摘要
目的分析输尿管结石患者术后尿道感染致脓毒症(简称尿源性脓毒症)的影响因素及外周血中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、降钙素原(PCT)的诊断价值。方法回顾性分析2017年2月-2020年1月于山西医科大学第一医院泌尿外科行输尿管镜钬激光碎石术治疗的输尿管结石患者508例的临床资料,根据术后尿源性脓毒症发生情况分为尿源性脓毒症组25例及非尿源性脓毒症组483例,比较两组术后12 h外周血NLR、PLR、PCT水平,使用受试者工作特征(ROC)曲线评估外周血NLR、PLR、PCT水平对输尿管结石患者术后尿源性脓毒症的诊断价值,并归纳输尿管结石患者术后发生尿源性脓毒症的影响因素。结果尿源性脓毒症组术后12 h外周血NLR、PLR、PCT水平均高于非尿源性脓毒症组(P<0.001)。经ROC曲线分析,发现术后12 h外周血NLR、PLR、PCT水平对输尿管结石患者术后尿源性脓毒症均具有较高诊断价值(P<0.05),其截断值分别为6.50、215.87、1.85 ng/ml。术前尿路感染、手术时间是输尿管结石患者术后发生尿源性脓毒症的影响因素(P<0.05)。结论引起输尿管结石患者术后发生尿源性脓毒症的高危因素较多,临床可积极监测外周血NLR、PLR、PCT水平,以尽早诊断尿源性脓毒症,及时予以针对性治疗。
OBJECTIVE To analyze the influencing factors of sepsis caused by postoperative urinary tract infection in patients with ureteral calculi and the diagnostic value of neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR) and procalcitonin(PCT).METHODS The clinical data of 508 patients with ureteral calculi underwent ureteroscopic holmium laser lithotripsy in department of urology of the First Hospital of Shanxi Medical University from Feb.2017 to Jan.2020 were retrospectively analyzed.According to the occurrence of postoperative urinary sepsis,the patients were divided into 25 cases in urinary sepsis group and 483 cases in non-urinary sepsis group.The peripheral blood NLR,PLR and PCT levels were compared between the two groups at 12 h after surgery.The receiver operating characteristic curve(ROC) was used to evaluate the value of peripheral blood NLR,PLR and PCT levels in the diagnosis of postoperative urinary sepsis in patients with ureteral calculi,and the influencing factors of occurrence of postoperative urinary sepsis in patients with ureteral calculi were summarized.RESULTS The levels of peripheral blood NLR,PLR and PCT in urinary sepsis group were significantly higher than those in non-urinary sepsis group at 12 h after surgery(P<0.001).ROC curve analysis found that the levels of peripheral blood NLR,PLR and PCT at 12 h after surgery had high diagnostic value for postoperative urinary sepsis in patients with ureteral calculi(P<0.05),and their cut-off values were 6.50,215.87 and 1.85 ng/ml,respectively.Preoperative urinary tract infection and operation time were the influencing factors of postoperative urinary sepsis in patients with ureteral calculi(P<0.05).CONCLUSION There were many high-risk factors that cause urinary sepsis in patients with ureteral calculi.The levels of peripheral blood NLR,PLR and PCT could be actively monitored in clinical practice to diagnose urinary sepsis as soon as possible and provided timely targeted treatment.
作者
孟娟
蔡宏瑜
张旭辉
杨华
黄亚妮
MENG Juan;CAI Hong-yu;ZHANG Xu-hui;YANG Hua;HUANG Ya-ni(Yuncheng Vocational Nursing College,Yuncheng,Shanxi 044000,China;不详)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2021年第20期3082-3085,共4页
Chinese Journal of Nosocomiology
基金
山西省重点研发计划科研基金资助项目(201803D121082)。
作者简介
孟娟(1979-),女,研究生,讲师,研究方向:泌尿系统疾病。
