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