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目的:评估术前预警评分系统(POWSS)在上尿路结石合并重度肾积水患者行腔内碎石治疗中的应用价值。方法:回顾性分析2013年1月到2017年7月在本院行上尿路腔内碎石治疗的重度肾积水患者147例的临床资料，POWSS评分>7.5分者89例为高分组，其中41例术前行肾穿刺造瘘；POWSS评分≤7.5分者58例为低分组，其中19例术前行肾穿刺造瘘。对比两组患者的术后感染发生率。结果:高分组未穿刺造瘘的患者术后感染率为35.42%(17/48)，显著高于低分组未穿刺造瘘患者的5.13%(2/39)，两组比较差异有统计学意义(n P＝0.001)，而进行术前穿刺造瘘的高分组患者术后感染率为7.32%(3/41)，显著低于术前未穿刺造瘘的高分组患者(n P＝0.002)。n 结论:POWSS评分能筛选出上尿路结石患者行腔内碎石发生术后感染的高危人群，对于重度肾积水的高危患者宜术前行患侧肾穿刺造瘘术，以降低感染发生率。“,”Objective:To evaluated the value of pre-operation warming score system(POWSS) in upper urinary calculi patients with serious hydronephrosis.Methods:From January 2013 to July 2017, 147 upper urinary calculi patients with serious hydronephrosis who underwent intracavity lithotripsy were analyzed.Eighty-nine patients who were rated>7.5 with POWSS were divided into high-score group, which included 41 patients who underwent percutaneous nephrectomy.Fifty-eight patients who were rated≤7.5 with POWSS were divided into low-score group, which included 19 patients who underwent percutaneous nephrectomy, infection rate after intracavity lithotripsy were compared between two groups.Results:The infection rate after intracavity lithotripsy of patients without percutaneous nephrectomy in high-score group and low-score group were 35.42% and 5.13% respectively, there was a significant difference between two groups(n P=0.001). Percutaneous nephrectomy before intracavity lithotripsy in high-score upper urinary calculi patients could reduced the infection rate(7.32% vs. 35.42%, n P=0.002).n Conclusions:POWSS could sifted out high-risk patients of infection after intracavity lithotripsy in upper urinary calculi, percutaneous nephrectomy before intracavity lithotripsy contributed to the reduction of infection rate in high-risk upper urinary calculi patients with serious hydronephrosis.