术前尿白细胞计数及中段尿培养与输尿管镜术后全身炎症反应综合征的关系

527200广东,罗定市人民医院泌尿外科 1;510530广州,中山大学附属第三医院岭南医院泌尿外科 2

全身炎症反应综合征;输尿管镜;尿白细胞;尿培养

Correlations between preoperative mid-stream urine culture, urine white cell and postoperative systemic inflammatory response syndrome of ureteroscopic Holmium laser lithotripsy
Luo Likuang1, Zhan Hailun2 ,Liao Weiqiang1, Liu Chuangming1.

Department of Urology, Luoding People's Hospital, Guangdong 527200(,)China; 2Department of Urology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510530, China.

Systemic inflammatory response syndrome; Ureteroscopy; Urine white cell; Urine culture

DOI: 10.3877/cma.j.issn.1674-3253.2016.02.012

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目的 探讨术前尿白细胞计数及中段尿培养与输尿管镜术后全身炎症反应综合征(SIRS)的关系。方法 回顾性分析 2011年 1月至 2015年 6月输尿管镜钬激光碎石取石术治疗输尿管中下段结石的临床资料,所有病例术前均行尿常规、中段尿细菌培养及使用抗生素,分析评价术前尿常规、中段尿培养与输尿管镜术后 SIRS之间的关系。结果 452例输尿管结石患者输尿管镜钬激光碎石取石术均获成功。术前尿常规 381例患者尿沉渣白细胞计数升高,其中 61例术后发生 SIRS,尿白细胞计数阳性患者术后 SIRS发生率与阴性者相比,差异无统计学意义( P=0.861),以尿白细胞计数阳性来预测术后 SIRS的敏感度为 16.0%,特异度为 83.1%。中段尿培养阳性者 102例,其中 20例术后发生 SIRS,中段尿培养阳性患者术后 SIRS发生率与阴性者相比,差异无统计学意义( P=0.287),以尿培养来预测术后 SIRS的敏感度为 19.6%,特异度为 84.9%。结论 在应用抗生素情况下,术前尿白细胞计数和尿培养与输尿管镜钬激光碎石取石术后 SIRS的发生之间无明显相关性,不是有效的预测指标,但由于样本量较少,结论还需更多临床病例和严格前瞻性临床试验进一步检验。
Objective To explore the relationship between preoperative mid-stream urine culture, urine white cell and postoperative systemic inflammatory response syndrome (SIRS) of ureteroscopic Holmium laser lithotripsy. Methods The clinical data of patients who underwent ureteroscopic Holmium laser lithotripsy from January 2011 to June 2015 was analyzed retrospectively. Preoperative mid-stream urine culture and urine white cell were done and all patients were treated with antibiotics before operation. The relationship between preoperative mid-stream urine culture, urine white cell and SIRS were analyzed. Results 452 patients with ureteral calculi were successfully underwent ureteroscopic Holmium laser lithotripsy. 381 patients had a positive urine white cell and 61 patients developed SIRS. There was no statistical difference between positive and negative urine white cell groups in terms of SIRS (P=0.861). The sensitivity and specificity of using urine white cell to determine the onset of SIRS were 16.0% and 83.1%. 102 patients had a positive urine culture and 20 patients developed SIRS. There was no statistical difference between positive and negative urine culture groups in terms of SIRS (P=0.287). The sensitivity and specificity of using urine white cell to determine the onset of SIRS were 19.6% and 84.9%. Conclusion s There is no obvious correlation between preoperative mid-stream urine culture, urine white cell and postoperative SIRS in patients undergoing ureteroscopic holmium laser lithotripsy when antibiotics were used. They were not efficient indicators for SIRS. However the conclusion still need more clinical cases and prospective clinical trials to test because of small sample size.
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