经皮肾镜手术治疗肾结石并发感染患者的疗效及CRP、PCT水平变化研究

Study on the effects of percutaneous nephrolithotomy in patients with nephrolith complicated with infection and the changing of CRP and PCT

目的探讨肾结石并发感染患者采用经皮肾镜手术的临床疗效,观察手术前后患者CRP、PCT水平的变化,为临床治疗提供一定的指导依据。方法选择2016年7月-2018年11月本院泌尿外科接诊的肾结石并发感染患者100例作为研究对象,所有患者均使用经皮肾镜手术进行治疗,观察患者术前、术后血清C-反应蛋白(CRP)、降钙素原(PCT)水平检测及其阳性率,并对经皮肾镜手术治疗疗效进行评估分析。结果术后48 h患者血清CRP(7.32±0.57) mg/L、PCT(0.24±0.08)μg/L水平明显低于术前血清CRP(18.13±0.85) mg/L、PCT(0.75±0.23)μg/L和术后6 h血清CRP(8.96±0.71) mg/L、PCT(0.27±0.12)μg/L水平,差异有统计学意义(P<0.05);术后48 h患者CRP(53.00%)、PCT(17.00%)阳性率明显低于术前CRP(100.00%)、PCT(86.00%)和术后6 h CRP(76.00%)、PCT(34.00%),差异有统计学意义(P<0.05);患者术后临床疗效显著,总有效率高达90.00%,术后并发症发生率较低,仅有5.00%。结论经皮肾镜手术治疗肾结石并发感染疗效显著,可降低患者术后血清CRP、PCT水平及其阳性率、术后并发症发生率,结石清除率较高,安全性高且积极有效,值得在医院推广实施。

Objective To investigate the clinical effects of percutaneous nephrolithotomy in patients with nephrolith complicated with infection and the modification of CRP and PCT,and provide relevant guidance for clinical treatment.Methods 100 patients with nephrolith complicated with infection from and got treatment in urology surgery department of our hospital during July 2016 and November 2018 were selected as study subjects.All patients were treated with percutaneous nephrolithotomy. Serum C-reaction Protein( CRP),procalcitonin( PCT) levels and their positive rates of the patients were observed before and after surgery.The clinical efficacy of percutaneous nephrolithotomy was analyzed. Results 48 hours after the operation,the serum concentrations of CRP( 7.32±0.57) mg/L and PCT( 0.24±0.08) μg/L were significantly lower than preoperative serum CRP( 18.13±0.85) mg/L and PCT( 0.75±0.23) μg/L,and the serum CRP( 8.96±0.71) mg/L and PCT( 0.27±0.12) μg/L of6 h after operation,differences were statistically significant( P<0.05).48 hours after the operation,the positive rate of CRP( 53.00%) and PCT( 17.00) were significantly lower than preoperative positive rate of CRP( 100.00%) and PCT( 86.00%) and 6 h postoperative positive rate of CRP( 76. 00%) and PCT( 34. 00%),the differences were statistically significant( P<0.05).The treatment obtained obvious clinical efficacy,and the total effective rate was as high as 90.00%,the probability of postoperative complications is low,only 5.00%.Conclusions Percutaneous nephrolithotomy is effective in the treatment of patients with kidney stones complicated with infection,the levels of serum CRP,PCT and their positive rates and probability of postoperative complications are significantly decreased after surgery,with high stone clearance rate,the safety is high and it is active and effective,and it is worth promoting in the hospital.