Correlation analysis between S.T.O.N.E. score and stone clearance rate or the complications in renal calculi patients treated with percutaneous nephrolithotomy

doi:10.3877/cma.j.issn.1674-3253.2021.02.008

Abstract

Abstract:

Objective

To investigate the correlation between S.T.O.N.E. kidney stone score and stone clearance rate or complications after PCNL for renal calculi.

Methods

The clinical data of patients with renal calculi who underwent PCNL surgery from October 2012 to October 2018 in our hospital were retrospectively analyzed. The patients were divided into stone clearance group and non stone clearance group according to postoperative stone clearance status, and the differences in S.T.O.N.E. scores between the two groups were compared. Postoperative complications were also graded according to Clavien-Dindo classification, and the differences in S.T.O.N.E. scores between no complications and grade 1-2 complications (non-severe complication group) and grade 3-4 complications (severe complication group) were compared.

Results

A total of 630 patient data were counted, of which 381 were included in the final analysis. Of these, 246 had complete stone clearance and 135 had residual stones. There was significant difference in S.T.O.N.E. score between the two groups (P>0.001). Of the 381 patients, 188(49.34%) had no postoperative complications, and 193(50.66%) patients had complications of varying degrees after surgery. There were 158 cases of grade 1-2 complications and 35 cases of grade 3-4 complications. There was significant difference in S.T.O.N.E. score between severe complication group and non-severe complication group (P=0.006).

Conclusion

S.T.O.N.E. kidney stone scoring system can predict the removal effect of PCNL for renal calculi, and the score is correlated with the degree of complications.

Key words: PCNL, S.T.O.N.E. score, Stone clearance rate, Complication

Jianfang Zhou, Cheng Gao, Dongrong Yang. Correlation analysis between S.T.O.N.E. score and stone clearance rate or the complications in renal calculi patients treated with percutaneous nephrolithotomy[J]. Chinese Journal of Endourology(Electronic Edition), 2021, 15(02): 121-125.

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References 18

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项目	1分	2分	3分	4分
S(mm²)	0～399	400～799	800～1599	≥1600
T(mm)	≤100	>100	-	-
O	无或轻度积水	中或重度积水	-	-
N(个)	1	2～3	完全鹿角形结石	-
E(Hu)	≤950	>950	-	-

项目	1分	2分	3分	4分
S(mm²)	0～399	400～799	800～1599	≥1600
T(mm)	≤100	>100	-	-
O	无或轻度积水	中或重度积水	-	-
N(个)	1	2～3	完全鹿角形结石	-
E(Hu)	≤950	>950	-	-

级别	定义
Ⅰ级	和正常的术后临床进程有差别，但不需要药物治疗或不需要以下治疗方案干预：手术、内镜和放射干预。允许治疗的方案有：物理治疗及药物治疗，如抗生素、退热药、止吐药、利尿剂及镇痛剂，该等级包括伤口感染。
Ⅱ级	需要Ⅰ级并发症定义以外的特殊药物治疗，输血及全静脉营养
Ⅲ级	需要手术治疗、内镜或者放射干预
Ⅲa级	不需全身麻醉
Ⅲb级	需全身麻醉
Ⅳ级	威胁生命的并发症（包括中枢神经系统并发症），需要IC或ICU监护
Ⅳa级	单个器官功能衰竭（包括血液透析）
Ⅳb级	多器官功能衰竭
Ⅴ级	死亡

级别	定义
Ⅰ级	和正常的术后临床进程有差别，但不需要药物治疗或不需要以下治疗方案干预：手术、内镜和放射干预。允许治疗的方案有：物理治疗及药物治疗，如抗生素、退热药、止吐药、利尿剂及镇痛剂，该等级包括伤口感染。
Ⅱ级	需要Ⅰ级并发症定义以外的特殊药物治疗，输血及全静脉营养
Ⅲ级	需要手术治疗、内镜或者放射干预
Ⅲa级	不需全身麻醉
Ⅲb级	需全身麻醉
Ⅳ级	威胁生命的并发症（包括中枢神经系统并发症），需要IC或ICU监护
Ⅳa级	单个器官功能衰竭（包括血液透析）
Ⅳb级	多器官功能衰竭
Ⅴ级	死亡

指标	例数	年龄[岁，M(Q₂₅～Q₇₅)]	性别(例)		侧别(例)		中位手术时间[min，M(Q₂₅～Q₇₅)]	血红蛋白下降[g/L，M(P₂₅～P₇₅)]	S.T.O.N.E评分[分，M(P₂₅～P₇₅)]
指标	例数	年龄[岁，M(Q₂₅～Q₇₅)]	男	女	左	右	中位手术时间[min，M(Q₂₅～Q₇₅)]	血红蛋白下降[g/L，M(P₂₅～P₇₅)]	S.T.O.N.E评分[分，M(P₂₅～P₇₅)]
结石清除组	246	53（42～60）	155	91	134	112	105（90～135）	9.50（3～18）	8（7～8）
结石残留组	135	53（43～60）	82	53	66	69	130（110～170）	12（3～21）	8（7～10）
P值		0.934	0.662		0.297		<0.001	0.121	<0.001

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