一个数据驱动的S.T.O.N.E.E.的修订. 石测量得分:在PCNL后改善了无石头状态的预测准确性
Bingjian Wei1, Jiahu Chen1, Yang Fu1
1Department of Urology, Huai'an First Affiliated Hospital of Nanjing Medical University, Huai'an, China.
Science progress
|November 11, 2025
概括
一个修订后的STONE. 用几率比重加权的石测量得分,可以改善皮肤石切除术 (PCNL) 后无石头率的预测. 这种增强的系统更好地对患者进行分层,识别低风险组,成功率超过90%.
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.
- 手术结果研究研究.
背景情况:
- 皮肤瘤切除术 (PCNL) 的成功通常是使用像S.T.O.N.E.这样的评分系统来预测的.
- 现有的系统可能在预测无石头率 (SFR) 中缺乏精度.
- 目标是改进S.T.O.N.E.E.的精细化. 系统用于更准确的SFR预测.
研究的目的:
- 开发一个改进的S.T.O.N.E. 使用因子加权的石测量得分系统.
- 为了提高预测无结石率 (SFR) 的皮肤穿神经切除术 (PCNL) 后.
- 改善PCNL结果的临床风险分层.
主要方法:
- 对283名接受PCNL的患者进行了回顾性队列研究.
- 后勤回归分析确定了SFR的独立预测因素.
- 根据赔率比率 (ORs) 进行了加权,以创建修订后的STONEE. 一个比分,一个分数.
主要成果:
- 石头的大小,阻碍和密度是重要的预测因素,分别被赋予2,3和3的重量.
- 修订后的得分显示了可比的歧视 (AUC 0.804 vs 0.814),但风险重新分类优越 (NRI = 0.233).
- 一个经过修订的低风险组 (分数0-5) 实现了91.9%的SFR,明显高于传统系统的低风险组 (81.4%).
结论:
- 这是一个因子加权的S.T.O.N.E. 该系统为PCNL提供了增强的临床风险分层.
- 它准确地确定了一个低风险患者队列,其SFR>90%.
- 改进的系统有助于PCNL的手术前咨询和手术规划.
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