The Study On The Value Of The Bacterial Culture Results Of Stones And Pelvic Urine In Predicting The Post-PCNL SIRS

ObjectiveTo determine the correlation among preoperative midstream urine、interoperate pelvic urine and the cultural results of bacterial stones ofpercutaneous nephrolithotomy(PCNL), and also ascertained the clinicalsignificance of stone culture and pelvic urine culture in PCNL.Methodspatients undergoing PCNL from July2011to February2012were chosen,who fulfilled our selection criteria. Midstream urine was cultured preoperativelyand the samples, including stones and pelvic urine, were collected for bacterialculture during operation. all correlative factors of SIRS were monitoredpostoperatively，including the heart rate, respiratory rate,patients’ temperature,white cell count and arterial carbon dioxide Pressure.ResultsA total of58patients fulfilled the selection criteria of study. Midstream urineculture was positive in13.8%of cases, pelvic urine culture was positive in 22.4%and stone culture was positive in24.1%. The most prevalent bacterialculture results was Escherichia. The positive rate of midstream urine culturalhad no statistically obvious difference between infection stones andnon-infection stones (P＞0.05). The incidence of positive pelvic urine culture ofthe patients with infection stones was significantly higher than those withnon-infection stones and the difference was statistically significant(P＜0.01).37.9%patients developed SIRS and2patients suffered septic shock. The rate ofSIRS in the patients with infected stones and in those without infected stoneswas obviously different, and the difference was statistically significant(P＜0.01).The rate of SIRS in the patients with positive pelvic urine culture and in thosewithout positive pelvic urine culture was also obviously different (P＜0.01). Thepositive midstream urine culture did not predict the post-PCNL SIRS（P>0.05）.conclusionsThe prevalent culture positive specimen were stone culture and pelvic urineculture, which were significantly higher than preoperative midstream urineculture. The preoperative midstream urine culture can not effectively reflect thebacterial culture results of stones and pelvic urine. The incidence of SIRS wasrelated to positive pelvic urine culture and infected stones，and the positive stoneculture and pelvic urine culture were better predictors of the post-PCNL SIRSthan midstream urine culture.