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不同肾结石评分系统在经皮肾镜取石术中的应用价值研究
引用本文:霍旺盛 雷婷婷 王艳军 陈立斌 尹清江. 不同肾结石评分系统在经皮肾镜取石术中的应用价值研究[J]. 国际泌尿系统杂志, 2020, 40(5): 780-784. DOI: 10.3760/cma.j.cn431460-20190411-00004
作者姓名:霍旺盛 雷婷婷 王艳军 陈立斌 尹清江
摘    要:
目的 探讨Guy's分级系统、S.T.O.N.E.评分系统及SHA.LIN评分系统在经皮肾镜取石术(PCNL)中的应用价值。方法 回顾性分析哈密红星医院2016年6月至2018年5月间行PCNL治疗的142例肾结石患者的临床资料,按照Guy's分级系统、S.T.O.N.E.评分系统及SHA.LIN评分系统分别对患者的术前结石特征进行量化分级和评分,分析并比较三种评分系统与结石清除率、围手术期并发症及手术时间等因素之间的关系。结果 患者结石清除率为66.9% (95/142),43例(30.3%)出现围手术期并发症。三种评分系统与术后结石清除率、术中出血量及手术时间均具有相关性(P<0.05),仅SHA.LIN评分系统与预测出血量有相关性(P=0.023)。Guy's分级系统、S.T.O.N.E.评分系统及SHA.LIN评分系统的受试者工作特征曲线的曲线下面积分别为0.742、0.828、0.894。结论 三种肾结石评分系统均具有完善病情评估的能力,三种评分系统与术后结石清除率、术中出血量及手术时间均具有相关性,而SHA.LIN评分系统在预测出血量方面优于Guy's分级系统和S.T.O.N.E.评分系统。

关 键 词:肾结石  肾造口术   经皮  结石清除率  

Application value of different renal calculi scoring systems in the outcome of percutaneous nephrolithoyomy
Abstract:
Objective  To investigate the application value of the grading system of Guy's,the scoring system of S.T.O.N.E. and SHA.LIN in percutaneous nephrolithotomy.Methods  The clinical data of patients with kidney calculi and treated with percutaneous nephrolithotomy(PCNL) from May 2018 to June 2016 were retrospectively collected.According to the criterion of the following three nephrolithometry scoring systems,we quantified the characteristics of preoperative stones in patients,analysed and compared the correlations between the following three scoring systems and the stone clearance rate,the perioperative complications, the total hemorrhages quantities and the operation time.Results  A total of 142 patients were observed, who were treated with PCNL.The stone free rate was 66.9%(95/142) and complications occurred in 43 cases(30.3%).The three scoring systems were closely related to the postoperative clear stone rate,the intraoperative blood loss and the operation time(P<0.05),but only the SHA.LIN neprolithometry score was associated with estimated blood loss(P=0.023).The scoring systems of Guy's,S.T.O.N.E. and SHA.LIN were different in areas under the curves(AUC),their values were 0.742,0.828,0.894,repestively.Conclusions  The following three systems of kidney stones all have the ability to improve the assessment of the disease. The three scoring systems are closely related to the postoperative clear stone rate,the intraoperative blood loss and the operation time, however the scoring system of SHA.LIN is superior to the Guy's stone score and the S.T.O.N.E. nephrolithometry scoring systems in the aspects of estimating blood loss and clearing stone rate.
Keywords:Kidney Calculi  Nephrostomy  Percutaneous  Stone Clearance Rate  
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