SHA.LIN和Guy's评分系统评估老年经皮肾镜碎石取石术患者结石清除率的价值

Comparison of value of SHA.LIN and Guy’s scoring systems in assessing stone clearance in elderly patients undergoing percutaneous nephrolithotomy

目的 比较SHA.LIN和Guy’s评分系统评估老年经皮肾镜碎石取石术(PCNL)患者结石清除率的价值。方法 选择2014-08—2019-08南方医科大学附属花都医院行PCNL的150例老年患者,根据结石清除效果分为结石清除组(92例)和残留组(58例)。术前均进行SHA.LIN和Guy’s评分系统评分。绘制ROC曲线,比较SHA.LIN和Guy’s评分系统预测PCNL结石清除率的敏感性和特异性。结果 150例患者结石清除率为61.33%。结石清除组患者的结石大小、手术时间、术后住院时间均小(短)于结石残留组;SHA.LIN和Guy’s评分均低于结石残留组,差异均有统计学意义(P<0.05)。通过绘制ROC曲线可知,SHA.LIN评分系统评估老年PCNL患者结石清除的敏感性为89.89%、特异性为84.48%、曲线下面积(AUC)为0.926(95%CI:0.875~0.976),Guy’s系统分别为76.49%、51.33%、0.703(95%CI:0.593~0.812),差异均有统计学意义(P<0.05)。结论 SHA.LIN和Guy’s评分系统均能预测老年PCNL患者的结石清除率,但SHA.LIN评分系统的敏感性、特异性高于Guy’s评分系统,准确性更高。

Objective To compare the value of SHA.LIN and Guy’s scoring system in assessing stone clearance in elderly patients with percutaneous nephrolithotomy(PCNL).Methods A total of 150 elderly patients with PCNL from August 2014 to August 2019 were selected as the subjects, and all of them were evaluated by SHA.LIN and Guy’s systematic scores before surgery. ROC curves were drawn to compare the sensitivity and specificity of SHA.LIN and Guy’s score in predicting stone clearance.Results Among the 150 elderly patients, there were 92 cases in the stone clearance group and 58 cases in the residual group, and the stone clearance rate was 61.33%. The stone size, operation time and postoperative hospitalization time in the stone clearance group were lower than those of the stone residual group(P<0.05). The scores of Sha.Lin and Guy’s in the stone clearance group were lower than those of the stone residual group(P<0.05). According to the ROC curve, the sensitivity, specificity and AUC of SHA.LIN system for stone removal in elderly PCNL patients were 89.89%, 84.48%, and 0.926(95%CI: 0.875~0.976), and the sensitivity, specificity and AUC of Guy’s system for stone removal in elderly PCNL patients were 76.49%,51.33%, and 0.703(95%CI:0.593~0.812).Conclusion Both SHA.LIN and Guy’s system score could predict the stone clearance rate of elderly PCNL patients, but the sensitivity and specificity of SHA.LIN system score were higher than Guy’s system score, and the accuracy was higher.