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目的:评估输尿管镜碎石术围手术期应用血必净预防术后全身炎症反应综合征(SIRS)的效果。方法:64例采用输尿管镜碎石术治疗输尿管结石合并尿路感染的患者随机分为两组各32例。对照组围术期给予常规抗菌药预防术后SIRS发生;观察组在对照组基础上加用血必净50 ml加入0.9%氯化钠注射液100 ml ivd。比较两组患者术后SIRS发生率及术后2,4,6 d的实验室检查指标。结果:观察组术后SIRS发生率为9.38%,显著低于对照组34.38%(P<0.05);两组脓毒症发生率比较差异无统计学意义(P>0.05)。观察组术后各时间段血白细胞计数、C反应蛋白、降钙素原、细菌内毒素水平等均显著低于对照组(P<0.05)。结论:输尿管结石合并泌尿系统感染患者输尿管镜碎石术围手术期使用血必净联合抗菌药预防术后SIRS效果明显优于单用抗菌药,可有效地改善术后各项实验室指标指标,值得临床推广应用。
Objective: To evaluate the effect of perioperative application of Xuebijing in the prevention of postoperative systemic inflammatory response syndrome (SIRS) by ureteroscopic lithotripsy. Methods: Sixty-four patients undergoing ureteroscopic lithotripsy for ureteral calculi combined with urinary tract infection were randomly divided into two groups of 32 patients. The patients in the control group were given routine antimicrobial agents to prevent postoperative SIRS. The observation group was given Xuebijing 50 ml plus 0.9% sodium chloride injection 100 ml iv on the basis of the control group. The incidence of postoperative SIRS in both groups was compared with the laboratory tests at 2, 4 and 6 days after operation. Results: The incidence of postoperative SIRS in the observation group was 9.38%, which was significantly lower than that in the control group (34.38%, P <0.05). There was no significant difference in the incidence of sepsis between the two groups (P> 0.05). The levels of leukocyte, C-reactive protein, procalcitonin and bacterial endotoxin in the observation group were significantly lower than those in the control group (P <0.05). Conclusions: Ureteroscopic lithotripsy in patients with ureteral calculi and urinary tract infection during perioperative use of Xuebijing combined with antimicrobial agents to prevent postoperative SIRS was significantly better than that of antimicrobial agents alone, which could effectively improve the postoperative laboratory indexes, Worthy of clinical application.