| Objective:By collecting clinical cases and conducting postoperative follow-up,we analyzed the changes of blood routine white blood cell count,procalcitonin(PCT),interleukin-6(IL-6)in urine culture negative percutaneous nephrolithotomy patients before and after operation,and then investigated the early warning significance and clinical value of the changes for preventing the occurrence of urosepsis.Method: from January 2019 to January 2022,144 patients with kidney stones who met the research criteria and underwent percutaneous nephrolithotomy and lithotripsy in the second Department of Urology of Gansu Provincial People’s hospital were selected and retrospectively analyzed,including 101 males and 43 females,with an average age of(44.66± 14.11)years.The stones were located in the left kidney in 75 cases and in the right kidney in 69 cases.The average maximum diameter of the stones was(2.13 ± 0.54)cm.Among them,9 cases of ipsilateral calculi in the same patient underwent secondary surgery,6 cases of bilateral kidney stones in the same patient underwent fractional surgery,including 1 case of horseshoe kidney complicated with kidney stones,2 cases of patients with underlying disease hypertension and high blood pressure monitored after admission but failed to effectively control,5 cases of patients with underlying disease diabetes and high blood glucose monitored after admission but failed to effectively control,2 cases of patients with idiopathic thrombocytopenia complicated with kidney stones,According to the patient’s condition,all patients were given symptomatic treatment before operation,so that the blood pressure,blood glucose,platelets and other conditions were relatively stable.The urine culture results of all patients were negative before operation,and 1 case of Candida glabrata and 1 case of Pseudomonas aeruginosa in the urine culture results after operation.Urinary sepsis occurred in 14 cases after operation.At the same time,according to the urine routine examination results of all patients after admission,patients with urinary tract infection were given antibiotic anti infection treatment before operation,lasting for 3-5 days,and the urine routine and urine culture were reviewed.All relevant examinations of patients were improved before operation,and it was clear that there was no contraindication of corresponding operation,and then surgical treatment was carried out.All patients were placed in the lithotomy position first,and the ureteral catheter was placed in the renal pelvis along the ureter in advance,and then the patient was changed to the prone position suitable for PCNL surgery.The blood routine white blood cell count,PCT and IL-6 of 144 patients before and after operation were summarized,and the patients were divided into sepsis group and non sepsis group according to whether there was urinary sepsis,and the related indicators were statistically analyzed.Results:According to the statistical results,gender differences were found to be statistically significant;There were significant differences in routine white blood cells,interleukin-6,procalcitonin,and creatinine between sepsis groups;There were significant differences in routine white blood cells,interleukin-6,procalcitonin,urea,and creatinine between the non sepsis group;There were significant differences(P < 0.05)in routine white blood cells,interleukin-6,and procalcitonin in postoperative blood between sepsis and non sepsis groups,which were exploratory.Conclusion:In this study,we compared the values of blood routine white blood cell(WBC)count,PCT,and IL-6 in patients who developed urosepsis and those who did not,after percutaneous nephrolithotomy for renal stones with negative urine culture,and concluded that the above inflammatory indexes have clear clinical significance and can be used as an early warning and monitor for the occurrence,development,and prognosis of urosepsis,And enable accurate assessment of the patient’s current condition.Second,by analyzing the corresponding indicators,we can guide the rational application of preoperative antimicrobials and effectively reduce or avoid the possibility of postoperative urogenic sepsis,which is compliant with the concept of "" rapid recovery "",and beneficial to the early rehabilitation of patients and treatment safety.Again,the related indicators are common clinical use indicators,most hospitals can carry out,and inspection is inexpensive and sample acquisition is easy to operate,which can reduce the financial burden on patients and save medical costs,so that both doctors and patients profit,and have good promotion value. |
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