【摘要】 目的探讨应用S.T.O.N.E.肾结石评分系统评估经皮肾镜取石术(PCNL)的疗效及并发症的临床意义。方法回顾性分析河南省人民医院泌尿外科2017-10—2019-06间因肾结石行PCNL的136例患者的临床资料,采用S.T.O.N.E.肾结石评分系统对术前结石进行评分,分析S.T.O.N.E.评分及其子项目与清石率及并发症的关系。结果 136例患者的结石清除率为72.06%(98/136),S.T.O.N.E.评分为(8.21±1.74)分,无残石组和结石残留组分别为(7.63±1.49)分和(9.68±1.45)分,2组间存在显著差异(t=-7.260,P <0.001)。54例(54/136,39.71%)出现并发症,无并发症组和并发症组评分无显著差异(t=-1.098,P=0.274)。Logistic回归分析显示PCNL术后是否残留结石与S.T.O.N.E.评分相关(OR=2.542,95%CI:1.782～3.628,P <0.001),子项目中的S评分(OR=2.824,95%CI:1.750～4.557,P <0.001)和N评分(OR=4.334,95%CI:2.504～7.503,P <0.001)也是结石残留的独立预测因素,但是否出现并发症与S.T.O.N.E.评分及其各个参数均不相关(P> 0.05)。结论 S.T.O.N.E.肾结石评分系统可有效评估PCNL术后是否残留结石,但对并发症的预测作用有待进一步验证。更多还原

【Abstract】 Objective To investigate the application value of S.T.O.N.E.nephrolithometry scoring system in predicting the outcomes of percutaneous nephrolithotomy( PCNL).Methods The clinical data of 136 patients with renal calculi undergoing PCNL from October 2017 to June 2019 in Henan Provincial People’s Hospital were analyzed retrospectively.Renal calculi were scored according to S.T.O.N.E.nephrolithometry scoring system.The correlation between S.T.O.N.E.scores and the stone-free rate,complications were analyzed.Results The stone-free rate was 72.06%( 98/136) in this study.The mean S.T.O.N.E.score of the 136 patients was( 8.21 ± 1.74).The score of patients without residual calculus was( 7.63 ± 1.49),significantly lower than that of residual stone group( 9.68 ± 1.45)( t =-7.260,P < 0.001).Complications occurred in 54 cases( 54/136,39.71%).The difference of scores between these two groups was not statistically significant( t =-1.098,P = 0.274).Logistic regression analysis showed that the S.T.O.N.E.score correlate with residual calculi after PCNL( OR = 2.542,95% CI: 1.782 ～ 3.628,P < 0.001).The scores of S( OR = 2.824,95% CI: 1.750 ～ 4.557,P < 0.001) and N( OR = 4.334,95% CI: 2.504 ～ 7.503,P < 0.001) were independent predictors of residual stones.However,there was no significant correlation between S.T.O.N.E.scores and complications( P > 0.05).Conclusion S.T.O.N.E.scoring system can predict postoperative stone-free status after PCNL,but its clinical value of predicting complications needs to be further evaluated.更多还原