Department of Urology, Cheeloo College of Medicine, Shandong Provincial Hospital, Shandong University, No. 324 Jingwu Road, Huaiyin District, Jinan, 250021, Shandong, China.
Department of Urology, The Second Affiliated Hospital Affiliated to Shandong First Medical University, Taian, Shandong, China.
Int Urol Nephrol. 2021 Apr;53(4):669-677. doi: 10.1007/s11255-020-02718-1. Epub 2021 Jan 7.
To investigate whether the perioperatively combined application of dexamethasone and furosemide could alleviate the inflammation in patients undergoing percutaneous nephrolithotomy (PCNL).
147 patients undergoing PCNL between November 2018 and October 2019 were enrolled in the study. 77 patients accepted a single dose of dexamethasone and furosemide administration (EXP group, n = 77), and 70 patients did not (CON group, n = 70). Demographic and perioperative data, inflammatory markers including interleukin-6 (IL-6) and procalcitonin (PCT), and clinical outcomes were compared between the two groups.
Compared with the CON group, the incidence rate of urosepsis of the EXP group were significantly lower (11.69% vs. 24.29%, p = 0.046). 3 patients developed severe urosepsis in the EXP group, while 5 patients developed severe urosepsis in the CON group. Compared with those in the CON group, the patients with postoperative urosepsis in the EXP group showed lower serum levels of IL-6 at postoperative hour two (p = 0.045) and at postoperative day one (p = 0.031) and lower serum levels of PCT at postoperative day one (p = 0.015). There was a better clinical outcome of a shorter postoperative hospital stay (p = 0.015) in patients with postoperative urosepsis in the EXP group than in those in the CON group.
The perioperatively combined application of dexamethasone and furosemide was beneficial for alleviating postoperative inflammatory reaction and caused a better clinical outcome of a shorter postoperative hospital stay.
研究地塞米松和呋塞米联合应用是否能减轻经皮肾镜取石术（PCNL）患者的炎症反应。
研究纳入了 2018 年 11 月至 2019 年 10 月期间接受 PCNL 的 147 例患者。其中 77 例患者接受地塞米松和呋塞米单次给药（EXP 组，n=77），70 例患者未接受（CON 组，n=70）。比较两组患者的一般资料和围手术期数据、炎症标志物白细胞介素-6（IL-6）和降钙素原（PCT）以及临床结局。
与 CON 组相比，EXP 组尿脓毒症的发生率明显较低（11.69% vs. 24.29%，p=0.046）。EXP 组有 3 例发生严重尿脓毒症，CON 组有 5 例发生严重尿脓毒症。与 CON 组相比，EXP 组术后发生尿脓毒症的患者术后 2 小时（p=0.045）和术后 1 天（p=0.031）血清 IL-6 水平较低，术后 1 天（p=0.015）血清 PCT 水平较低。EXP 组术后发生尿脓毒症患者的临床结局更好，术后住院时间更短（p=0.015）。
地塞米松和呋塞米联合应用可减轻术后炎症反应，缩短术后住院时间，改善临床结局。
