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目的:探讨尿白细胞计数(WBC)及C反应蛋白(CRP)水平在经尿道输尿管镜下碎石术术后感染风险中的预测价值。方法:采用经尿道输尿管镜下碎石术治疗输尿管结石640例,术前24h内行尿常规及CRP检测。根据术前尿WBC计数10个/HP、CRP 8mg/L为界分组,统计分析两组术后感染发生率。其次,联合尿WBC计数、CRP进行亚组分组,统计分析四组术后感染发生率。结果:640例病例中,尿WBC<10个/HP 509例,>10个/HP 131例;CRP<8mg/L 481例,CRP>8mg/L 159例;发热68例,无发热572例。尿WBC>10个/HP的患者中,14.50%术后出现发热,与尿WBC<10个/HP相比,两组间术后感染发生率差异无统计学意义。术前CRP>8mg/L,术后感染发生率显著高于CRP正常患者(28.93%∶4.57%,P<0.001)。尿WBC>10个/HP、CRP>8mg/L术后感染发生率显著高于尿WBC<10个/HP、CRP>8mg/L,尿WBC>10个/HP、CRP<8mg/L以及尿WBC<10个/HP、CRP<8 mg/L三个亚组(36.36%∶26.98%∶7.14%∶3.92%,P<0.001)。结论:术前CRP水平>8mg/L是术后感染的重要危险因素,与尿WBC计数相比,更具重要的预测价值。综合考虑二个参数,可指导合理选择手术时机、加强术前准备,降低术后感染的风险。
Objective: To investigate the predictive value of urinary white cell count (WBC) and C-reactive protein (CRP) in the risk of transurethral ureteroscopic lithotripsy. Methods: Transurethral ureteroscopic lithotripsy was used to treat 640 cases of ureteral calculi. Urinary routine and CRP were performed 24h before surgery. According to preoperative urine WBC count 10 / HP, CRP 8mg / L as a bounded group, statistical analysis of the incidence of postoperative infection in both groups. Second, combined urinary WBC count, CRP subgroups, statistical analysis of the incidence of postoperative infection in four groups. Results: Among 640 cases, urine WBC was less than 10 / HP 509 cases,> 10 / HP 131 cases; CRP <8mg / L 481 cases, CRP> 8mg / L 159 cases; fever 68 cases, 572 without fever. 14.50% of the patients with urinary WBC> 10 / HP had fever after operation. There was no significant difference in the incidence of postoperative infection between the two groups as compared with the urine WBC <10 / HP. Preoperative CRP> 8mg / L, postoperative infection was significantly higher than the normal CRP patients (28.93%: 4.57%, P <0.001). The incidence of postoperative infection of WBC> 10 / HP and CRP> 8mg / L was significantly higher than that of urine WBC <10 / HP, CRP> 8mg / L, urine WBC> 10 / HP, CRP <8mg / L and urine WBC <10 / HP, CRP <8 mg / L three subgroups (36.36%: 26.98%: 7.14%: 3.92%, P <0.001). Conclusion: The preoperative CRP level> 8mg / L is an important risk factor for postoperative infection, which has more important predictive value than the urine WBC count. Considering two parameters can guide the rational choice of timing of operation, enhance preoperative preparation and reduce the risk of postoperative infection.