在RIRS结果预测中,验证骨盆石角作为infundibulopelvic角度的替代品
J C Elises1, D Parikesit2, M Zogan3
1Seoul National University Hospital, Department of Urology, Seoul, South Korea.
Journal of the Formosan Medical Association = Taiwan yi zhi
|December 11, 2025
概括
盆腔石角 (PSA) 准确地预测了逆行性内手术 (RIRS) 后的无石率,为内石角 (IPA) 提供了可靠的替代方案. 这项验证证实支持PSA.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 内分泌病学 在内分泌病学.
- 腎石病的管理方法
背景情况:
- 内角 (IPA) 是一个公认的预测器,可以预测逆行性内手术 (RIRS) 后的无结石率 (SFR),特别是在下极结石.
- 盆腔石角 (PSA) 已被提出作为一种更简单的替代测量方法.
- 与IPA和其他评分系统相比,需要对PSA的实用性进行外部验证.
研究的目的:
- 在逆行性内手术 (RIRS) 后,外部验证盆腔石角 (PSA) 作为无石率 (SFR) 的预测指标.
- 评估PSA相对于膜内角 (IPA) 和其他已建立的评分系统的实用性.
- 评估PSA的观察者间可靠性和预测性能.
主要方法:
- 对110名接受RIRS治疗下极结石的患者进行了回顾性审查.
- 由五位泌尿科医生独立计算PSA,IPA,RIRS得分和Resorlu-Unsal Stone Score (RUSS) 的结果.
- 后勤回归和ROC分析,以评估无石头状态的预测性能 (CT上没有残留碎片>2毫米).
主要成果:
- 58.2%的患者实现了没有石头的状态.
- 纳入PSA的RIRS评分系统的预测性能 (AUC=0.7242) 与基于IPA的模型 (AUC=0.7021) 的预测性能相当.
- 在多变量分析中,PSA和IPA都与SFR显著相关,观察者间可靠性高 (克朗巴赫的α>0.95).
结论:
- 在预测RIRS之后的SFR方面,PSA是IPA的可行和可靠替代品,具有可比的准确性.
- 这些发现支持在结石管理的临床评分系统中更广泛地采用PSA.
- 需要进一步研究PSA在新手术技术中的作用,例如吸附辅助RIRS.
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