本文選題：經(jīng)皮腎鏡碎石術(shù) + 尿膿毒血癥��； 參考：《青島大學(xué)》2014年碩士論文

【摘要】：目的：探討通過監(jiān)測血漿降鈣素原(procalcitonin, PCT)水平對于早期診斷繼發(fā)于經(jīng)皮腎鏡碎石術(shù)(percutaneous nephrolithotomy, PCNL)的尿膿毒血癥的臨床意義。 方法：回顧性分析青島大學(xué)附屬醫(yī)院泌尿外科住院部2012年1月至2013年11月收治的復(fù)雜上尿路結(jié)石并行PCNL手術(shù)患者共98例,按照2013年歐洲泌尿外科學(xué)會指南(EAU Guidelines)對尿膿毒血癥的診斷標(biāo)準(zhǔn)分為觀察組(PCNL術(shù)后繼發(fā)尿膿毒血癥)48例和對照組(PCNL術(shù)后未出現(xiàn)尿膿毒血癥)50例,回顧性分析兩組患者術(shù)前、術(shù)后6h內(nèi)、術(shù)后24h所檢測的血漿PCT和C-反應(yīng)蛋白(c-reactive protein, CRP)水平,計算兩組數(shù)據(jù)均數(shù)、標(biāo)準(zhǔn)差,組內(nèi)數(shù)據(jù)統(tǒng)計分析采用配對t檢驗,P0.05為差異具有統(tǒng)計學(xué)意義；組間數(shù)據(jù)統(tǒng)計分析采用成組t檢驗,P0.05為差異具有統(tǒng)計學(xué)意義；評價PCT和CRP對尿膿毒血癥的診斷效能采用受試者工作特征曲線(ROC曲線),計算ROC曲線下面積(AUC),對AUC比較采用Z檢驗,P0.05為差異具有統(tǒng)計學(xué)意義,并分析PCT和CRP對尿膿毒血癥的診斷敏感度、特異度以及最佳截斷點(diǎn)(臨界值)。 結(jié)果：兩組患者術(shù)前PCT、CRP水平均在正常范圍,組內(nèi)、組間比較均無統(tǒng)計學(xué)意義(P0.05)；觀察組48例患者均于術(shù)后6h內(nèi)出現(xiàn)尿膿毒血癥,對觀察組和對照組患者的PCT、CRP水平進(jìn)行組內(nèi)比較,發(fā)現(xiàn)其均較術(shù)前升高(P0.05),進(jìn)行組間比較,發(fā)現(xiàn)觀察組PCT水平較對照組明顯升高(P0.01),而觀察組CRP亦較對照組升高(P0.05),但對兩項診斷指標(biāo)PCT和CRP的診斷效能進(jìn)行ROC曲線分析,結(jié)果顯示PCT的AUC較CRP的AUC大,差異比較具有統(tǒng)計學(xué)意義(P0.05)。 結(jié)論：PCNL術(shù)后疑似繼發(fā)尿膿毒血癥時,測定血PCT水平有助于對尿膿毒血癥的早期臨床診斷,PCT對尿膿毒血癥的診斷效能較CRP更高。
[Abstract]:Objective: to investigate the clinical significance of monitoring plasma procalcitonin (PCT) level in early diagnosis of urinary sepsis secondary to percutaneous nephrolithotripsy (PCNL). Methods: a retrospective analysis of 98 patients with complicated upper urinary calculi treated by PCNL from January 2012 to November 2013 was performed in the Department of Urology, affiliated Hospital of Qingdao University. According to the guidelines of the European Society of Urology (2013), Eau Guidelines-based criteria for the diagnosis of urinary sepsis were divided into observation group (n = 48) and control group (n = 50). The levels of plasma PCT and C-reactive protein (CRP) were measured within 6 hours and 24 hours after operation. The mean and standard deviation of the two groups were calculated. The statistical analysis of the data in the group was statistically significant by pairing t test (P0.05). There was statistical significance in statistical analysis of data between groups by using group t test (P0.05). To evaluate the effectiveness of PCT and CRP in the diagnosis of urinary sepsis the ROC curve was used to calculate the area under the ROC curve and the area under the ROC curve was calculated. There was significant difference in AUC using Z test (P0.05). The sensitivity, specificity and optimal cut-off point of PCT and CRP in the diagnosis of urinary sepsis were analyzed. Results: the preoperative levels of PCTnCRP in both groups were in the normal range, and there was no significant difference between the two groups, while in the observation group, the urinary sepsis was found in 48 patients within 6 hours after operation, and the levels of PCTnc-CRP in the observation group and the control group were compared. It was found that the level of PCT in the observation group was significantly higher than that in the control group, and the CRP in the observation group was also higher than that in the control group. However, the diagnostic efficacy of two diagnostic indexes, PCT and CRP, was analyzed by ROC curve analysis. The results showed that the AUC of PCT was larger than that of CRP, and the difference was statistically significant (P 0.05). Conclusion determination of blood PCT level is helpful to the early clinical diagnosis of urinary sepsis in patients with suspected secondary sepsis after urine PCNL. PCT is more effective than CRP in the diagnosis of urinary sepsis.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R699.2

【參考文獻(xiàn)】

相關(guān)期刊論文 前5條

1 陳文靜;曲彥;胡丹;;外源性清蛋白輸入對ARDS小鼠CRP和前降鈣素影響[J];青島大學(xué)醫(yī)學(xué)院學(xué)報;2009年03期

2 孔萬權(quán);莊榮;魏大臻;龔裕強(qiáng);王征;孫來芳;陳大慶;;降鈣素原與血清C-反應(yīng)蛋白聯(lián)合測定對嚴(yán)重多發(fā)傷患者早期細(xì)菌感染的診斷價值[J];重慶醫(yī)學(xué);2009年16期

3 郭衛(wèi)紅;宋宏先;安艷芳;;血清降鈣素原的測定及在臨床中的應(yīng)用[J];國際檢驗醫(yī)學(xué)雜志;2010年02期

4 謝健敏;盧解紅;余一海;;血清降鈣素原對危重患者感染的預(yù)測價值[J];廣東醫(yī)學(xué);2013年02期

5 呂煒;崔文珍;李貴玲;韓崇旭;;中段尿培養(yǎng)病原菌分布與耐藥性變遷[J];中華醫(yī)院感染學(xué)雜志;2013年08期

，

本文編號：2049940