Study On The Effect Of Carboxymethyl Chitosan Washing Solution To Prevent Flexible Ureteroscopic Lithotripsy Infection,Bleeding And Pain After Operation

Objective Flexible ureteroscopic lithotripsy is a rubble and stone surgery through the body's natural urinary tract.Although the operation has a high stone discharge rate,shorter hospitalization time,a relatively lower incidence of complications,the flexible ureteroscopic lithotripsy postoperative systemic inflammatory response,urinary tract infections,bleeding and pain are widely reported,which seriously affect the prognosis and quality of life of patients.Carboxymethyl chitosan washing solution is a kind of washing solution that can prevent adhesion,promote cell growth,tissue regeneration,and wound healing.It also has strong hemostasis and antibacterial activity.It has been widely used in gynecology,orthopedics,urology and other surgical fields,and shows good effects in preventing postoperative infection and strengthening hemostasis.Therefore,the purpose of this study was to analyze the effect of carboxymethyl chitosan washing solution on the occurrence of systemic inflammatory reaction syndrome,urinary tract infection,bleeding and pain after flexible ureteroscopic lithotripsy and its clinical application value.Methods A total of 200 cases of patients with upper urinary tract stones admitted to our hospital from December 2016 to June 2018 were selected and treated with flexible ureteroscopic lithotripsy.They were randomly divided into the control group and the observation group with 100 cases in each group.Normal saline was used in the control group during the operation,and carboxymethyl chitosan washing solution was used in the observation group.Serum CRP level,WBC count and neutrophil percentage were compared between the two groups before surgery,and at 2h,24 h after surgery.The incidence of SIRS and urinary tract infection rate were compared between the two groups.The bleeding time and amount were compared between the two groups.And the pain level was compared between the two groups at 1h,24 h,48h after surgery.Following up after surgery half a year,the removal rate,recurrence rate and complications were compared between the two groups.Results 1.The serum CRP level,WBC count and neutrophil percentage in the observation group were significantly lower than those in the control group at 2 h and 24 h after operation.The difference was statistically significant.2.The incidence of SIRS and bacteriuria in the observation group were significantly lower than those in the control group.The difference was statistically significant(P<0.05).3.The bleeding time and amount of the observation group were significantly lower than that of the control group,and the difference was statistically significant(P <0.05).4.The degree of pain of the observation group has no difference with the control group before at 1h after operation.The degree of pain of the observation group was alleviated than the control group before at 24 h,48h after operation and the difference was statistically significant(P < 0.05).5.The removal effect of stone in the observation group was consistent with no statistical difference with the control group(P>0.05).The recurrence rate was different between the two groups,but no statistical significance(P>0.05)after half a year following-up.The incidence of complications in the observation group was less than the control group,the difference was statistically significant(P<0.05).Conclusions Carboxymethyl chitosan washing solution is safe and effective for preventing systemic inflammatory reaction syndrome,urinary tract infection,bleeding and pain after ureteroscopic lithotripsy.