感染可能性评分对输尿管软镜术后尿脓毒症的早期预测价值

摘要

Objective To explore the screening value of infection probability score(IPS) in early prediction of urosepsis after flexible ureteroscope.Methods Totally 304 patients with upper urinary calculi after flexible ureteroscope from June 2013 to August 2015 were selected as the research object by purposive sampling method. The participants were divided into the infected group and the non-infected group based on systemic inflammatory response syndrome(SIRS) diagnostic criteria. The diagnostic test and ROC curve analysis were used to evaluate the diagnostic value and identify an appropriate cut-off score.Results The area under curve (AUC) of IPS was 0.812 (P<0.01) and the cut-off score was 14. The IPS retest Cronbach′s α was 0.754 and it had good construct validity. The sensitivity,specificity and Youden index of IPS ≥14 were 76.0%,85.0%,and 0.61,which indicated good consistency with SIRS diagnosis.Conclusions IPS has a high screening value in early prediction of urosepsis after flexible ureteroscope,and it can be applied to clinical practice.%目的：探讨感染可能性评分（IPS）对输尿管软镜术后尿源性脓毒血症的筛查价值。方法采用目的抽样法选取2013年6月—2015年8月304例上尿路结石输尿管软镜术后患者，以全身炎症反应综合征（SIRS）为诊断标准，将患者分为感染组和非感染组，采用诊断试验和ROC曲线分析方法，评价IPS的诊断价值，找出合适截断点。结果 IPS评分的ROC曲线下面积为0.812，差异有统计学意义（P＜0.01），且该评分的合适截断点为14分；IPS评分重测Cronbach′s α系数为0.754，且有较好的结构效度；IPS≥14分的灵敏度、特异度、约登指数分别为76.0%、85.0%、0.61，与SIRS诊断的一致性较好（k=0.724，P＜0.01）。结论 IPS评分对泌尿系结石术后尿源性脓毒血症具有较高的筛查价值，适合临床护士对输尿管软镜术后尿源性脓毒血症的筛查。