系统症状、国际前列腺症状评分（IPSS）、生活质量评分（QoL）和视觉疼痛评分（VAS）.按麻醉方式分为3组,局麻组（12例）,局麻加静脉复合麻醉组（10例）和全麻组（38例）进行疼痛评分比较.结果 膀胱镜下置管或拔管时患者疼痛感分别为,局麻组11例（91%）,局麻加静脉复合麻醉组8例（80%）,全麻组38例均无疼痛感.带管期间54例（90%）患者有泌尿系统症状,依次为夜尿42例（70%）、尿频39例（65%）、尿急36例（60%）、尿不尽35例（58%）、排尿困难31例（52%）、肉眼血尿21例（35%）、尿失禁18例（30%）;患者有腰腹痛和下腹痛45例（75%）.QoL＂不满意＂29例（48%）,其中由继发性膀胱过度活动症（OAB）所致18例（62%）,疼痛所致5例（17%）.结论 输尿管支架管引起的泌尿系症状和疼痛严重影响患者日常生活,48%的患者感觉生活质量下降.继发性OAB是引起患者生活质量下降的主要原因.
Objective To assess the symptoms of patients due to indwelling double ureteral stent and their impact on quality of life. Methods Sixty patients were assessed by the specific questionnaire. Average time of indwelling stent was 21.4 d. All patients finished the special questionnaire when the stent was removed by cystoscope, including specific urinary symptoms, IPSS （international prostate symptom score）, VAS （visual analogic scale） and QOL （quality of life）. To assess the pain feeling, the patients were divided into 3 groups by varied methods of anesthesia, including local anesthesia, balance anesthesia and general anesthesia. Results Insertion or removal of ureteral stents with local anesthesia provoked pain in 11 of 12 （91%） patients and 8 of 10 （80%） patients in balance anesthesia group. But 38 patients of general anesthesia group did not feel any pain when inserting stents. In 54 of 60 （90%） patients, the indwelling catheter provoked one or several urinary symptoms： nocturia （70%）, frequency （65%）, urgency （60%）, tenesmus （58%）, dysuria （52%）, hematuria （35 % ） and incontinence （30 %）. 75 % of the patients experienced pain, in the flank and lower abdomen. 29 （48 %） patients were found to be unsatisfied with their quality of life due to the indwelling stent. Among them, 18 （62%） patients demonstrated that the provoked overactive bladder symptoms were the main influence factor of QOL, compared with 5（17 %） patients complaining pain feeling. Conclusions Urinary symptoms and pain associated with indwelling double J ureteral stents could interfere the daily activities and 50 % of patients were found reduced quality of life. Overactive bladder symptoms were the main influence of QOL during the time of indwelling stent.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2010年第12期828-830,共3页
Chinese Journal of Urology
关键词
输尿管疾病
导管
留置
生活质量
Ureteral diseases
Catheters, indwelling
Quality of life
