■一般来说,治疗泌尿系结石的方法有很多,其中经皮肾镜取石术(PCNL)是一种微创、高效的方法,现在成为泌尿结石的一线管理,特别是在复杂的石头和staghorne结石的情况下。准确评估石材位置,结石形态学,肾积水程度以及泌尿系统异常在经皮肾镜取石术中极为重要。
■本研究的目的是评估S.T.O.N.E评分以及影响PCNL疗效的其他因素。
■对71例肾结石患者的描述性研究,从2022年7月至2023年7月,在河内医科大学医院接受了PCNL和PCNL之前的泌尿系统多层CT扫描。所有患者均获得知情同意书并同意参与研究。这些因素包括石头面积,轨道长度(从皮肤表面到石头中心),尿路扩张的程度,涉及的花簇的数量,石头的密度,肾实质厚度,在MSCT非对比期上测量输尿管壁厚度和脂肪浸润。这些因素用于预测PCNL的有效性,包括结石清除率(SCR)和手术时间。
■患者组的平均年龄为53.8±12.3。男女比例为1.54。以下因素与手术时间之间存在显着差异(p<0.05):结石面积(<400、400-799、800-1599和>1600mm2),尿路扩张的程度(没有或可能有中度或重度扩张),涉及的柱体数量(≤2、3和staghorne结石),肾实质厚度(<18mm和≥18mm)。相比之下,以下因素与手术时间无显著差异(p>0.05):轨道长度(<100和≥100mm),和石材密度(<950和≥950HU)。关于S.T.O.N.E分数(包括五个因素:大小,轨道长度,妨碍,涉及的花簇数量,和评估石材密度),S.T.O.N.之间有很强的相关性E评分与手术时间(p<0.001,r=0.94),和SCR(p=0.001,r=-0.97)。
■对这些因素的评估在预测PCNL的有效性中起着重要作用。
UNASSIGNED: Generally, there are many methods for the treatment of urinary stones, of which percutaneous nephrolithotomy (PCNL) is a minimally invasive and highly effective method, and now become the first-line management for urinary stones, especially in the cases of complex stones and staghorne calculi. Accurate assessment of stone location, stone morphology, degree of hydronephrosis as well as urinary system abnormalities is extremely important in the percutaneous nephrolithotomy strategy.
UNASSIGNED: The aim of this study was to evaluate the S.T.O.N.E score as well as other factors that influenced the effectiveness of PCNL.
UNASSIGNED: Descriptive study on 71 patients with kidney stones, who underwent multi-slice CT scan of the urinary system before PCNL and then PCNL at Hanoi Medical University Hospital from July 2022 to July 2023. All patients received the informed consent and agreed to participate in the study. The factors included the stone area, the track length (from the skin surface to the stone central), the degree of urinary tract dilatation, the number of involved calyces, the density of stone, the renal parenchyma thickness, the ureteral wall thickness and fat infiltration measured on MSCT non-contrast phase. These factors were used to predict the effectiveness of PCNL including the stone clearance rate (SCR) and the operation time.
UNASSIGNED: The mean age of the patient group was 53.8±12.3. The male/female ratio was 1.54. There was a significant difference (p<0.05) between the following factors and the operation time: the stone area (<400, 400-799, 800-1599 and >1600 mm2), the degree of urinary tract dilatation (no or might and moderate or severe dilatation), the number of involved calyces (≤ 2, 3 and staghorne calculi), the renal parenchyma thickness (<18 mm and ≥18mm). In contrast, there were no significant differences between the following factors and the surgery time (p>0.05): the track length (<100 and ≥100 mm), and the stone density (<950 and ≥950 HU). Regarding the S.T.O.N.E score (included five factors: Size, Track length, Obstruction, Number of involved calyces, and Evaluation of stone density), there was a strong correlation between S.T.O.N.E score and the surgery time (p<0.001, r=0.94), and the SCR (p=0.001, r=-0.97).
UNASSIGNED: The evaluation of these factors played an important role in the prediction of the effectiveness of PCNL.