术前血清IL-6和降钙素原二联检测联合智能控压输尿管软镜碎石术治疗输尿管上段结石的疗效  

Clinical efficacy of preoperative detection of serum interleukin-6 and procalcitonin combined with intelligent pressure-controlled flexible ureteroscopic lithotripsy intreatmentof upper ureteral calculi

作　　者：黄欣坤 刘坤[2] 刘浩 杨焱邦 徐坚 陈志永 HUANG Xinkun;LIU Kun;LIU Hao;YANG Yanbang;XU Jian;CHEN Zhiyong(Department of Urology,Affiliated Shuyang Hospital,Xuzhou Medical University,Shuyang 223600,CHINA)

机构地区：[1]徐州医科大学附属沭阳医院泌尿外科,江苏沭阳223600 [2]南京医科大学附属淮安第一医院泌尿外科

出　　处：《江苏医药》2024年第11期1155-1158,共4页Jiangsu Medical Journal

基　　金：淮安市卫生健康科研立项项目(HAWJ202002)。

摘　　要：目的 探讨术前血清IL-6和降钙素原检测联合智能控压输尿管软镜碎石术治疗输尿管上段结石的有效性与安全性。方法 120例输尿管上段结石患者随机分为四组,每组30例。检测+控压组术前接受血清IL-6和降钙素原检测并行智能控压输尿管软镜碎石术;控压组行智能控压输尿管软镜碎石术;检测组术前接受血清IL-6和降钙素原检测并行常规输尿管软镜碎石术;对照组行常规输尿管软镜碎石术。比较检测+控压组和检测组中不同感染状态患者术前血清IL-6和降钙素原水平。比较四组患者手术相关指标、术后1d血常规和血浆CRP水平以及术后1d和1个月的结石清除率。结果 检测+控压组和检测组术前中段尿培养阳性和术后1d白细胞计数升高患者的血清IL-6水平分别高于阴性和正常患者(P<0.05),术后发热患者的术前血清IL-6和降钙素原水平均高于未发热患者(P<0.05)。检测+控压组和控压组手术时间短于检测组和对照组,检测+控压组住院时间短于对照组(P<0.05)。检测+控压组和控压组术后1d和1个月的结石清除率均高于检测组和对照组(P<0.05)。检测+控压组术后1d白细胞计数、中性粒细胞计数和血浆CRP水平均低于其他三组(P<0.05)。结论 术前检测血清IL-6和降钙素原可能与输尿管上段结石患者围手术期的感染状态相关,联合智能控压输尿管软镜碎石术可安全、有效地治疗输尿管上段结石。Objective To explore the clinical efficacy and safety of preoperative detection of serum interleukin-6°(IL-6)and procalcitonin(PCT)combined with intelligent pressure-controlled flexible ureteroscopic lithotripsy(FURL)in the treatment of upper ureteral calculi.Methods A total of 120 patients with upper ureteral calculi were randomly divided into four groups with 30 cases each.Group A received preoperative detection of serum IL-6 and PCT combined with intelligent pressure-controlled FURL.Group B received intelligent pressure-controlled FURL.Group C received preoperative detection of serum IL-6 and PCT combined with conventional FURL.Group D received conventional FURL.The preoperative serum levels of IL-6 and PCT were compared among the patients with different infection states in groups of A and C.The surgery-related indicators,routine blood test and plasma CRP level at one day after operation,and stone clearance rate at one day and one month after operation were compared among the four groups.Results,The serum IL-6 level in the patients with positive urine culture before surgery and elevated white blood cell count at one day after operation were higher than those in negative and normal patients in groups of A and C(P<o.05),respectively.The serum levels of IL-6 and PCT were increased in the patients with postoperative fever than those without fever in groups of A and C(P<0.05).The surgical time in groups of A and B was shorter than that in groups of C and D,and the hospital stay in group A was shorter than that in group D(P<0.05).The stone clearance rate in groups of A and B was higher than that in groups of C and D at one day and one month after operation(P<0.05).The white blood cell count,neutrophil count and plasma CRP level in group A were lower than those in the other three groups at one day after operation(P<0.05).Conclusion Preoperative detection of serum IL-6 and PCT may be closed related to perioperative infection status of the patients,which combined with intelligent pressure-controlled FURL can safely an

关 键 词：输尿管上段结石 智能控压输尿管软镜碎石术 白细胞介素-6 降钙素原 

分 类 号：R699[医药卫生—泌尿科学]