Research On The Effect Of Intraoperative Doctor-patient Communication Combined With Real-time Operation Video In Flexible Ureteroscopic Lithotripsy

Objective:To explore the effect of intraoperative doctor-patient communication combined with real-time operation video in flexible ureteroscopic lithotripsy: 1.The influence on the operation time;2.Effect on postoperative anxiety and depression of patients;3.The influence on patients’ understanding of health education after operation;4.The influence on stone removal.Methods:Patients with upper urinary tract calculi who underwent flexible ureteroscopic lithotripsy in our hospital from October 2017 to October 2019 were selected and the general data of the selected patients and the characteristics of the stones were recorded.In the preoperative informed consent process,the patients were informed that they may be allowed to watch the real-time video of the operation,in the meantime,the operation assistant will clarify the procedure of the operation.Explained the purpose and significance of the study to the patients.The patients were randomized into two groups:patients in the experimental group watched the real-time operation video during the operation,while patients in the control group did not watch the real-time operation video during the operation.The operation time,self-rated anxiety and depression scores of the patients evaluated by the SAS(self-rating anxiety scale)and SDS(self-rating depression scale),hospital discharge education time and postoperative stone-free rate of the two groups were recorded.The data were analyzed by IBM SPSS 22.0 statistical software.Results:1.There was no significant difference in general demographic characteristics such as sex,age between the experimental group and the control group(P>0.05),and there was no significant difference in stone distribution and stone size between these two groups(P>0.05).2.Before operation,the anxiety scores of the experimental group were 46.40±8.087 and that of the control group were 46.94 ±7.953,the difference was not statistically significant between the two groups(P =0.901).The depression scores of the experimental group were 49.29 ±8.498 and that of the control group were 49.48 ±8.285,there was no significant difference between these two groups(P=0.777).3.After the operation,the anxiety scores of the patients in the experimental group and the control group were 40.23 ±7.072 and 43.75 ±7.100 respectively,and the anxiety scores in the experimental group were significantly lower than those in the control group(P=0.004);the depression scores of the patients in the experimental group and the control group were 41.33 ±8.012 and 44.81 ±7.715 respectively,and the depression scores in the experimental group were significantly lower than those in the control group(P=0.020).After the operation,compared with the control group,both the anxiety scores and the depression scores of the experimental group significantly dropped than that of the control group(P<0.001).4.The mean operation time of the experimental group was(59.23 ±22.549)minutes,the mean operation time of the control group was(60.06 ±23.209)minutes,there was no statistical significance of mean operation time between the two groups(P=0.933).The mean hospital discharge education time of experimental group was(11.69±2.380)minutes,the mean hospital discharge education time of control group was(13.27 ±2.151)minutes,the mean hospital discharge education time of experimental group was lower than that of the control group,and the difference was statistically significant(P=0.002).5.One month after the operation,the stone-free rate of the experimental group was60.42%,while the stone-free rate of the control group was 52.08%,and there was no significant difference between these two groups(P=0.4105).Conclusion:During the flexible ureteroscopic lithotripsy,the doctor-patient communication combined with real-time operation video will not prolong the operation time,but can significantly reduce the anxiety and depression of the patients after the operation,improve the efficiency of postoperative health education and reduce the risk of the conflict between doctors and patients.However,it has no influence on the stone-free rate.