一种用于标准化肾结石患者内镜检查时肾乳头外观描述的分级系统建议。
A Proposed Grading System to Standardize the Description of Renal Papillary Appearance at the Time of Endoscopy in Patients with Nephrolithiasis.
作者信息
Borofsky Michael S, Paonessa Jessica E, Evan Andrew P, Williams James C, Coe Fredric L, Worcester Elaine M, Lingeman James E
机构信息
1 Department of Urology, Indiana University School of Medicine , Indianapolis, Indiana.
2 Department of Anatomy and Cell Biology, Indiana University School of Medicine , Indianapolis, Indiana.
出版信息
J Endourol. 2016 Jan;30(1):122-7. doi: 10.1089/end.2015.0298. Epub 2015 Oct 9.
BACKGROUND AND PURPOSE
The appearance of the renal papillae in patients with nephrolithiasis can be quite variable and can range from entirely healthy to markedly diseased. The implications of such findings remain unknown. One potential reason is the lack of a standardized system to describe such features. We propose a novel grading scale to describe papillary appearance at the time of renal endoscopy.
METHODS
Comprehensive endoscopic renal assessment and mapping were performed on more than 300 patients with nephrolithiasis. Recurring abnormal papillary characteristics were identified and quantified based on degree of severity.
RESULTS
Four unique papillary features were chosen for inclusion in the PPLA scoring system- ductal Plugging, Pitting, Loss of contour, and Amount of Randall's plaque. Unique scores are calculated for individual papillae based on reference examples.
CONCLUSIONS
The description and study of renal papillary appearance in stone formers have considerable potential as both a clinical and research tool; however, a standardized grading system is necessary before using it for these purposes.
背景与目的
肾结石患者肾乳头的外观可能差异很大，从完全健康到明显病变不等。这些发现的意义尚不清楚。一个潜在原因是缺乏描述此类特征的标准化系统。我们提出一种新颖的分级量表来描述肾脏内镜检查时的乳头外观。
方法
对300多名肾结石患者进行了全面的内镜肾脏评估和绘图。根据严重程度识别并量化反复出现的异常乳头特征。
结果
PPLA评分系统纳入了四个独特的乳头特征——导管堵塞、凹陷、轮廓消失和兰德尔斑数量。根据参考示例为各个乳头计算独特的分数。
结论
结石形成者肾乳头外观的描述和研究作为临床和研究工具都有很大潜力；然而，在将其用于这些目的之前，需要一个标准化的分级系统。
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