The Predictive And Diagnostic Ability Of Multiple Inflammatory Markers For Postoperative Urosepsis In Patients Undergoing Ureteroscopic Lithoreipsy

Objective:To explore and evaluate the diagnostic efficacy and clinical application of white blood cells,neutrophil percentage,procalcitonin and interleukin-6 in early warning and diagnosis of urosepsis after ureteroscopic lithotripsy,so that it is able to provide a reference basis for early clinical diagnosis and intervention of urinary sepsis after ureteroscopic lithotripsy.Methods:This study collected the demographic and perioperative data of 141 patients with upper urinary tract stones treated with ureteroscopic lithotripsy from January 2020 to January 2021 in the Department of Urology,Shandong Provincial Hospital.These patients are divided into urosepsis Group(observation group)and non-urosepsis group(control group).This study collected and analyzed age,diabetes,hydronephrosis,pyuria,urine culture,urine nitrite,postoperative hospital stay of the two groups.The value of inflammatory biomarkers including IL-6,PCT,WBC,and neutrophil were tested preoperatively(T0),after two hours postoperatively(T1),and after one day postoperatively(T2),so that it can be used to evaluate the diagnostic efficacy of each inflammatory marker for urosepsis after ureteroscopic lithotripsy.Results:1.General clinical data:There were no statistically significant differences between observation group and control group in terms of age,diabetes,hydronephrosis,pyuria,urine culture,and urine nitrite.The average length of hospital stay of observation group was higher than that of control group,and it was statistically significant.2.The comparison of inflammatory markers among groups:(1)Univariate analysis showed no significant difference in the serum levels of IL-6,PCT,WBC,and neutrophil between observation group and control group preoperatively(T0).(2)After two hours postoperatively(T1),univariate analysis showed no significant difference in the serum levels of PCT and WBC between observation group and control group,while there were significant differences in the serum levels of neutrophil and IL-6 between observation group and control group.(3)After one day postoperatively(T2),univariate analysis showed no significant difference in the serum levels of WBC between observation group and control group,while there were significant differences in the serum levels of neutrophil,IL-6 and PCT between observation group and control group.3.The comparison of inflammatory markers intra groups:(1)In the observation group,the level of WBC at T2 was higher than which at T1;the level of neutrophil at T1 and T2 was higher than which at T0;the level of PCT at T1 was higher than which at T0,and the level of PCT at T2 was higher than which at T1;the level of IL-6 at T1 was higher than which at T0,and the level of IL-6 at T2 was lower than which at T1.(2)the level of WBC at T1 was higher than which at T0,and the level of WBC at T2 was higher than which at T1;the level of neutrophil at T1 and T2 was higher than which at T0;the level of PCT at T1 and T2 was higher than which at T0;the level of IL-6 at T1 was higher than which at T0,and the level of IL-6 at T2 was lower than which at T1.Conclusions:IL-6,PCT,WBC and neutrophil have different ability to diagnose postoperative urosepsis in patients undergoing ureteroscopic lithotripsy.All of four inflammatory markers can not predict the occurrence of postoperative urosepsis preoperatively(T0).After two hours postoperatively(T1),WBC and PCT are not suitable for diagnosing urosepsis,while neutrophil and IL-6 increase significantly in patients with urosepsis,especially IL-6 is extremely valuable in the prediction and early diagnosis of urosepsis.After one day postoperatively(T2),WBC has little diagnostic value for postoperative urinary sepsis,while neutrophil,IL-6 and PCT increase significantly in patients with urosepsis,especially IL-6 and PCT have excellent diagnostic efficiency.