输尿管软镜碎石术后结石清除的影响因素及RUSS评分修订量表的预测价值研究  

Study on the influencing factors of stone clearance after ureteroscopic lithotripsy and the predictive value of RUSS revised scale

作　　者：黄远彪 史云强[2] 王荣 郭朝勇 张学才[1] Huang Yuanbiao;Shi Yunqiang;Wang Rong;Guo Chaoyong;Zhang Xuecai(Department of Urology,the People's Hospital of Huili County,Liangshan Yi Autonomous Prefecture 615100,China;Department of Urology,Yanftn Hospital,Affiliated Hospital of Kunming Medical University,Kunming 610051,China)

机构地区：[1]会理县人民医院泌尿外科,凉山奔族自治州615100 [2]昆明医科大学附属医院延安医院泌尿外科,昆明610051

出　　处：《国际泌尿系统杂志》2022年第4期655-659,共5页International Journal of Urology and Nephrology

摘　　要：目的探讨输尿管软镜碎石术(FURL)术后结石清除的影响因素及Resorlu-Unsal肾结石评分(RUSS)修订量表的预测价值.方法回顾性分析2017年1月至2020年6月在会理县人民医院和昆明医科大学附属医院延安医院行FURL治疗的208例肾结石患者的临床资料,根据结石清除效果分为结石清除组(144例)和结石残留组(64例).比较两组的基线临床资料,采用logistic回归模型分析FURL术后结石清除效果的独立影响因素,同时描绘受试者工作特征(ROC)曲线评价RUSS评分修订量表对结石清除效果的预测价值.结果结石清除组的结石面积、结石CT值、肾盏累及数量、合并肾下盏结石且肾盂漏斗角度(IPA)<45°、合并肾下盏结石、合并肾脏解剖结构异常比例及合并鹿角形结石比例均低于结石残留组,而多发结石比例、结石最大径1、2级比例高于结石残留组,差异均有统计学意义(均P<0.05).多因素lo-gistic分析结果显示,结石面积、肾盏累及数量、多发结石、IPA及结石最大径分级是FURL术后结石清除效果的独立影响因素(均P<0.05).评分在1~2分中,RUSS量表的结石清除率要高于RUSS评分修订量表,而评分在0、3分中,RUSS量表的结石清除率要低于RUSS评分修订量表,差异均有统计学意义(均P<0.05);结石清除组的RUSS量表和RUSS评分修订量表评分显著少于结石残留组(P<0.05).ROC曲线分析结果显示,RUSS评分修订量表的结石清除效果的曲线下面积为0.87,高于其他指标(P<0.05).结论FURL术后的结石清除效果可能与结石面积、肾盏累及数量、多发结石、IPA及结石最大径分级有关,同时基于RUSS评分修订量表可准确预测术后结石清除效果.Objective To investigate the influencing factors o£stone removal after soft uretero-scopic lithotripsy(FURL)and the predictive value o£Resorlu-Unsal stone score(RUSS)score revision scale.Methods The clinical data of 208 patients with renal stones who received FURL treatment in peoples hospital of Huili County and Yan'an affiliated hospital of Kunming medical university from January 2017 to June 2020 were retrospectively analyzed,and they were divided into stone removal group(144 cases)and stone residual group(64 cases)according to stone removal effect.The baseline clinical data of the two groups were compared.The independent influencing factors of stone removal after FURL were analyzed by logistic regression model,and the predictive value of RUSS score revision scale for stone removal was evaluated by describing receiver operating characteristic(ROC)curve.Results Area clear set o£stones,stone of CT value,quantity,proportion of multiple stones,calyces involving merger renal calyx calculi and renal pelvis funnel angle(IPA)<45°,merge the calyx,stones proportion o£maximum diameter 2,level 3,the proportion of abnonnal renal anatomy and the combining antler shape proportion than stones residual group,The proportion of grade 1 maximum diameter of stone was higher than that of residual stone group,the differences were statistically significant(all P<0.05).Multivariate logistic analysis showed that stone area,number of calycalis involved,multiple stones,IPA and stone diameter grade were independent influencing factors of stone removal effect after FURL(all P<0.05).The calculus clearance rate of RUSS scale was higher than that of RUSS scale when the score was 1-2,while the calculus clearance rate of RUSS scale was lower than that of RUSS scale when the score was 0 and 3,with statistical significance(all P<0.05).The scores of RUSS scale and RUSS score revision scale in the calculus removal group were significantly lower than those in the calculus residual group(P<0.05)ROC curve analysis showed that the area under the c

关 键 词：肾结石 输尿管镜检查 碎石术 结石清除率 RUSS评分 

分 类 号：R699[医药卫生—泌尿科学]