To explore the effect of Dexamethasone on systemic inflammatory response syndrome(SIRS) after percutaneous nephrolithotomy(PCNL)

There were 486 patients diagnosed with renal calculi and received PCNL in the Third Affiliated Hospital, Sun Yat-sen University from January 2011 to March 2015. After exclusion, 369 cases were included in the statistical analysis. And the patients were divided into two groups according to whether Dexamethasone was used during the operation. The incidence of fever and SIRS, and the data of other prognostic indicators were recorded.

There were 209 cases in the group Dexamethasone DEX(+), 160 cases in the other group DEX(-), there was no significant different between two groups about the baseline indicators (P>0.05). The operation time of group DEX(+) was longer than group DEX(-) [(106±74) min vs (81±58) min, P<0.001], the proportion of patients required to use of vasoactive drugs was higher in group DEX(+) (22.5% vs 8.8%, P<0.001), there were no significant difference in the need to transfusion or the size of between the two groups tube (P>0.05). The primary outcomes: there were no significant difference in the incidence of SIRS, fever, score of SIRS (P>0.05); The secondary outcomes: The incidence of postoperative hypotension was higher in group DEX(+) (14.8% vs 7.5%, P=0.03), the reduction of HGB level in group DEX(+) was more than group DEX(-) [(11.6±2.0) g/L vs (8.0±2.3) g/L, P<0.001], there were no significant difference in postoperative renal function and length of hospital stay between the two groups (P>0.05).

It dose not suggest that the intraoperative use of Dexamethasone has a preventive effect on the occurrence of SIRS after PCNL, however, further studies are needed to verify it.