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目的:探讨血清降钙素原(PCT)对于上尿路结石围手术期感染的预测判断、感染程度评估的价值,及其对于治疗的指导意义。方法:选取我院2015年9月1日~2016月5月30日入院的行上尿路结石腔内激光碎石治疗的患者作为研究对象,入院时测定血清PCT、血内毒素、血常规、尿常规等,行尿细菌培养,手术次日晨测定血清PCT、血常规等。对符合要求的184例患者以入院时症状体征、辅助检查等综合判断,分为感染组、较为隐匿的感染组、无感染组,对其PCT进行组间比较。将这184例患者以术后是否发生全身炎症反应综合征、脓毒症分为术后感染组与无感染组,对其术前、术后PCT进行组间比较。结果:入院时感染组及较为隐匿的感染组PCT水平均高于无感染组,差异有统计学意义。感染组PCT高于较为隐匿的感染组,差异有统计学意义。术后感染组与术后无感染组的术前PCT比较差异无统计学意义。术后感染组术后次日晨PCT高于术后无感染组,差异有统计学意义。术后感染组与术后无感染组术后次日晨PCT均高于术前,差异有统计学意义。结论:PCT可作为上尿路结石围手术期是否发生感染的有效预测指标,并可协助评估感染严重程度。检测PCT有利于指导围手术期治疗。
Objective: To investigate the predictive value of serum procalcitonin (PCT) for perioperative infection of upper urinary calculi, the evaluation of the degree of infection, and its guiding significance for the treatment. Methods: Patients in our hospital who were admitted to the hospital from September 1, 2015 to May 30, 2015 were treated with laser lithotripsy in urolithiasis. Serum PCT, serum endotoxin, blood routine, Urine and so on, urine bacterial culture, surgery the next morning serum PCT, blood and so on. A total of 184 patients who met the requirements were divided into infection group, the more obscure infection group and no infection group according to the symptoms and signs and the auxiliary examination on admission. The 184 patients with postoperative systemic inflammatory response syndrome, sepsis was divided into postoperative infection group and no infection group, its preoperative and postoperative PCT were compared between groups. Results: The PCT levels in the infection group and the more occult infection group were higher than those in the non-infected group on admission, the difference was statistically significant. The infection group PCT was higher than the more occult infection group, the difference was statistically significant. There was no significant difference in preoperative PCT between postoperative infection group and postoperative infection group. The PCT after operation in the postoperative infection group was higher on the next morning than that of the non-infected group after operation, the difference was statistically significant. The PCT of the postoperative infection group and the postoperative non-infected group were higher than the preoperative day after surgery, the difference was statistically significant. Conclusion: The PCT can be used as a valid predictor of infection during perioperative upper urinary tract calculi and can assist in assessing the severity of the infection. Detection of PCT is conducive to guiding perioperative treatment.