简明量表对于输尿管支架相关症状的分析与干预——相较于输尿管支架症状问卷(USSQ)
Analysis and Intervention of Stents-Related Symptoms by Concise Scale—Compared to the Ureteral Stent Symptoms Questionnaire (USSQ)

目的：通过对输尿管支架置入术后患者主动汇报症状的归纳总结，尝试构建对输尿管支架置入相关症状严重程度进行评估的简洁量表，并提高输尿管支架置入患者的生活满意度。方法：来自同一临床中心接受输尿管镜碎石术(URS)或经皮肾镜碎石术(PCNL)治疗泌尿结石或输尿管狭窄后留置输尿管支架的90名患者组成了前瞻性观察队列。收集了每位患者的所有特征和手术细节。90名患者分为两组。在支架置入后第1、3、7、14和28天(如果留置时间超过28天)，30名患者完成了中文版输尿管支架症状问卷(USSQ)。此外，他们还被要求在取出输尿管支架时报告对其日常生活影响最大的四种症状。根据这些患者的报告，并结合USSQ、相关文献以及专家意见，我们构建了一个由患者报告结局(PROs)为启发的简明量表，由另外60名患者在输尿管支架置入后的同一时间点填写，并验证了该量表的信度。无论是USSQ还是简明量表，我们都设定了分值阈值。分值越高意味着我们将对患者的输尿管支架相关症状越为积极地干预。最后，两组患者在拔除输尿管支架时均会对生活满意度进行评分并进行比较。结果：简明量表通过了信度评价。简明量表组的填写完成率(83.3%)相较于USSQ组(73.3%)更高，完成时间更短，并且在存在相对更高的并发症和医疗干预率的情况下，简明量表组的生活满意度仍然更高。总结：随着泌尿系结石患者的增加，特别是中老年患者的比重增加，我们构建的简明量表相较于USSQ更适用于临床上输尿管支架置入术后的随访，其内容保留了最关键的核心输尿管支架相关症状，利于患者理解，完成更加快捷，对于患者和医生来说都降低了时间成本，并且在我们的研究中，完成简明量表的患者也能够获得更多的生活满意度。这可能与简明量表能够更为准确评估患者的症状严重程度并引导泌尿外科医生做出干预有关。
Purpose: By summarizing the symptoms reported by patients after ureteral stent implantation, we attempted to establish a concise scale for evaluating the severity of stent-related symptoms (SRS). It is timelier and more efficient to intervene in the symptoms of patients compared with Ureteral stent symptom questionnaire (USSQ), thereby improving the life satisfaction of patients with ureteral stent implantation. Methods: 90 patients from a single clinical center with indwelling ureteral stent after ureteroscopy (URS) or Percutaneous Nephrolithotomy (PCNL) for urinary calculi comprised the prospective observational cohort. All the characteristics and surgery details of each patient were collected. 90 patients were divided into two groups. Chinese version of the Ureteral Stent Symptoms Questionnaire (USSQ) was accomplished by 30 patients on days 1, 3, 7, 14 and 28 (if the indwelling time was above 28 days) after stent implantation through online questionnaire tool. Also, they were required to report four symptoms that most affected their daily lives when removing the ureteral stent. Based on these reports and clinical experiences, we have established a concise scale based on patient-reported outcomes (PROs), which was filled out by the remaining 60 patients in our study at the same time point after ureteral stent implantation and verified the reliability of concise scale. Whether it is the USSQ or the concise scale, we have set thresholds for the scores. A score above the threshold means that we will intervene on the patient's relatively severe symptoms. Finally, both groups of patients would score their life satisfaction when removing