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在RIRS之后的无石头率:来自单中心研究的多变量分析和预测名录
Kemal Kayar1, Ridvan Kayar2, Kayhan Gorkem Tuncel2
1Department of Urology, Haydarpasa Numune Training and Research Hospital, University of Health Sciences, Tibbiye Street. No: 23, Uskudar, Istanbul, 34668, Türkiye. kemal.kayar@hotmail.com.
World journal of urology
|June 10, 2025
概括
在逆行性内手术 (RIRS) 后预测残留结石至关重要. 使用石块体积,内骨盆角 (IPA) 和囊参与的新型诺米克图准确地识别了有风险的患者,改善了手术结果.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 腎臟病學 (nephrology) 是一種醫學專業.
- 手术瘤学手术瘤学
背景情况:
- 逆行性内手术 (RIRS) 后的残留结石是一个重大的临床挑战.
- 准确预测残留石头对于优化患者的治疗结果和手术规划至关重要.
研究的目的:
- 在RIRS之后,确定剩余石头的关键预测因素.
- 开发和验证一个基于nomogram的风险分层模型,用于预测RIRS后的剩余石头.
主要方法:
- 对274名因结石而接受RIRS治疗的患者进行了回顾性分析.
- 多变量逻辑回归和接收器操作特征 (ROC) 曲线分析以确定预测因素.
- 使用Python库开发和验证一个名ogram,通过对应指数 (C-index) 和校准图表进行评估.
主要成果:
- 石块体积> 498 毫米3,内骨盆角 (IPA) ≤ 44°,以及多个石头杯是残留石头的显著预测因素.
- 该名录显示出出色的预测性歧视 (C指数:0.839) 并将患者分为四个风险类别.
- 石头体积是一个比石头大小 (AUC: 0.793) 更强大的预测因素 (AUC: 0.819).
结论:
- 开发的诺米图,结合石块体积,IPA和干涉,是预测RIRS后残留石块的临床有价值的工具.
- 该模型的术前应用可以指导个性化治疗策略,并改善患者对预期结果的咨询.
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