诺莫格拉姆模型用于预测患上上尿路结石的患者紧急体外冲击波石的临床有效性:单中心回顾性研究
Zhenya Shen1, Shaohui Zhang1, Yang Gui1
1Department of Emergency Medicine, The First Affiliated Hospital of Henan University of Science and Technology, 471000 Luoyang, Henan, China.
Archivos espanoles de urologia
|March 3, 2026
概括
这项研究确定了预测外体冲击波石 (ESWL) 对上尿路结石的成功的关键因素. 一个经过验证的诺姆图有助于预测紧急ESWL的石头驱逐结果.
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.
- 医疗成像医学成像
背景情况:
- 上部泌尿道结石构成了重大的临床挑战.
- 紧急体外冲击波石 (ESWL) 是一种常见的治疗方式.
- 预测ESWL疗效对于优化患者的治疗结果至关重要.
研究的目的:
- 为了确定影响紧急ESWL临床疗效的因素,用于上尿路结算.
- 开发和验证一个名ogram模型来预测ESWL后的石头驱逐.
- 加强紧急ESWL程序的决策.
主要方法:
- 对502名接受紧急ESWL的患者进行了回顾性分析.
- 有效和无效组之间的临床,实验室和微积分特征的比较.
- 多变量逻辑回归和名ogram构造用于结果预测.
- 使用ROC曲线,校准图和决策曲线分析进行验证.
主要成果:
- 140名患者 (27.9%) 经历了无效的治疗.
- 失败的独立风险因素:延迟ESWL,高尿白血球,高肌/尿酸,大石径,高石密度,严重水.
- 保护因素:高估计的膜过率,尿道结石.
- 介导因素:ESWL能量,冲击次数.
- 诺莫格拉姆显示出强大的预测性能 (AUC=0.862).
结论:
- 一个经过验证的名图有效地预测了紧急ESWL结果.
- 诺米图集成了独立的预测因素和介导因素,以提供可靠的决策支持.
- 这种工具可以帮助临床医生在紧急ESWL的情况下管理上尿路结石.
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