S.T.O.N.E.评分系统对经皮肾镜疗效的预测价值

Preoperative evaluation value of S.T.O.N.E nephrolithometry scoring system for percutaneous nepherolithomy

目的探讨S.T.O.N.E.肾结石评分系统预测经皮肾镜碎石取石术(PCNL)后结石清除率和术后并发症之间的关系,评价其预测PCNL治疗效果的价值。方法选取从2017年7月至2017年12月在我院施行PCNL的120例肾结石患者临床资料,通过分析患者一般情况、结石特征、手术情况及围手术期情况等,利用术前泌尿系CT平扫资料给S.T.O.N.E.评分系统的各指标进行测量并根据测量结果对患者进行评分,分析患者评分情况与结石清除率、术后并发症、手术时间,估计失血量,住院天数之间的关系。结果120例肾结石患者的结石清除率为85.5%(102/120),并发症发生率为6.7%(8/120),平均S.T.O.N.E.评分为(7.6±1.1)分。结石清除组的S.T.O.N.E.评分为(7.5±1.1)分,结石残留组的S.T.O.N.E.评分为(8.3±1.1)分,两组患者S.T.O.N.E.评分之间的差异有统计学意义(Z=-2.426,P=0.015)。S.T.O.N.E.评分与结石清除率(OR=2.740,P<0.01),手术时间(r=0.419,P<0.01)有相关性,但与术后并发症(OR=1.233,P>0.05),估计失血量(r=0.100,P>0.05),总住院天数(r=0.065,P>0.05)及术后住院天数(r=0.050,P>0.05)均不相关。结论S.T.O.N.E.评分越高PCNL术后结石清除率越低,手术时间越长,其与术后并发症的发生率,术中估计失血量,总住院天数及术后平均住院天数无相关性。

Objective To investigate the relationship between S.T.O.N.E.nephrolithometry scoring system with stone clearance rate and postoperative complications,and to evaluate its ability to predict postoperative stone clearance rate and complications after percutaneous nephrolithotomy(PCNL).Methods The clinical data of 120 patients with renal calculus who underwent PCNL from July 2017 to December 2017 in our hospital were selected.The patient's general condition,stone characteristics,operation status and perioperative parameters were analyzed.Each patient was scored according to S.T.O.N.E nephrolithometry scoring system,the relationship between patient scores and stone clearance rate,postoperative complications,estimated blood loss,and postoperative hospital stay were analyzed.Results The overall stone clearance rate was 85.5%(102/120),the complication rate was 6.7%(8/120),and the average S.T.O.N.E.score was(7.6±1.1).The mean S.T.O.N.E.score of the stone free group and the stone residual group was(7.5±1.1)and(8.3±1.1),respectively.The difference between the S.T.O.N.E.scores of the two groups was statistically significant(Z=-2.426,P=0.015).The stone score were correlated with stone clearance rate(OR=2.740,P<0.05)and with operative time(r=0.419,P<0.05),but not correlated with postoperative complications(r=0.050,P>0.05),estimated blood loss(r=0.100,P>0.05),total hospital stay(r=0.065,P>0.05)and postoperative hospital stay(r=0.050,P>0.05).Conclusions The stone clearance rate after PCNL is correlated with S.T.O.N.E.score,however,there was no significant correlation between S.T.O.N.E.score with the incidence of postoperative complications.