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前列腺癌患者经直肠超声引导下前列腺穿刺活检的相关危险因素。

Risk factors associated with transrectal ultrasound guided prostate needle biopsy in patients with prostate cancer.

作者信息

Lee Sheng-Hui, Chen Shao-Ming, Ho Chung-Rong, Chang Phei-Lang, Chen Chien-Lun, Tsui Ke-Hung

机构信息

Division of Geriatric Urology, Department of Surgery, Chang Gung Memorial Hospital at Taipei, Chang Gung University College of Medicine, Gueishan Township, Taoyuan County 333, Taiwan (R.O.C.).

出版信息

Chang Gung Med J. 2009 Nov-Dec;32(6):623-7.

Abstract

BACKGROUND

Transrectal ultrasound (TRUS) guided prostate needle biopsy is a commonly used diagnostic procedure. We determined associated risk factors for patients who suffered major complications and required hospitalization after TRUS-guided prostate biopsy.

METHODS

A total of 1,529 patients, 27 to 92 years old (mean 67.6 years) were included in this study conducted between January 2003 and July 2006. Each patient underwent sextant prostate biopsy under transrectal ultrasound guidance. Six-core transrectal biopsies were performed by urologists, consultant urologists and residents in training.

RESULTS

The mean prostate-specific antigen (PSA) level and prostate volume were 113.2 ng/ml and 46.2 grams, respectively. One hundred forty-seven patients had complications. Some patients may have had more than one complication, but no major sequelae were seen immediately after biopsy. Sixty-two (4.1%) of these patients had gross hematuria, while 26 (1.7%) had acute urinary retention, 21 (1.4%) had urinary tract infection, 17 (1.1%) had hematospermia,14 (0.9%) had anal bleeding and 7 (0.5%) had anal pain. Urinary tract infection and rectal preparation were found significantly associated with complications.

CONCLUSIONS

The results of our study demonstrate that minor complications occur without sequelae. Thus, TRUS-guided prostate needle biopsy is a safe and effective diagnostic tool. Urinary tract infection and rectal preparation might affect the complication rate.

摘要

背景

经直肠超声(TRUS)引导下的前列腺穿刺活检是一种常用的诊断方法。我们确定了经直肠超声引导下前列腺活检后发生严重并发症并需要住院治疗的患者的相关危险因素。

方法

本研究纳入了2003年1月至2006年7月期间的1529例患者,年龄在27至92岁之间(平均67.6岁)。每位患者在经直肠超声引导下进行前列腺六分区穿刺活检。由泌尿外科医生、泌尿外科顾问医生和接受培训的住院医生进行六针经直肠活检。

结果

前列腺特异性抗原(PSA)平均水平和前列腺体积分别为113.2 ng/ml和46.2克。147例患者出现并发症。有些患者可能有不止一种并发症,但活检后立即未发现严重后遗症。其中62例(4.1%)出现肉眼血尿,26例(1.7%)出现急性尿潴留,21例(1.4%)出现尿路感染,17例(1.1%)出现血精,14例(0.9%)出现肛门出血,7例(0.5%)出现肛门疼痛。发现尿路感染和直肠准备与并发症显著相关。

结论

我们的研究结果表明,轻微并发症不会留下后遗症。因此,经直肠超声引导下的前列腺穿刺活检是一种安全有效的诊断工具。尿路感染和直肠准备可能会影响并发症发生率。

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