S.T.O.N.E.影像评分系统在输尿管镜钬激光碎石术治疗输尿管结石中的临床应用

Clinical application of S.T.O.N.E. imaging scoring system in ureteroscopic holmium laser lithotripsy for ureteral calculi

目的探讨S.T.O.N.E.影像评分系统在输尿管镜钬激光碎石术治疗输尿管结石中的应用效果。方法回顾性分析2017年1月—2019年12月江苏省东台市人民医院泌尿外科收治的输尿管结石行输尿管镜钬激光碎石的98例患者的临床资料,根据术后结石清除情况,分为结石清除组和结石残留组。使用S.T.O.N.E.影像评分系统对两组患者进行评分,比较两组患者的手术时间、术后住院时间、手术并发症及S.T.O.N.E.评分,并分析S.T.O.N.E.影像评分系统对结石清除率的预测价值。结果98例患者于术后1周复查结石残留情况,结石清除组76例,结石残留组22例。结石清除组的手术时间、术后住院天数短于结石残留组,手术并发症发生率低于结石残留组,差异有统计学意义(P<0.05)。两组S.T.O.N.E.各项评分比较,差异有统计学意义(P<0.05),结石残留组S.T.O.N.E.总分高于结石清除组,差异有统计学意义(P<0.05)。S.T.O.N.E.评分预测结石清除率的AUC为0.952(95%CI 0.938~0.971,P<0.05),准确性较高。结论S.T.O.N.E.影像评分系统可以有效的预测输尿管镜钬激光碎石术后结石的清除情况,值得临床广泛应用推广。

Objective To explore the effect of S.T.O.N.E.image scoring system in predicting the stone clearance rate of ureteroscopic holmium laser lithotripsy in the treatment of ureteral calculi.Methods The clinical data of 98 patients with ureteral calculi who underwent ureteroscopic holmium laser lithotripsy treated in Dongtai People′s Hospital,Jiangsu Province from January 2017 to December 2019 were retrospectively analyzed.According to the postoperative calculus removal,they were divided into calculus removal group and calculus residual group.Both groups were scored by S.T.O.N.E.imaging scoring system.Surgical duration,postoperative hospital stay,surgical complications and S.T.O.N.E were compared between the two groups.And to analyze the predictive value of the S.T.O.N.E.imaging score system for stone clearance.Results The 98 patients were reexamined one week after surgery for stone residue,including 76 cases in the stone removal group and 22 cases in the stone residue group.The operation time and postoperative hospital stay of the stone removal group were shorter than those of the residual stone group,and the incidence of surgical complications was lower than that of the residual stone group,the differences were statistically significant(P<0.05).The differences in S.T.O.N.E.scores between the two groups were statistically significant(P<0.05).The total S.T.O.N.E score of the stone residue group was higher than that of the stone removal group,and the difference was statistically significant(P<0.05).The AUC of predicting calculus clearance by S.T.O.N.E.score was 0.952(95%CI:0.938-0.971,P<0.05),showing high accuracy.Conclusion S.T.O.N.E.imaging scoring system can effectively predict the clearance of ureteral calculi after ureteroscopic holmium laser lithotripsy,which is worthy of wide clinical application.