输尿管镜碎石取石术改善结石患者性生活与生活质量的作用研究

Effect of transurethral ureteroscopic lithotripsy on the postoperative sex life and quality of life of patients with calculi

目的研究经尿道输尿管镜碎石取石术在改善结石患者性生活与生活质量方面的作用。方法选取2018年1月~2019年6月在本院接受经尿道输尿管镜钬激光碎石术(URL)治疗的48例输尿管结石患者纳入URL组,另选取同期在本院接受体外冲击波碎石术(ESWL)治疗的48例患者纳入ESWL组,对比两组临床疗效指标:术后疼痛缓解率、碎石成功率、2周内结石排净率,统计两组患者术后并发症发生率;随访6月调查两组患者的性生活质量与生活质量。结果URL组术后疼痛缓解率、碎石成功率、2周内结石排净率均高于ESWL组,差异有统计学意义(P<0.05);URL组术后并发症发生率为4.17%,ESWL组为8.33%,两组术后并发症对比,差异无统计学意义(P>0.05);随访6月,两组患者性欲评分无统计学差异(P>0.05),URL组患者性勃起/唤起(25.59±5.92分)、性高潮(24.98±5.64分)、性生活满意度(23.19±4.85分)及总分(96.57±9.73)均高于ESWL组(依次:23.16±5.84分、22.46±5.27分、21.12±4.61分、90.43±9.62分)(P<0.05);URL组患者生活质量SF-36量表中生理职能(56.65±8.42分)、情感职能(65.89±8.02)、心理健康(68.53±9.74)、社会功能(54.47±8.12)得分均高于ESWL组(依次:47.89±8.96分、57.51±7.25分、62.19±9.31分、51.19±7.31分)(P<0.05),躯体疼痛(12.07±1.89分)低于ESWL组(18.24±2.13分)(P<0.05)。结论经尿道输尿管镜碎石取石术疗效确切,术后恢复快,有利于改善患者性生活与生活质量。

Objective To study the effect of transurethral ureteroscopic lithotripsy on improving sexual life and quality of life of patients with calculi.Methods Forty-eight patients with ureteral calculi who underwent tranurethral holmium laser lithotripsy(URL)in our hospital from January 2018 to June 2019 were enrolled in the URL group,and other 48 patients who received extracorporeal shock wave lithotripsy(ESWL)in our hospital during the same period were enrolled in the ESWL group.The clinical efficacy indexes of the two groups were compared including postoperative pain relief rate,lithotripsy success rate,stone clearance rate within 2 weeks.The incidence of postoperative complications in the two groups were analyzed.The sexual life quality and life quality of patients in the two groups were evaluated during 6 months follow-up.Results The postoperative pain relief rate,lithotripsy success rate and stone clearance rate within 2 weeks of the URL group were all higher than those of the ESWL group,with statistical significance(P<0.05).The incidence of postoperative complications was 4.17%in the URL group and 8.33%in the ESWL group,and there was no significant difference in postoperative complications between the two groups(P>0.05).After 6 months of follow-up,there was no statistically significant difference in libido scores between the two groups(P>0.05),and the satisfaction of sexual arousal/arousal(25.59±5.92 points),orgasm(24.98±5.64 points),sexual satisfaction(23.19±4.85 points)and total score(96.57±9.73 points)in the URL group were all higher than those in the ESWL group(23.16±5.84 points,22.46±5.27 points,21.12±4.61 points,90.43±9.62 points)(P<0.05).The scores of physiological function(56.65±8.42),emotional function(65.89±8.02),mental health(68.53±9.74),and social function(54.47±8.12)in the URL group were all higher than those in the ESWL group(47.89±8.96,57.51±7.25,62.19±9.31,51.19±7.31)in the SF-36 scale of quality of life(P<0.05),while the score of physical pain(12.07±1.89)was lower than that in the ESWL group(18.24±2.13)(P<0.05).Conclusion Transurethral ureteroscopic lithotripsy has definite curative effect and quick postoperative recovery,which is beneficial to improve the prognosis sex life and life quality of patients.