Guiding Value Of Inflammatory Mediators Spectrum Combined With Procalcitonin In The Treatment Of Ureteral Calculi Complicated With Urosepsis

ObjectiveTo evaluate the value of inflammatory mediators combined with procalcitonin in the perioperative safe management of ureteral nodules with urogenital sepsis according to the Sepsis 3.0,the European diagnostic standard for sepsis in 2016.MethodsThe clinical data of 90 cases of ureteral calculi admitted between June 2017 and June 2019 in Hunan Provincial People's Hospital was collected,and 32 patients with urogenital sepsis after ureteral calculi were selected as the study group.58 patients with urogenic sepsis served as a control group.The clinical data and perioperative biochemical indexes of the two groups of patients was analyzed and compared,and multiple logistic regression was used to analyze the risk factors associated with urinary sepsis.Results1.In the single factor analysis of clinical data,the results showed that 5factors were statistically significant(P<0.05),including the patient's age,history of previous stone surgery,history of hypertension,positive urine bacterial culture before surgery,and unused before surgery antibiotic.2.Serum IL-4,IL-6,IL-10,TFN-?,IFN-?,CRP,PCT indexes of ureterogenic sepsis group before ureteral calculi were significantly higher than that of non-septic group,and the difference between the two groups was significant(P<0.05);the plasma inflammatory mediators,CRP,PCT indicators in the urogenital sepsis group after ureteral calculi were higher than those in the non-septic group,and the difference between the two groups was significant(P<0.05).3.Multivariate Logistic regression analysis showed that preoperative PCT and preoperative IL-6 may be a risk factor for urinary-derived sepsis after ureterostomy.Conclusion1.The occurrence of urinary sepsis after ureteral calculi is related to the patient's age,hypertension,positive urine culture before surgery,no antibiotics before surgery,and history of previous stone surgery.2.The combined detection of inflammatory mediator spectrum and plasma procalcitonin level is helpful for the early diagnosis of urinary sepsis after ureteral calculi,and it has guiding significance for the diagnosis of urinary sepsis.3.The increase of IL-6 and PCT is an important signal that will cause urosepsis after ureteral calculi.