| Purpose:Further research improved Guy’s grading for kidney stones PCNL after a stone free rate forecasts and related factors. Methods:The study collected a total of our department from December 2012 to December 2014 were treated 270 cases of kidney stones in patients with relevant information, All the stones underwent PCNL(Percutaneous nephrolithotomy) surgery, Preoperative KUB(Abdominal plain radiography) and CT(Computed tomography) to clear the stones of the relevant situation, Make improvements based on Guy’s staging of the kidney.Grade1: The anatomy of the kidney collecting system lower single normal renal calculi, The anatomy of the kidney collecting system of normal renal pelvis single calculi; Grade2a: The anatomy of the kidney collecting system highly single normal renal calculi;Grade2b: The anatomy of the kidney collecting system of normal renal multiple stones(Multiple stones scattered in 2 or more calyces), The anatomy of the normal kidney collecting system part of the antlers of kidney stones(< 1/2 of all calyces), Abnormal anatomy of the kidney collecting system of single stones; Grade3: The anatomy of the kidney collecting system abnormal renal multiple stones(Multiple stones scattered in 2 or more calyces), part of the antlers of kidney stones( ≥1/2 of all calyces), Calyx diverticulum calculi;Grade4a: complete staghorn calculi; Grade4b:severe spinal malformation of kidney stones, Renal dysplasia with kidney stones; complete staghorn calculi and renal calyx multiple stones. Research collected before and after surgery in patients with relevant information, using SPSS19.0 statistical package for data analysis, multivariate regression analysis, to understand the risk factors related to a period after PCNL stone-free rate. Results:Grade1: 75 patients, a stone free-rate was 96%; Grade2a: 69 patients, a stone-free rate was 89.9%; Grade2b: 48 patients, a stone-free rate was 54.17%; Grade3: 36 patients, a stone-free rate was 50%; Grade4a: 21 patients, a stone-free rate was 33.33%; Grade4b: 21 patients, one of the stone-free rate was 19.05%. Multivariable linear regression analysis showed: the classification of kidney stones, kidney congenital malformations, degree of hydronephrosis are relevant factors to predict kidney stone free rate, Which is the most dangerous factor in kidney stone free rate. Improve the Guy ’s classification can better predict stone free rate.Conclusion:1.According to the specific circumstances of clinical staging for Guy’s kidney stones make improvements, Added two kidney stones subtype classification and appropriate adjustments Guy’s classification of kidney stones, Makes the classification more reasonable and practical of kidney stones,closer to clinical, With stone free rate has more relevance. The classification method is simple and practical, easy to operate, can be re-high, can be used for preoperative evaluation and surgical risk associated PCNL stone free rate.2.According to preoperative imaging data were graded on patient kidney stones develop in tabular form on postoperative stone free rate and related surgical risk prediction. |
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