改良Guy's分级法与SHA.LIN评分预测经皮肾镜取石术结石清除率的研究分析

A Study on Modified Guy's Classification and SHA. LIN Score in Prediction of Calculus Clearance Rate in Patients after Percutaneous Nephrolithotomy

目的探讨改良Guy's分级法与SHA.LIN评分对经皮肾镜取石术结石清除率的预测价值。方法选取2013年1月—2016年12月行经皮肾镜取石术治疗的128例肾结石患者作为研究对象,回顾性分析所有患者的临床资料,根据结石清除情况将患者分为结石清除组86例和结石残留组42例,所有患者均进行一般临床资料记录以及改良Guy's分级和SHA.LIN评分,通过非条件单因素和多因素Logistic回归模型分析影响结石清除率的相关因素。结果两组的手术时间、术中出血量、改良Guy's分级、SHA.LIN总评分、结石负荷(S)、结石的解剖分布(A)、通道长度(L)和受累肾盏数量(N)比较差异有统计学意义(P<0.05)。改良Guy's分级、SHA.LIN总评分以及S、A、L和N均为影响结石患者结石清除率的独立危险因素(P<0.05)。结论 SHA.LIN评分法、改良Guy's分级法可作为临床上评估肾结石手术患者结石清除率的重要评分系统。

Objective To investigate values of modified Guy's classification and SHA.LIN score in prediction of calculus clearance rate in patients after percutaneous nephrolithotomy.Methods Clinical data of 128 patients with renal calculi after percutaneous nephrolithotomy admitted during January 2013 and December 2016 was retrospectively analyzed,and the patients were divided into calculus clearance group(n=86)and residual calculus group(n=42)according to clearance conditions.Generally clinical data was recorded,and modified Guy's grading and SHA.LIN score were performed in all patients,and then related factors affecting calculus clearance rate were analyzed by unconditional single factor and multiple factor Logistic regression model analysis.Results There were significant differences in operative time,intraoperative bleeding volume,modified Guy's classification,the total score of SHA.LIN,calculus load(S),anatomical distribution of calculus(A),length of channel(L)and number of involved calyx(N)in two groups(P<0.05).Modified Guy's classification,the total score of SHA.LIN,S,A,L and N were independent risk factors affecting calculus clearance rate in patients with calculi.(P<0.05).Conclusion SHA.LIN score and modified Guy's classification methods can be used as important scoring systems in evaluation of calculus clearance rate in patients after percutaneous nephrolithotomy in clinical.