S.T.O.N.E.评分系统与经皮肾镜取石术并发症的相关性研究  

Correlation between S.T.O.N.E. nephrolithometry scoring system and the complications of percutaneous nephrolithotomy

作　　者：郑秀龙[1] 李延江[2] 荆涛[2] 贾月峰[2] 王笑山 程国升 ZHENG Xiulong;LI Yanjiang;JIN Tao;JIA Yuefeng;WANG Xiaoshan;CHENG Guoheng(Department of Urology,Pingdu People＇s Hospital,Pingdu,Shandong,266700,China;De partment of Urology,Affiliated Hospital of Qingdao University;aDepartment of General Sur gery,People＇s Hospital of Gaoqing Count;Department of Critical Care Medicine,Linyi Cen tral Hospital)

机构地区：[1]平度市人民医院泌尿外科,山东平度266700 [2]青岛大学附属医院泌尿外科 [3]高青县人民医院普外科 [4]临沂市中心医院重症医学科

出　　处：《临床泌尿外科杂志》2018年第11期894-898,共5页Journal of Clinical Urology

摘　　要：目的:探讨S.T.O.N.E.评分系统[包括结石横截面积(S)、皮肾通道距离(T)、梗阻程度(O)、受累肾盏数(N)和结石密度(E)]与经皮肾镜取石术(PCNL)并发症的相关性。方法:回顾性研究417例行PCNL患者的临床资料,根据S.T.O.N.E.评分系统对结石进行评分;根据改良的Clavien分级系统对PCNL并发症进行分级,将无并发症及Ⅰ级并发症归为A组、Ⅱ级及以上并发症归为B组,分析S.T.O.N.E.评分与PCNL并发症的关系。结果:本研究417例患者的S.T.O.N.E.评分为5～12分,平均(7.51±1.62)分,125例(29.98%)患者出现Ⅱ级及以上并发症(主要为感染和出血)。A组S.T.O.N.E.评分为5～11分,平均(7.28±1.52)分;B组S.T.O.N.E.评分为5～12分,平均(8.06±1.72)分,两组评分差异有统计学意义(t=-4.37,P<0.001)。两组S(1.38±0.64,1.64±0.79)、T(1.24±0.43,1.39±0.49)、N(1.82±0.82,2.06±0.81)的评分差异有统计学意义(P=0.002、0.002、0.004),两组O(1.48±0.50,1.51±0.50)、E(1.37±0.48,1.45±0.50)的评分差异无统计学意义(P=0.544、0.124)。Logistic回归分析显示S评分(OR=1.560,95%CI:1.138～2.139,P=0.006)、T评分(OR=3.052,95%CI:1.766～5.273,P<0.001)是PCNL术后Ⅱ级及以上并发症的独立预测因素。结论:S.T.O.N.E.评分与PCNLⅡ级及以上并发症相关,具有预测PCNL并发症的作用,其中S、T是PCNLⅡ级及以上并发症的独立预测因素。Objective：To investigate the correlation between S.T.O.N.E.nephrolithometry scoring system[included stone size（S）,tract length（T）,obstruction（O）,number of calices containing stones（N）,stone essence（E）]and the complications of percutaneous nephrolithotomy（PCNL）.Method：The clinical data of 417 patients undergoing PCNL were analyzed retrospectively.Renal calculi were scored according to S.T.O.N.E.scoring system.We graded the complications according to the modified Clavien classification system,patients with gradeⅠcomplications and patients without complication were classified as Group A,patients with gradeⅡ and higher complications were classified as Group B.The correlation between S.T.O.N.E.score and the complications of PCNL was analyzed.Result：The mean S.T.O.N.E.score was 7.51±1.62（range,5-12）of the 417 patients in the study.GradeⅡ and higher complications mainly including infection and hemorrhage occurred in 125 cases（29.98%）.The mean S.T.O.N.E.score of Group A was 7.28±1.52（range,5-11）,which was significantly lower than that of Group B（8.06±1.72,range,5-12）（t=-4.37,P〈0.001）.The scores of S,T,N between the two groups was significantly different（P=0.002,0.002,0.004,respectively）.There was no significantly difference in the scores of O or E between the two groups（P=0.544,0.124,respectively）.Logistic regression analysis showed that the scores of S（OR=1.560;95%CI：1.138-2.139;P=0.006）and T（OR=3.052;95%CI：1.766-5.273;P〈0.001）were independent predictors of gradeⅡand higher complications after PCNL.Conclusion：The S.T.O.N.E.nephrolithometry score is correlated with gradeⅡ and higher complications and can be used to predict PCNL complications.And S and T are independent predictors of grade Ⅱ and higher complications after PCNL.

关 键 词：S.T.O.N.E.评分系统 经皮肾镜取石术 并发症 

分 类 号：R692.4[医药卫生—泌尿科学]