The Research Of The Value With Kidney Stones Classiifcation To Predict Stone Free Rate After Percutaneous Nephrothotomy

Purpose:To explore the effectiveness and the value with kidney stones classification topredict stone free rate after percutaneous nephrothotomy.Methods:This study collected the data of122cases of kidney stones in patients treated inour department from July2011to December2011. All patients underwent PCNLtreatment of kidney stones. Preoperative abdominal plain film and ultrasound and/orcomputed tomography were performed to confirm the diagnosis and kidney stonesgraded. Include grade I (group A), solitary stone in mid/lower pole or solitary stone inthe pelvis with simple anatomy; grade II (group B), solitary stone in upper pole ormultiple stones in a patient with simple anatomy or a solitary stone in a patient withabnormal anatomy; grade III (group C), multiple stones in a patient with abnormalanatomy or stones in a caliceal diverticulum or partial staghorn calculus; grade IV(group D), staghorn calculus or any stone in a patient with spina bifida or spinalinjury. Collect the date of preoperative and postoperative of all patients. The SPSS17.0Statistics sofeware package for date analysis and using multivariate regressionanalysis to compare the impact of various on the PCNL postoperative stone free rate.Results:Patients in group A26cases; group B,46cases; group C,21cases; group D,29cases. The stone free rate of single operation is84.61%,69.56%,52.38%,42.27%,respectively. Ten types of postoperative complications in22cases, but no seriouscomplications, such as grade Ⅳ and grade Ⅴ. Multivariate linear regression analysisshowed that: regression coefficients in multivariate regression analysis of the relevantfactor of kidney stone residue is1.103, OR value is2.753,（P﹤0.05）, the differencewas statistically significant. regression coefficients of number of tracts is-1.885, ORvalue is0.153,（P﹤0.05）, the difference was statistically significant. regressioncoefficients of other constant is-0.667, OR value is0.508,（P﹥0.05）, the differencewas not statistically significant. Conclusion:1. the kidney stone score have contain many factors such as number, shape,location of kidney stones and renal anatomical structure. This score system is simpleeasy to operate, without adding additional cost of hospitalization, and it can help toassessment risk and clinical outcome of PCNL preoperative.2. kidney stones score might not be perfect, we can further refine it, so that it canmore accurately predict the stone free rate of PCNL postoperative and objectiveevaluation of surgical difficulty.