| Objective To investigate the correlation of the Guy’s stone score and S.T.O.N.E.nephrolithometry scoring system respectively with stone free rate,postoperative complications and intraoperative estimated blood loss of PCNL.Methods The clinical data of 343 patients undergoing PCNL was analyzed retrospectively.The stones were graded and scored according to the Guy’s stone score and the S.T.O.N.E.scoring system.The postoperative complications of PCNL were graded according to the modified Clavien system,patients with gradeⅠcomplications and patients without complication were classified as Group A,patients with gradeⅡand higher complications were classified as Group B.To analysis the correlation of the two scoring system respectively with stone free rate,postoperative complications,intraoperative estimated blood loss and compare the Guy ’s classification and S.T.O.N.E.scoring system in PCNL preoperative prediction ability.Results As for the Guy’s stone score,there were grade I in 80 patients(23.32%),grade II in 84 patients(24.49%),grade III in 89 patients(25.95%),grade IV in 90 patients(26.24%).The total SFR was 65.6%,the SFR of I,II,III and IV were 88.8%(71/80),82.1%(69/84),49.4%(44/89),45.6%(41/90).SF(stone free)group was(0.24±1.09),RF(residual fragment)group was(3.14±0.91),the difference was statistically significant(P<0.001).The intraoperative estimated blood loss was 2-1000 ml,with an average of 54.64 ml,there was a significant difference in intraoperative estimated blood between different grades(grade I =36.14±59.77 ml,grade II =65.46±39.39 ml,grade III =62.16±44.16 ml,grade IV=53.56±95.84ml;P>0.05).Logistic regression showed that Guy’s stone score was correlated with the rate of stone free and postoperative complications,and the regression coefficients were 0.808,0.270,OR value was 2.243,1.310(P< 0.05).The S.T.O.N.E.score was(7.58±1.49),SF(stone free)group was(7.24±1.35),RF(residual fragment)group was(8.22±1.53),the difference was statistically significant(t=-6.093,P < 0.001).The scores of S,O,N between the two groups were significantly difference(P=0.005,P < 0.001,P < 0.001,respectively),while there was no significantly difference in the scores of T and E between the two groups.There was no correlation of the total score of S.T.O.N.E and the scores of each individual respectively with the postoperative complications of PCNL(P>0.05).Logistic regression showed that S.T.O.N.E.nephrolithometry scoring system was correlated with the rate of stone free,and the regression coefficients were 0.472,OR value was 1.603(P< 0.05).Linear regression showed that there was no statistical relationship between S.T.O.N.E.nephrolithometry scoring system and estimated blood loss(b=0.070 P=0.195).There was a significant difference between the stone free group and the residual fragment group in the two scoring systems(Guy’s grading system: 0.24±1.09 to 3.14±0.91,P<0.001;S.T.O.N.E.score system: 7.24±1.35 to 8.22±1.53,P<0.001).Logistic regression showed that the two scoring systems were able to evaluate the rate of stone free after PCNL(Guy’s classification system: OR=2.243,P<0.05;S.T.O.N.E.score system:OR=1.603,P<0.05).The Guy’s stone score system was correlated with postoperative complications,the regression coefficient was 0.270,OR value was 1.310(P < 0.05).There was no statistical significance between the two scoring systems and the intraoperative estimated blood loss.The state of stone clearance of AUC in percutaneous nephrolithotomy between Guy’s classification and S.T.O.N.E.scoring system was statistically significant(Guy’s grade: 0.673 [95%CI 0.613-0.732];S.T.O.N.E.scoring system: 0.724 [95%CI 0.668-0.779];P > 0.05).Conclusion The results showed that the two kinds of stone score systems could be used to evaluate the stone free rate of PCNL,and the S.T.O.N.E.scoring system is more accurate than the Guy ’s grading system,the Guy’s stone score system can also evaluate postoperative complications,while the S.T.O.N.E.scoring system was not able to evaluate the postoperative complications.The two scoring systems have no capacity of predicting the intraoperative blood loss. |
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