输尿管结石患者输尿管镜钬激光碎石术后感染PCT与CRP检测及感染状况分析

Detection of PCT and CRP in patients with ureterolithiasis after holmium laser lithotripsy

目的研究输尿管结石患者输尿管镜钬激光碎石术后感染降钙素原(procalcitonin,PCT)、C-反应蛋白(C-reactive protein,CRP)水平检测及感染情况。方法选取2017年9月至2019年1月本院接诊的130例输尿管结石伴狭窄患者作为研究对象。按照感染情况随机分为感染组(n=15)和非感染组(n=115)。鉴定感染组患者病原菌种类与耐药性,比较两组患者尿液CRP、PCT水平。结果输尿管镜钬激光碎石术后130例患者中有15例患者出现感染,感染率为11.54%。输尿管结石术后感染的13例患者中,分离病原菌17株,其中分离出革兰阴性菌最多,共计10株(58.82%),其次为革兰阳性菌6株(35.29%)。革兰阴性菌中,80.00%的大肠埃希菌对头孢哌酮耐药,80.00%铜绿假单胞菌对头孢他啶耐药。革兰阳性菌中,70.00%肠球菌属对青霉素耐药、62.53%金黄色葡萄球菌对青霉素耐药、62.50%对红霉素耐药。感染组患者CRP、PCT水平明显高于未感染组CRP、PCT水平,差异有统计学意义(P<0.05)。结论输尿管结石行钬激光碎石术患者术后病原菌感染多以革兰阴性菌为主,且感染患者尿液中CRP、PCT水平明显升高。

Objective To study the detection of PCT and CRP levels and infection in patients with ureteral calculi after ureteroscopic holmium laser lithotripsy. Methods 130 cases of ureteral calculi with stricture in our hospital from September 2017 to January 2019 were selected as the study subjects. According to the infection situation, they were randomly divided into infection group(n=15) and non-infection group(n=115).Pathogenic bacteria and drug resistance were identificated in the infected group, and urine CRP, PCT levels were compared between the two groups. Results Among 130 cases of ureteroscopic holmium laser lithotripsy, 15 cases had infection, the infection rate was 11.54%. Among 13 patients with ureteral calculi infection after operation, 17 strains of pathogenic bacteria were isolated, of which 10 strains(58.82%) were Gram-negative bacteria, and 6 strains(35.29%) were Gram-positive bacteria. Among the gram-negative bacteria, 80.00% of Escherichia coli were resistant to cefoperazone and 80.00% of Pseudomonas aeruginosa were resistant to ceftazidime. Among the Gram-positive bacteria, 70.00% of Enterococcus were penicillin-resistant, 62.53% of Staphylococcus aureus were penicillin-resistant and 62.50% were erythromycin-resistant. The levels of CRP and PCT in the infected group were significantly higher than those in the uninfected group(P<0.05). Conclusion Gram-negative bacteria were the main pathogenic bacteria after holmium laser lithotripsy for ureteral calculi, and the levels of CRP and PCT in urine were significantly increased.