The Study Of Warning Sepsis Secondary To PNL

Objective:To establish an efficient methods for multiple parameters warning and diagnosis sepsis after percutaneous nephrolithotripsy.Methods:From October 2015 to May 2016,104 patients undergoing percutaneous nephrolithotomy in The Second Affiliated Hospital of Kunming Medical University-Department of Urology for Urolithiasis, and who fulfilled selection cr-iteria,were recruited into our study. Respiratory rate,heart rate and temperature were res-pectively record before operation and 2,6,24 hours after operation.The scores of PCT, interleukin-6 and high-sensitivity C-reactive protein were detected at op-erativeday, postoperative 2 hours, postoperative 6 hours, postoperative 24 hours. Patients were distributed as:sepsis group, without sepsis group with the help of Re-trospective analysis method.The parameters of two groups were compared at di-ferent times. And we used receiver operating characteristic(ROC) curve to evaluate the roles of indicators in early diagnosing the sepsis secondary to PNL.Results:IL-6 increased in sepsis groups at postoperative 2 hours,and the levels of serum IL-6 of sepsis group were significant higher than that of without sepsis (P<0.05). The area under the ROC curve (95%CI) for the prediction of sepsis were 0.870 (0.790-0.850) for IL-6. The optimal cutoff values in the diagnosis of urosepsis were 75.06pg/mL for IL-6 with a 87.12% sensitivity and 76.4% specificity. PCT and hs-CRP increased in sepsis groups at postoperative 6 hours,and the levels of PCT and hs-CRP of sepsis group were singnificant higher than that of without sepsis (P<0.05). The optimal cutoff values in the diagnosis of urosepsis were 0.53 ng/mL for PCT with a 95.71% sensitivity and 89.12% specificity and 25.23mg/L for hs-CRP with a 87.42% sensitivity and 65.73% specificity. the heart rate of Sepsis group increased at postoperative 6 hours,the ratio were significant higher than that of without sepsis (P<0.05). Body temperature rise at postoperative 24 hours for sepsis group, the ratio were significant higher than that of without sepsis (P<0.05).A peripheral leukocytecout was significantily higher in the sepsis group than in the without sepsis group.Conclusion:The incidence of sepsis secondary to PNL was 18.27%.PCT, hs-CRP,IL-6 increased, transfusion speed can warning sepsis occurrence, besides fever and a peripheral leukocytecout is of clinical value.