降钙素原预判输尿管软镜术后感染风险的临床价值研究  

Clinical value of procalcitonin in predicting the risk of infection after retrograde intrarenal surgery

作　　者：胡义强 代龙文 李言雄 王建设 段江飞 杨为 邓小俊 胡英俊 高锐 HU Yiqiang;DAI Longwen;LI Yanxiong;WANG Jianshe;DUAN Jiangfei;YANG Wei;DENG Xiaojun;HU Yingjun;GAO Rui(Department of Urology,Lianxi District People's Hospital,Jiujiang,Jiangxi,332005,China)

机构地区：[1]九江市濂溪区人民医院泌尿外科,江西九江332005

出　　处：《当代医学》2023年第19期104-107,共4页Contemporary Medicine

基　　金：江西省卫生健康委员会(SKJP220217866)。

摘　　要：目的探讨降钙素原(PCT)预判输尿管软镜碎石取石术(RIRS)后感染风险的临床价值。方法选取2021年1—12月于本院行RIRS治疗的100例上尿路结石患者作为研究对象,依据术后24 h内体温变化及细菌培养结果分为对照组(体温<37℃,n=68)与观察组(体温≥37℃和/或尿细菌培养阳性,n=32)。检测并比较两组手术前后血清PCT、C反应蛋白(CRP)水平和WBC,分析PCT、CRP、WBC预判术后感染的诊断效能。结果术后,两组PCT、CRP、WBC水平均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05)。PCT、CRP、WBC诊断RIRS术后感染的AUC分别为0.893、0.721、0.708,截断值分别为1.75μg/L、40.15 g/L、69.12%,均具有一定诊断价值;PCT诊断RIRS术后感染的灵敏度、特异度均高于WBC,特异度高于CRP,差异有统计学意义(P<0.05)。结论PCT预判RIRS术后感染的灵敏度、特异度较高,可提高RIRS术后感染诊断准确率,有助于指导临床诊断及治疗,及时控制患者病情,改善其预后。Objective To investigate the clinical value of procalcitonin(PCT)in predicting the risk of infection after retrograde intrarenal surgery(RIRS).Methods 100 patients with upper urinary tract stones who underwent RIRS treatment in our hospital from January 2021 to December 2021 were selected as the study subjects,and they were divided into the control group(body temperature of<37℃,n=68)and an the observation group(body temperature of≥37℃and/or positive urine bacterial culture,n=32)according to the changes in body temperature and bacterial culture results within 24 hours after surgery.Serum levels of PCT,C-reactive protein(CRP)and WBC were measured and compared before and after surgery between the two groups,and the diagnostic efficacy of PCT,CRP,and WBC in predicting postoperative infection was analyzed.Results After operation,the levels of PCT,CRP and WBC of the two groups were higher than those before operation,the observation group were higher than the control group,the differences were statistically significant(P<0.05).The AUC of PCT,CRP and WBC in the diagnosis of RIRS postoperative infection were 0.893,0.721 and 0.708,respectively,and the cutoff values were 1.75μg/L,40.15 g/L and 69.12%,respectively,all of which had certain diagnostic value;the sensitivity and specificity of PCT in the diagnosis of RIRS postoperative infection were higher than WBC,and the specificity was higher than CRP,the differences were statistically significant(P<0.05).Conclusion PCT has high sensitivity and specificity in predicting postoperative infection after RIRS,which can improve the accuracy of infection diagnosis after RIRS,help to guide clinical diagnosis and treatment,timely control condition of patient,and improve their prognosis.

关 键 词：输尿管软镜碎石取石术 术后感染 降钙素原 C反应蛋白 

分 类 号：R691.4[医药卫生—泌尿科学]