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Abstract：
OBJECTIVE: To explore the impacts of delayed ureteral stent removal on the quality of life (QoL) and mental health of urinary calculi postoperative patients due to the corona virus disease 2019(COVID-19) pandemic.
METHODS: The demographic and clinical data of patients with ureteral stent placement after urinary endoscopic lithotripsy and returned to Peking University People\'s Hospital for stent removal from December 2019 to June 2020 were collected. Ureteral stent symptoms questionnaire (USSQ) score and the outcome 20-item self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were collected to estimate the QoL and mental status. The USSQ consisted of 44 questions in 6 domains (including urinary symptom, physical pain, general health, work performance, sexual function, and ureteral stent related infection). For most questions in each domain, its score was a five-point Likert-type scale from 1 to 5, and a small proportion of questions was quantified by 1 to 4 or 1 to 7 scale. SAS and SDS both contained 20 questions used to assess a patient\'s level of anxiety and depression. Its scoring for each item was on a four-point Likert-type scale from 1 to 4. A total score (ranging from 20 to 80) was the main statistical indicator. The level of clinical anxiety and depression was quantified by using standard scores (total score multiplied by 1.25 to produce integers). And the multi-group structural equation model was constructed by analysis of moment structure (AMOS) analysis.
RESULTS: Overall, 71 patients were enrolled for analysis. It was found that the median duration of ureteral stent time differed significantly between the control and delayed groups for 32 (30, 33) d and 94.5 (88, 103) d, respectively. The delayed group resulted in higher scores in the USSQ multidimensional, which included urinary symptoms, general health, work performance and ureteral stent related infections. Anxiety and depression were also significantly serious in the delayed group than in the control group. A longer indwelling time of a ureteral stent could exacerbate the effects of urinary symptoms and physical pain on work performance (P=0.029 < 0.05). Among them, the patients with severe urinary symptoms leading to poor work performance were most significantly affected by prolonged ureteral stent duration time (CR=2.619>1.96).
CONCLUSIONS: Patients with delayed ureteral stent removal due to the COVID-19 had resulted in worse QoL and mental status. Stents related symptoms are more severe in patients with higher anxiety and depression degree during COVID-19. To improve the QoL and mental health of patients after urinary calculi surgery during COVID-19, it is still not recommended to prolong the stent duration time or corresponding intervention measures should be taken.
METHODS: The demographic and clinical data of patients with ureteral stent placement after urinary endoscopic lithotripsy and returned to Peking University People\'s Hospital for stent removal from December 2019 to June 2020 were collected. Ureteral stent symptoms questionnaire (USSQ) score and the outcome 20-item self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were collected to estimate the QoL and mental status. The USSQ consisted of 44 questions in 6 domains (including urinary symptom, physical pain, general health, work performance, sexual function, and ureteral stent related infection). For most questions in each domain, its score was a five-point Likert-type scale from 1 to 5, and a small proportion of questions was quantified by 1 to 4 or 1 to 7 scale. SAS and SDS both contained 20 questions used to assess a patient\'s level of anxiety and depression. Its scoring for each item was on a four-point Likert-type scale from 1 to 4. A total score (ranging from 20 to 80) was the main statistical indicator. The level of clinical anxiety and depression was quantified by using standard scores (total score multiplied by 1.25 to produce integers). And the multi-group structural equation model was constructed by analysis of moment structure (AMOS) analysis.
RESULTS: Overall, 71 patients were enrolled for analysis. It was found that the median duration of ureteral stent time differed significantly between the control and delayed groups for 32 (30, 33) d and 94.5 (88, 103) d, respectively. The delayed group resulted in higher scores in the USSQ multidimensional, which included urinary symptoms, general health, work performance and ureteral stent related infections. Anxiety and depression were also significantly serious in the delayed group than in the control group. A longer indwelling time of a ureteral stent could exacerbate the effects of urinary symptoms and physical pain on work performance (P=0.029 < 0.05). Among them, the patients with severe urinary symptoms leading to poor work performance were most significantly affected by prolonged ureteral stent duration time (CR=2.619>1.96).
CONCLUSIONS: Patients with delayed ureteral stent removal due to the COVID-19 had resulted in worse QoL and mental status. Stents related symptoms are more severe in patients with higher anxiety and depression degree during COVID-19. To improve the QoL and mental health of patients after urinary calculi surgery during COVID-19, it is still not recommended to prolong the stent duration time or corresponding intervention measures should be taken.
摘要：
目的：探讨2019年冠状病毒病（COVID-19）大流行对泌尿系结石术后患者生活质量（QoL）和心理健康的影响。
方法：收集2019年12月至2020年6月在泌尿外科内镜碎石术后行输尿管支架置入术患者的人口学和临床资料。收集输尿管支架症状问卷（USSQ）评分和结果20项焦虑自评量表（SAS）和抑郁自评量表（SDS），以评估QoL和精神状态。USSQ由6个领域的44个问题组成(包括泌尿症状，身体疼痛,一般健康,工作表现,性功能,和输尿管支架相关感染)。对于每个领域的大多数问题，其评分为1~5分的Likert型5分量表,小部分问题用1~4或1~7量表量化.SAS和SDS均包含20个问题，用于评估患者的焦虑和抑郁水平。每个项目的评分均为1至4的4分Likert型评分。总分（20至80分）是主要统计指标。通过使用标准分数（总分乘以1.25以产生整数）来量化临床焦虑和抑郁的水平。并通过矩结构分析（AMOS）分析构建了多组结构方程模型。
结果：总体而言，71例患者被纳入分析。结果发现，对照组和延迟组的输尿管支架时间中位数差异显着，分别为32（30，33）d和94.5（88，103）d，分别。延迟组导致USSQ多维分数更高，其中包括泌尿症状，一般健康,工作表现和输尿管支架相关感染。延迟组的焦虑和抑郁也明显比对照组严重。输尿管支架留置时间越长,尿路症状和躯体疼痛对工作表现的影响越严重(P=0.029<0.05)。其中,尿路症状严重导致工作表现不佳的患者受输尿管支架持续时间延长的影响最大(CR=2.619>1.96).
结论：因COVID-19导致输尿管支架拔除延迟的患者导致QoL和精神状态恶化。在COVID-19期间，焦虑和抑郁程度较高的患者支架相关症状更严重。为改善COVID-19期间泌尿系结石术后患者的生活质量和心理健康状况,仍不建议延长支架持续时间或采取相应干预措施。
方法：收集2019年12月至2020年6月在泌尿外科内镜碎石术后行输尿管支架置入术患者的人口学和临床资料。收集输尿管支架症状问卷（USSQ）评分和结果20项焦虑自评量表（SAS）和抑郁自评量表（SDS），以评估QoL和精神状态。USSQ由6个领域的44个问题组成(包括泌尿症状，身体疼痛,一般健康,工作表现,性功能,和输尿管支架相关感染)。对于每个领域的大多数问题，其评分为1~5分的Likert型5分量表,小部分问题用1~4或1~7量表量化.SAS和SDS均包含20个问题，用于评估患者的焦虑和抑郁水平。每个项目的评分均为1至4的4分Likert型评分。总分（20至80分）是主要统计指标。通过使用标准分数（总分乘以1.25以产生整数）来量化临床焦虑和抑郁的水平。并通过矩结构分析（AMOS）分析构建了多组结构方程模型。
结果：总体而言，71例患者被纳入分析。结果发现，对照组和延迟组的输尿管支架时间中位数差异显着，分别为32（30，33）d和94.5（88，103）d，分别。延迟组导致USSQ多维分数更高，其中包括泌尿症状，一般健康,工作表现和输尿管支架相关感染。延迟组的焦虑和抑郁也明显比对照组严重。输尿管支架留置时间越长,尿路症状和躯体疼痛对工作表现的影响越严重(P=0.029<0.05)。其中,尿路症状严重导致工作表现不佳的患者受输尿管支架持续时间延长的影响最大(CR=2.619>1.96).
结论：因COVID-19导致输尿管支架拔除延迟的患者导致QoL和精神状态恶化。在COVID-19期间，焦虑和抑郁程度较高的患者支架相关症状更严重。为改善COVID-19期间泌尿系结石术后患者的生活质量和心理健康状况,仍不建议延长支架持续时间或采取相应干预措施。
