尿膿毒血癥的早期診斷及妊娠期尿膿毒血癥早期診治方法的臨床研究
發(fā)布時間：2019-02-19 08:43
【摘要】：研究目的1.檢測PCT、IL-6及CRP在尿膿毒血癥患者血清中的表達(dá)水平,探討PCT聯(lián)合IL-6、CRP檢測在尿膿毒血癥早期診斷中的應(yīng)用價值。2.探索妊娠期尿膿毒血癥的早期快速診斷方法及臨床合理有效的治療方案,保障妊娠期婦女及胎兒的安全與健康。研究方法1.選取2014年9月~2016年12月因尿路感染在我院接受治療的105例患者的臨床資料,將其分為3組,其中急性膀胱炎組患者30例,男性14例,女性16例,年齡38—54歲;尿膿毒血癥組患者55例,男性25例,女性30例,年齡49—68歲;尿膿毒血癥并發(fā)休克組患者20例,男性11例,女性9例,年齡55—74歲。統(tǒng)計各組患者治療前后血常規(guī)NEU百分比、尿常規(guī)WBC計數(shù)、PCT、IL-6及CRP表達(dá)水平的變化,繪制ROC曲線評價各個炎癥指標(biāo)及多指標(biāo)聯(lián)合檢測在尿膿毒血癥早期診療應(yīng)用中的價值。2.分析2010年1月至2016年12月于我泌尿外科中心接受治療的32例妊娠期尿膿毒癥患者的臨床資料,年齡23—31歲,孕周21—30周;選取32例同期入院的妊娠期急性膀胱炎患者為對照組,年齡22—32歲,孕周20—29周,比較兩組患者治療前后的血常規(guī)中性粒細(xì)胞百分比、尿常規(guī)白細(xì)胞計數(shù)以及PCT、IL-6及CRP表達(dá)水平的變化,評價各個炎癥指標(biāo)在妊娠期尿膿毒血癥早期診斷應(yīng)用中的價值,總結(jié)妊娠期尿膿毒血癥的有效治療方法。研究結(jié)果1.血清PCT、IL-6和CRP的表達(dá)水平在尿膿毒血癥組、尿膿毒血癥并發(fā)休克組與急性膀胱炎組相比均有統(tǒng)計學(xué)差異(P0.05);PCT與其他指標(biāo)相比,單指標(biāo)的診斷價值最大;PCT聯(lián)合IL-6、CRP檢測優(yōu)于單一指標(biāo)檢測的診斷價值。2.妊娠期尿膿毒血癥組與急性膀胱炎組相比,血清PCT、IL-6及CRP的表達(dá)水平均有統(tǒng)計學(xué)差異(P0.05),三種炎癥指標(biāo)聯(lián)合應(yīng)用優(yōu)于血常規(guī)NEU百分比及尿常規(guī)WBC計數(shù)的診斷價值。雙J置入術(shù)后3天及7天分別與治療前相比血常規(guī)NEU百分比、尿常規(guī)WBC計數(shù)、PCT、IL-6及CRP的數(shù)值均下降,各個炎癥指標(biāo)數(shù)值下降的幅度均有統(tǒng)計學(xué)差異(p0.05)。結(jié)論1.PCT、IL-6及CRP在尿膿毒血癥診斷方面優(yōu)于血常規(guī)NEU百分比及尿常規(guī)WBC計數(shù),單一PCT應(yīng)用有較高的診斷價值。PCT、IL-6及CRP聯(lián)合檢測有助于尿膿毒血癥的早期診斷,對評價尿路感染的嚴(yán)重程度有一定的臨床意義。2.PCT及IL-6、CRP檢測有助于妊娠期尿膿毒血癥的早期診斷,對評價感染的嚴(yán)重程度及療效有一定的臨床指導(dǎo)意義。中晚期妊娠期尿膿毒血癥的患者,適時的腔道手術(shù)治療及雙J管置入術(shù),可解除梗阻,利于感染控制。
[Abstract]:Objective 1. To detect the expression of PCT,IL-6 and CRP in serum of patients with urinary sepsis and to explore the value of PCT combined with IL-6,CRP in the early diagnosis of urinary sepsis. 2. To explore the early rapid diagnosis and clinical effective treatment of urinary sepsis in pregnancy to ensure the safety and health of pregnant women and fetuses. Method 1. The clinical data of 105 patients treated with urinary tract infection from September 2014 to December 2016 were divided into three groups: 30 patients with acute cystitis, 14 males and 16 females aged 38-54 years. There were 55 patients with urosepsis, 25 males and 30 females aged 49-68 years, and 20 patients with sepsis complicated with shock, 11 males and 9 females aged 55-74 years. The changes of blood routine NEU percentage, urine routine WBC count, PCT,IL-6 and CRP expression were analyzed before and after treatment. To evaluate the value of ROC curve in the early diagnosis and treatment of urinary sepsis. To analyze the clinical data of 32 cases of gestational urinary sepsis treated in our urology center from January 2010 to December 2016, aged 23-31 years, 21-30 weeks of gestational age; Thirty-two patients with acute cystitis complicating pregnancy, aged 22-32 years and 20-29 weeks of gestation, were selected as control group. The percentage of neutrophils, urine leukocyte count and PCT, before and after treatment were compared between the two groups. The changes of IL-6 and CRP expression, the value of various inflammatory indexes in early diagnosis of urinary sepsis during pregnancy was evaluated, and the effective treatment of urinary sepsis during pregnancy was summarized. Results 1. The levels of serum PCT,IL-6 and CRP were significantly higher in sepsis group, sepsis complicated shock group and acute cystitis group (P0.05); PCT compared with other indexes, the diagnostic value of single index was the greatest; The diagnostic value of PCT combined with IL-6,CRP is better than that of single index detection. 2. Compared with acute cystitis group, the expression of serum PCT,IL-6 and CRP in pregnant women with urinary sepsis were significantly different (P0.05). The combined use of the three inflammatory markers was superior to the diagnostic value of routine blood NEU percentage and urine routine WBC count. The percentage of blood routine NEU, urine routine WBC count, PCT,IL-6 and CRP were decreased 3 and 7 days after double J implantation, respectively. There was significant difference in the extent of the decrease of each inflammatory index (p0.05). Conclusion\ The detection of 2.PCT and IL-6,CRP is helpful to the early diagnosis of urinary sepsis in pregnancy and has a certain clinical significance in evaluating the severity and curative effect of infection. The patients with urinary sepsis in late pregnancy can be relieved of obstruction and infection control by timely surgical treatment of cavities and double J tube implantation.
【學(xué)位授予單位】：蘭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R714.258
本文編號：2426323
[Abstract]:Objective 1. To detect the expression of PCT,IL-6 and CRP in serum of patients with urinary sepsis and to explore the value of PCT combined with IL-6,CRP in the early diagnosis of urinary sepsis. 2. To explore the early rapid diagnosis and clinical effective treatment of urinary sepsis in pregnancy to ensure the safety and health of pregnant women and fetuses. Method 1. The clinical data of 105 patients treated with urinary tract infection from September 2014 to December 2016 were divided into three groups: 30 patients with acute cystitis, 14 males and 16 females aged 38-54 years. There were 55 patients with urosepsis, 25 males and 30 females aged 49-68 years, and 20 patients with sepsis complicated with shock, 11 males and 9 females aged 55-74 years. The changes of blood routine NEU percentage, urine routine WBC count, PCT,IL-6 and CRP expression were analyzed before and after treatment. To evaluate the value of ROC curve in the early diagnosis and treatment of urinary sepsis. To analyze the clinical data of 32 cases of gestational urinary sepsis treated in our urology center from January 2010 to December 2016, aged 23-31 years, 21-30 weeks of gestational age; Thirty-two patients with acute cystitis complicating pregnancy, aged 22-32 years and 20-29 weeks of gestation, were selected as control group. The percentage of neutrophils, urine leukocyte count and PCT, before and after treatment were compared between the two groups. The changes of IL-6 and CRP expression, the value of various inflammatory indexes in early diagnosis of urinary sepsis during pregnancy was evaluated, and the effective treatment of urinary sepsis during pregnancy was summarized. Results 1. The levels of serum PCT,IL-6 and CRP were significantly higher in sepsis group, sepsis complicated shock group and acute cystitis group (P0.05); PCT compared with other indexes, the diagnostic value of single index was the greatest; The diagnostic value of PCT combined with IL-6,CRP is better than that of single index detection. 2. Compared with acute cystitis group, the expression of serum PCT,IL-6 and CRP in pregnant women with urinary sepsis were significantly different (P0.05). The combined use of the three inflammatory markers was superior to the diagnostic value of routine blood NEU percentage and urine routine WBC count. The percentage of blood routine NEU, urine routine WBC count, PCT,IL-6 and CRP were decreased 3 and 7 days after double J implantation, respectively. There was significant difference in the extent of the decrease of each inflammatory index (p0.05). Conclusion\ The detection of 2.PCT and IL-6,CRP is helpful to the early diagnosis of urinary sepsis in pregnancy and has a certain clinical significance in evaluating the severity and curative effect of infection. The patients with urinary sepsis in late pregnancy can be relieved of obstruction and infection control by timely surgical treatment of cavities and double J tube implantation.
【學(xué)位授予單位】：蘭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R714.258
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