摘要
目的探讨改良S.T.O.N.E评分对一期肾输尿管软镜碎石取石术(FURL)结石清除率(SFR)的预测价值及优势。方法回顾性分析淄博市中心医院西院泌尿外科2018年1月至2021年8月完成的93枚肾脏FURL术的临床资料。应用改良S.T.O.N.E评分将患肾分为简单组(5~7分,n=31)、中间组(8~11分,n=52)和复杂组(12~17分,n=10),比较不同组患肾术中和术后1个月SFR的差异。通过绘制改良S.T.O.N.E评分与SHA.LIN、S.T.O.N.E和RUSS评分的受试者工作特征曲线(ROC),比较改良S.T.O.N.E评分与其他3种评分ROC曲线下面积(AUC)的差异。结果93枚肾脏FURL术中和术后1个月SFR分别为74.19%和80.65%,二者差异有统计学意义(P=0.0412)。改良S.T.O.N.E评分结果显示,简单组、中间组和复杂组术中SFR分别为96.77%、69.23%和30.00%,术后1个月分别为96.77%,80.77%和30.00%;中间组患肾术中、术后SFR差异有统计学意义(P=0.0412),简单组和复杂组术中、术后SFR差异无统计学意义(P均>0.05)。改良S.T.O.N.E评分预测术中SFR的AUC与SHA.LIN、S.T.O.N.E评分比较,差异无统计学意义(P均>0.05);与RUSS评分比较差异具有统计学意义(P=0.0072)。改良S.T.O.N.E评分预测术后1个月SFR的AUC与SHA.LIN、S.T.O.N.E及RUSS评分比较,差异无统计学意义(P均>0.05)。结论在上述4种肾结石评分系统中,改良S.T.O.N.E评分预测一期肾FURL术中及术后1个月SFR的准确性最高,值得临床推广。
Objective To explore the modified S.T.O.N.E scoring system in predicting the stone-free rate(SFR)of one-stage renal flexible ureteroscopic lithotripsy(FURL).Methods The clinical data of 93 cases undergoing FURL during Jan.2018 and Aug.2021 were retrospectively analyzed.According to the modified S.T.O.N.E score,the affected kidneys were divided into simple group(5-7 points,n=31),intermediate group(8-11 points,n=52)and complex group(12-17 points,n=10),and the 1-month SFR after surgery among the three groups were compared.The receiver operating characteristic(ROC)curve of the modified S.T.O.N.E,SHA.LIN,S.T.O.N.E and RUSS scores were plotted to compare the differences in the area under the ROC curve(AUC).Results The intraoperative and 1-month SFR were 74.19%and 80.65%,respectively(P=0.0412).The modified S.T.O.N.E score showed the intraoperative SFR in the simple,intermediate and complex group were 96.77%,69.23%and 30.00%,respectively;the 1-month SFR were 96.77%,80.77%and 30.00%,respectively.There were significant differences in the intraoperative and postoperative SFR in the intermediate group(P=0.0412),while there was no difference between the simple and complex groups(P>0.05).Compared with the SHA.LIN and S.T.O.N.E scores,the modified S.T.O.N.E score showed no difference in AUC for predicting intraoperative SFR(all P>0.05);but there was difference compared with the RUSS score(P=0.0072).There was no significant difference in the AUC among the modified S.T.O.N.E score,SHA.LIN,S.T.O.N.E and RUSS score in predicting 1-month SFR(all P>0.05).Conclusion Among the four renal stone scoring systems,the modified S.T.O.N.E score has the highest accuracy in predicting SFR during one-stage renal FURL and 1-month SFR after surgery,and it is worthy of clinical promotion.
作者
苏文桂
徐海龙
杨猛
崔伟
聂清生
SU Wengui;XU Hailong;YANG Meng;CUI Wei;NIE Qingsheng(Clinical College of Weifang Medical University,Weifang 261053,Shandong,China;Department of Urology,Peking University Medical Zibo Hospital,Zibo 255051,Shandong,China;Department of Urology,Zibo Central Hospital,Zibo 255036,Shandong,China)
出处
《山东大学学报（医学版）》
CAS
北大核心
2022年第6期57-63,共7页
Journal of Shandong University:Health Sciences
