《中国期刊全文数据库》收录期刊
《中国核心期刊(遴选)数据库》收录期刊
《中文科技期刊数据库》收录期刊

Surgical Research and New Technique ›› 2015, Vol. 4 ›› Issue (3): 145-148.

Previous Articles     Next Articles

The value of procalcitonin monitoring in early diagnosis and therapy of postoperative septic shock of upper urinary tract stones surgery

  

  • Received:2015-07-21 Revised:2015-08-23 Online:2015-09-28 Published:2015-10-08

Abstract: [Abstract] Objective To explore the value of procalcitonin monitoring in the early diagnosis and prognosis of postoperative septic shock of upper urinary tract stones endoscopic surgery. Methods From Jun 2012 to Dec 2013, 1027 patients undergoing minimally invasive percutaneous nephrolithotomy lithotomy or ureterscopy lithotripsy were prospective studied, the clinical data of patients with postoperative septic shock were analyzed. Procalcitonin, routine blood and blood biochemical indexes were detected at postoperative 4 h and 8 h. Useing PCT≥10ng/ml at 4 h after surgery as a threshold. Choosing the third generation cephalosporins or carbapenems at the early stage and taking active anti-shock treatmen. According to the results of bacterial culture, useing low-level antibiotics when PCT continues to decrease to < 2 ng/m at postoperative 48h, also, to strengthen support for treatment in patients with higher PCT level. Results Septic shock occurred in 7 cases, and 6 cases of septic shock in 12 patients whose PCT≥10ng/ml at postoperative 4h, PCT has a higher diagnostic sensitivity (85.7%) and specificity (99.4%) than c-reactive protein and white blood cells. PCT 27.8±18.4 ng/ml at postoperative 4 h and PCT 42.2±29.7 ng/ml at postoperative 48h, the difference is statistically significant(P<0.05). All cases were improved and discharged after active treatment according to the above principles when PCT decrease to <2 ng/ml on postoperative 8.4±4.2 d. The antibiotics use density and hospital stay of patients with higher PCT are stronger and longer than other patients. Conclution The monitoring of PCT has significant value in the early diagnosis and prognosis of postoperative septic shock of upper urinary tract stones surgery. Actively treating in earlier period and adjusting the dosage according to PCT level is beneficial to the outcome of septicshock.

Key words: procalcitonin, upper urinary tract stones, septic shock