摘要
目的分析C.O.L.V.E.I.评分系统对预测逆行输尿管软镜碎石术(retrograde intrarenal surgery,RIRS)术后结石清除率的价值。方法回顾性分析2020年10月至2021年10月湖南医药学院第一附属医院122例行RIRS的输尿管上段及肾结石患者的临床资料,建立C.O.L.V.E.I.评分系统[主要包括结石最大直径(cumulative stone diameter,C)、梗阻程度(obstruction,O)、肾盏漏斗部长度(length of calyces funnel,L)、累及肾盏数(visible number of calyces,V)、结石密度(essence of stone,E)、肾盂输尿管长轴线与肾下盏漏斗部长轴线的夹角(IPA,I)]进行评价,根据评分情况分成低分组41例、中分组66例、高分组15例,根据术后有无结石残留分成残留组28例与无残留组94例,观察患者手术相关情况,比较不同结石残留组C.O.L.V.E.I.评分差异,采用相关性分析C.O.L.V.E.I.评分系统预测RIRS术后结石清除率的价值。结果患者手术均顺利完成,结石总清除率为77.05%。高分组手术时间最长,低分组结石清除率最高,三组比较差异有统计学意义(P<0.05)。残留组C、L、V、E评分均高于无残留组,差异有统计学意义(P<0.05);在O、I评分方面,两组比较差异无统计学意义(P>0.05);评分系统中C、L、V同术后结石清除率有显著相关性,差异有统计学意义(P<0.05);C、O、L、V、E、I联合与结石清除率的相关性最为明显,差异有统计学意义(P<0.05)。结论应用C.O.L.V.E.I.评分系统预测RIRS术后结石清除率的价值突出。
Objective This study aimed to analyze clinical application of the C.O.L.V.E.I.scoring system in predicting stone clearance rate after retrograde intrarenal surgery(RIRS).Methods The clinical data of 122 patients with upper ureteral and renal calculi who underwent RIRS in The First Affiliated Hospital of Hunan Medical University from October 2020 to October 2021 were retrospectively analyzed to establish a C.O.L.V.E.I.scoring system[mainly including cumulative stone diameter(C),obstruction(O),length of calyces funnel(L),visible number of calyces(V),essence of stone(E),infundibulopelvic angle(IPA,I)]for evaluation,and the patients were divided into a low group(41 cases),medium group(66 cases)and high group(15 cases)according to the scoring.According to the presence of postoperative residual stones,the patients were divided into a residual group(28 cases)and non-residual group(94 cases).The implementation of treatment in patients was observed,the C.O.L.V.E.I.scores of the different residual stone groups were compared,and correlation analysis was performed to assessclinical application of the C.O.L.V.E.I.scoring system in predicting the stone clearance rate after RIRS.Results All patients’operations were successful.The total clearance rate of calculi was 77.05%.The operation time in the high group was longest,and the calculus clearance rate of the low group was highest,and the difference among the three groups had statistical significance(P<0.05).The scores of C,L,V and E in the residual group were higher than those in the non-residual group(P<0.05),but no significant difference was observed in the O and I scores between the groups(P>0.05).The C,L and V in the scoring system significantly correlated with the postoperative stone clearance rate(P<0.05).The C,O,L,V,EI correlation is most obvious with the calculus clearance rate(P<0.05).Conclusion The C.O.L.V.E.I.scoring system is highly valuable in predicting the stone clearance rate after RIRS.
作者
张海峰
毛登久
周杰
Zhang Haifeng;Mao Dengjiu;Zhou Jie(Department of Urology,The First Affiliated Hospital of Hunan Medical University,Huaihua,Hunan 418000,China)
出处
《泌尿外科杂志（电子版）》
2022年第1期8-10,14,共4页
Journal of Urology for Clinicians(Electronic Version)
基金
2021年湖南省怀化市科技创新计划项目(编号:2021R3109)
