血必净预防经皮肾镜取石术后全身炎症反应综合征的临床研究

目的观察血必净在肾结石合并泌尿系统感染患者皮肾镜取石术（PCNL）围术期的临床应用疗效及对术后预防全身炎症反应综合征（SIRS）发生的效果。方法选取60例采用PCNL治疗的肾结石合并泌尿系统感染患者为研究对象,采用数字法随机将患者分为两组,其中对照组30例围术期给予常规抗生素预防术后SIRS发生,观察组在对照组治疗基础上给予血必净50 mL加入500 mL 5%葡萄糖溶液静脉滴注,观察比较两组患者术后SIRS发生率及术后生命体征、实验室指标情况。结果观察组术后SIRS发生率为16.7%（5/30）,低于对照组36.7%（11/30）,脓毒症发生率为0,低于对照组10.0%（3/30）,MODS发生率为6.7%（2/30）,低于对照组23.3%（7/30）,观察组术后2,4,6 d在白细胞计数、C反应蛋白（CRP）、降钙素原（PCT）等方面均优于对照组,住院时间短于对照组,差异有统计学意义（P〈0.05）。结论采用血必净预防肾结石合并泌尿系统感染患者PCNL后发生SIRS临床效果显著,能够有效地改善患者临床指标,减少多器官功能障碍综合征（MODS）及脓毒症的发生,缩短住院时间,提高结石治疗效果,值得临床推广应用,PCT监测在PCNL中有重要的临床价值。

Clinical Study on Xuebijing Injection for the Prevention of Systemic Inflam-matory Response Syndrome after Percutaneous Nephrolithotomy Surgery

Objective To observe and analyze the clinical efficacy of Xuebijing during the perioperative period of percutaneous nephrolithotomy （PCNL） for patients with kidney stones and urinary tract infection and its effect on preventing the incidence of systemic inflammatory response syndrome（SIRS） after operation. Methods 60 cases with kidney stones complicated by urinary tract infection treated by PCNL were selected as the subjects and divided into two groups according to the digital method. 30 cases in the control group were given conventional antibiotics during the perioperative period for preventing the incidence of SIRS after operation, and the observation group was given Xuebijing 50mL added into 5% glucose solution 500mL for intravenous drip on the basis of the treatment given to the control group. The incidence of SIRS, vital signs and laboratory indicators after operation of the two groups were observed and compared. Results The incidence of postoperative SIRS of the observation group was 16.7% （5/30） , lower than the control group＇s 36.7% （11/30）; the incidence of sepsis was 0, lower than 10.0% of the control group （3/30）; MODS rate was 6.7% （2/30）, lower than the control group＇s 23.3%（7/30）; the leucocyte count, C-reactive protein（CRP）, procalcitonin（PCT） of the observation group 2, 4, 6d after operation were better than those of the control group, the length of stay was shorter than that of the control group, the differences were statistically significant （P〈0.05）. Conclusion Xuebijing has significant clinical effect on preventing the incidence of SIRS after PCNL in patients with kidney stones and urinary tract infection, which can effectively improve the clinical indicators, reduce the incidence of multiple organ dysfunction syndrome（MODS） and sepsis, shorten the length of stay, increase the treatment effect of stones, and is worthy of clinical promotion and application. The monitoring of PCT has significant clinical value in PCNL.