The examination of the quality of life changes of patients with urolithiasis regarding different methods of treatment

Gvozdić, Branka; Milenković-Petronić, Dragica; Lađević, Nebojša; Vuksanović, Aleksandar; Durutović, Otaš

doi:10.2298/VSP180309060G

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Vojnosanitetski pregled

2020, vol. 77, br. 2, str. 158-164

Ispitivanje promena kvaliteta života bolesnika sa urolitijazom s obzirom na različite metode lečenja

Gvozdić Branka^a, Milenković-Petronić Dragica^b, Lađević Nebojša^b

, Vuksanović Aleksandar^c, Durutović Otaš^b

^aKlinički centar Srbije, Centar za anesteziologiju i reanimatologiju, Beograd, Srbija
^bKlinički centar Srbije, Centar za anesteziologiju i reanimatologiju, Beograd, Srbija + Univerzitet u Beogradu, Medicinski fakultet, Srbija
^cUniverzitet u Beogradu, Medicinski fakultet, Srbija + Klinički centar Srbije, Klinika za urologiju, Beograd, Srbija

e-adresa: nladjevic@yahoo.com

Ključne reči: urolitijaza; litotripsija; kvalitet života; ankete i upitnici; metodi; lečenje, ishod

Sažetak

Uvod/Cilj. Urolitijaza je jedno od najčešćih oboljenja u urologiji sa stalnim porastom incidence i prevalence u populaciji. Patogeneza ovog oboljenja je multifaktorijalna, a za posledicu ima veoma ozbiljne probleme koji mogu imati značajan uticaj na kvalitet života ovih bolesnika. Tokom prethodnih godina, hirurški modaliteti lečenja urolitijaze pretrpeli su evolutivne promene u korist minimalno invazivnih tehnika lečenja, postizanja bolje efikasnosti lečenja i poboljšanja kvaliteta života bolesnika. Cilj studije bio je da se ispita i proceni kvalitet života bolesnika sa urolitijazom u odnosu na pimenjenu metodu lečenja. Metode. Ispitivanje je dizajnirano kao panel studija (kombinacija studije preseka i kohortne studije). U studiju su bili uključeni bolesnici sa urolitijazom lečeni extracorporeal shock wave lithotripsy (ESWL) ili ureterorenoskopskom litotripsijom (URSL aparat Lithoclast) u periodu od jedne godine. Sto ispitanika ispunilo je kriterijume za uključivanje u studiju. Ispitanici su podeljeni u dve grupe: Lithoclast grupa (URSL) i ESWL grupa. Kao instrument za merenje kvaliteta života korišćen je Short Form (SF) 36 upitnik koji su bolesnici popunjavali neposredno pre i jedan mesec posle opercije. Rezultati. Analizom skora SF 36 upitnika preoperativno ustanovljeno je da postoji smanjenje kvaliteta života kod bolesnika sa urolitijazom u gotovo svim dimenzijama života. Nije bilo statistički značajne razlike u preoperativnom SF skoru između dve grupe bolesnika izuzev domena uloge fizičkog zdravlja u kojoj je Lithoclast grupa imala statistički značajno viši skor od ESWL grupe i mentalnog zdravlja u kojoj je ESWL grupa imala statistički značajno viši skor od Lithoclast grupe. Statističkom anlizom SF 36 upitnika postoperativno i ispitivanjem uticaja modaliteta lečenja na kvalitet života, ustanovljeno je da Lithoclast metoda postiže statistički značajno viši skor SF 36 u nekoliko dimenzija života i značajno utiče na poboljšanje kvaliteta života u odnosu na ESWL metodu koja, postoperativno, beleži blagi pad u skoru za neke dimenzije kvaliteta života. Zaključak. Procena kvaliteta života dobar je način za procenu modaliteta lečenja u kliničkoj praksi. Primenom SF 36 upitnika u našoj studiji ustanovljeno je da je ureterorenoskopska litotripsija (Lithoclast metoda) modalitet lečenja urolitijaze koja postoperativno daje statistički značajno poboljšanje kvaliteta života u nekoliko domena zdravlja u odnosu na ESWL metodu.

Abstract

Background/Aim. Urolithiasis is one of the most common urological illnesses with a continual rise in incidence and prevalence in the population. Its pathogenesis is multifactorial; hence, its consequences are serious problems that can significantly impact the quality of life of patients. In the last years, operational modes of urolithiasis treatment had undergone evolution changes towards minimally invasive treatment techniques aimed at improving its efficacy and patients' life quality. The aim of the study was to examine and evaluate the quality of life of the patients with urolithiasis depending on the applied treatment method. Methods. This research was designed as a panel study - a combination of a cross-sectional and cohort study. The sample included patients with urolithiasis treated with extracorporeal shock wave lithotripsy (ESWL) or ureteroscopic lithotripsy (Lithoclast). The research was carried during one year period and 100 respondents met the inclusion criteria. They were divided into two equal groups considering the applied method of the stone disintegration: the Lithoclast group (URSL) and the ESWL group. The instrument used for measuring the quality of life was Short Form (SF) 36 questionnaire. It was administrated to the patients immediately before the operation and one month after the operation. Results. The statistical analysis of the scores obtained preoperationally on the SF 36 questionnaire revealed the decrease in the quality of life of patients with urolithiasis in almost all dimensions of life. The statistically relevant difference in preoperative SF scores between the two groups of patients was not established except in the domain of the role of physical health and the domain of mental health. In the domain of the role of physical health, the Lithoclast group had a statistically significant higher score than the ESWL group, but in the domain of mental health, the ESWL group had a statistically significant higher score than the Lithoclast group. The postoperative statistical analysis of SF questionnaire and the examination of the impact of the treatment mode on the quality of life showed that the use of the Lithoclast method resulted in the much higher, statistically significant score at SF36 questionnaires regarding several life dimensions than the ESWL method. The application of the ESWL method even resulted in the decrease in the postoperational score for some life dimensions. Conclusion. The assessment of the quality of life is an adequate tool for the evaluation of treatment modes in the clinical practice. By using the SF 36 questionnaire in this study, we established that the ureteroscopic lithotripsy (the Lithoclast method) is a method that postoperatively results in much higher and statistically significant improvement of the quality of life of patients with urolithiasis in several health domains than the ESWL method.

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O članku

jezik rada: engleski
vrsta rada: izvorni naučni članak
DOI: 10.2298/VSP180309060G
objavljen u SCIndeksu: 02.03.2020.
metod recenzije: dvostruko anoniman

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