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比较 S.T.O.N.E 和 CROES 肾结石评分系统在预测经皮肾镜取石术后结石清除率和并发症发生率方面的应用:一项单中心 262 例研究。

Comparison of S.T.O.N.E and CROES nephrolithometry scoring systems for predicting stone-free status and complication rates after percutaneous nephrolithotomy: a single center study with 262 cases.

机构信息

Department of Urology, Izmir Bozyaka Training and Research Hospital, Karabaglar, Izmir, Turkey.

出版信息

Urolithiasis. 2017 Oct;45(5):489-494. doi: 10.1007/s00240-016-0935-0. Epub 2016 Nov 18.

Abstract

The aim of this study was to compare the accuracy of the CROES nephrolithometric nomogram and S.T.O.N.E. scoring system in predicting PCNL outcomes in terms of stone-free rate, estimated blood loss (EBL), operative time (OR), length of hospital stay (LOS), and complications. Patients who underwent PCNL for renal stones between May 2012 and January 2015 were analyzed retrospectively. The patients' demographic characteristics and operational features were recorded prospectively in all patients postoperatively. S.T.O.N.E. and CROES nephrolithometry scores' correlation with stone-free status, operation and fluoroscopy time, length of hospital stay (LOS) and blood loss (BL) was evaluated. Patients were categorized according to S.T.O.N.E. nephrolithometry and CROES nephrolithometry scores. Postoperative complications were graded according to modified Clavien classification (Dindo et al. in Ann Surg 240:205-213, 2004) and the correlation of both scoring systems with postoperative complications was also evaluated. We identified 437 patients who underwent PCNL between May 2012 and January 2015. A total of 262 patients who are available data for the CROES and S.T.O.N.E. scoring systems were included in the recent study. The mean S.T.O.N.E score was 7.65 ± 1.56 and the mean CROES score was 191.13 ± 64.39. The overall stone-free rate was 71.4%. Of the 262 patients, 89 experienced postoperative complications. Stone-free patients had significantly lower BMI (<0.001) and stone burden (p < 0.001). Regression analysis showed that both scoring systems were significantly associated with stone-free rates and operation time. We demonstrated that S.T.O.N.E. and CROES scoring systems were useful for predicting post-PCNL stone-free status. But both scoring systems were not useful for predicting post-PCNL complications.

摘要

本研究旨在比较 CROES 肾结石计量命名法和 S.T.O.N.E. 评分系统在预测经皮肾镜取石术(PCNL)结果方面的准确性,包括无结石率、估计失血量(EBL)、手术时间(OR)、住院时间(LOS)和并发症。回顾性分析 2012 年 5 月至 2015 年 1 月期间接受 PCNL 治疗的肾结石患者。所有患者术后均前瞻性记录患者的人口统计学特征和手术特征。评估 S.T.O.N.E. 和 CROES 肾结石计量评分与无结石状态、手术和透视时间、住院时间(LOS)和失血量(BL)的相关性。根据 S.T.O.N.E. 肾结石计量和 CROES 肾结石计量评分对患者进行分类。根据改良的 Clavien 分级(Dindo 等人,在 Ann Surg 240:205-213, 2004)对术后并发症进行分级,并评估两种评分系统与术后并发症的相关性。我们确定了 2012 年 5 月至 2015 年 1 月期间接受 PCNL 的 437 名患者。最近的研究共纳入了 262 名可获得 CROES 和 S.T.O.N.E. 评分系统数据的患者。S.T.O.N.E. 评分的平均值为 7.65±1.56,CROES 评分的平均值为 191.13±64.39。总的无结石率为 71.4%。在 262 名患者中,89 名患者发生术后并发症。无结石患者的 BMI 明显较低(<0.001)和结石负荷(p<0.001)。回归分析表明,两种评分系统均与无结石率和手术时间显著相关。我们证明,S.T.O.N.E. 和 CROES 评分系统可用于预测 PCNL 后的无结石状态。但是,这两种评分系统都不能预测 PCNL 后的并发症。

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