经会阴及经直肠前列腺穿刺活检安全性比较分析

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摘要目的:比较超声引导下经直肠与经会阴前列腺穿刺活检术诊断前列腺癌的安全性。方法:回顾性分析新疆维吾尔自治区人民医院及江西新余市人民医院2010年1月~2016年3月780例可疑前列腺癌患者初次行超声引导下经直肠与经会阴前列腺穿刺活检术的临床资料,对穿刺结果及穿刺后并发症情况做相关分析。结果:两组前列腺癌检出阳性率差异无统计学意义(P=0.846);两组患者年龄、前列腺体积、PSA值、体质指数及指诊异常均差异无统计学意义,手术时间差异有统计学意义。根据血清PSA水平分层比较血清PSA≤10 μg/L及＞10 μg/L两组肿瘤检出率差异无统计学意义;根据前列腺体积分层比较在前列腺体积＞50 ml时两组肿瘤检出率有统计学意义。两组在疼痛、血尿、便血、发热及菌血症方面差异有统计学意义。结论:两种前列腺穿刺方式肿瘤检出率相当、并发症少,是诊断前列腺癌的安全有效方法,在临床实践中可根据具体情况加以选择。

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	张培新贾宏亮艾尼娃蒲春林陈建森文彬李鸣李赟

关键词 ：前列腺肿瘤, 活组织检查, 直肠, 经会阴, 并发症

Abstract：To compare the safety between ultrasound-guided transrectal (TR) and transperineal (TP) approaches in prostate biopsy for prostate cancer detection. Methods: A retrospective study was conducted on 780 consecutive suspected prostate cancer patients initially given ultrasound-guided transrectal (n=412) and trasperineal (n=368) prostate biopsy, and the biopsy results and post-biopsy complications were compared between TR and TP. Results: The positive incidence in TR and TP groups was not significantly different (P=0.846). The age, prostate volume, PSA value, body mass index and digital examination between two groups showed no significant difference, and there was significant difference in operation time between two groups. The positive incidence between two groups according to PSA valus (PSA≤10 μg/L or >10 μg/L) was not significantly different. The positive incidence between two groups was significantly different while the prostate volume was greater than 50 mL. The complication rate in pain, hematuria, hematochezia, fever and bacteriaemia between two groups was significantly different. Conclusions: TR and TP are safe and effective for the diagnosis of prostate tumour, owing to the comparative tumor detection rate and few complication rate, and the option between TR and TP in clinical practice depends on the certain circumstances of each patient.

Key words： prostate turmour biopsy transrectal transperineal complication

收稿日期: 2016-05-03

ZTFLH:

R737.25

基金资助:新疆维吾尔自治区人民医院院级课题资助(20120130)

通讯作者: 李赟644823493@qq.com

引用本文:

张培新贾宏亮艾尼娃蒲春林陈建森文彬李鸣李赟. 经会阴及经直肠前列腺穿刺活检安全性比较分析[J]. 微创泌尿外科杂志, 2016, 5(5): 281-284.
Zhang Peixini Jia Hongliang Aniwan Pu Chunlin
Chen Jiansen Wen Bin Li Ming Li Yun. A comparative evaluation of transrectal versus
transperineal prostate biopsy in safety. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2016, 5(5): 281-284.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1210.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2016/V5/I5/281

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