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超声引导经直肠与经会阴前列腺穿刺活检的临床应用比较

[Comparison of ultrasound-guided transrectal and transperineal prostate biopsies in clinical application].

作者信息

Yuan Li-rong, Zhang Cheng-guang, Lu Lai-xing, Ruan Lei, Lan Jian-hong, Feng Sen-qiang, Luo Jin-dan

机构信息

Department of Urology, 2nd People’s Hospital of Yuhang, Hangzhou, Zhejiang, China.

出版信息

Zhonghua Nan Ke Xue. 2014 Nov;20(11):1004-7.

Abstract

OBJECTIVE

To compare the positive rates and complications of ultrasound-guided transrectal and transperineal prostate biopsies.

METHODS

We retrospectively analyzed 156 cases of ultrasound-guided transrectal (n = 97) and transperineal (n = 59) prostate biopsy, and compared the positive rate and post-biopsy complications between the two approaches.

RESULTS

The positive rates in the transrectal and transperineal groups were 48.4% and 44.1%, respectively, with no significant difference between the two approaches according to different PSA levels (P >0.05). No statistically significant differences were observed between the transrectal and transperineal groups in the post-biopsy incidence rates of such complications as hematuria (54.6% vs 42.4%, P >0.05), lower urinary tract symptoms (17.5% vs 22.0%, P >0.05), dysuria (9.3% vs 6.8%, P >0.05), and acute urinary retention (7.2% vs 6.8%, P >0.05). However, the incidence rates of post-biopsy infection and rectal bleeding were remarkably higher (15.5% vs 3.4%, P<0.05 and 50.5% vs 3.4%, P >0.01) while that of perineal swelling markedly lower in the former than in the latter (3.1% vs 13.6%, P <0.05).

CONCLUSION

Transrectal and transperineal biopsies are both effective for the diagnosis of prostate cancer. Since their complications vary, the choice between the two methods depends on the specific condition of the patient.

摘要

目的

比较超声引导下经直肠和经会阴前列腺穿刺活检的阳性率及并发症。

方法

回顾性分析156例超声引导下经直肠(n = 97)和经会阴(n = 59)前列腺穿刺活检病例,比较两种途径的阳性率及穿刺活检后并发症。

结果

经直肠组和经会阴组的阳性率分别为48.4%和44.1%,根据不同前列腺特异抗原(PSA)水平,两种途径之间无显著差异(P >0.05)。经直肠组和经会阴组在穿刺活检后血尿(54.6%对42.4%,P >0.05)、下尿路症状(17.5%对22.0%,P >0.05)、排尿困难(9.3%对6.8%,P >0.05)及急性尿潴留(7.2%对6.8%,P >0.05)等并发症的发生率方面无统计学显著差异。然而,穿刺活检后感染和直肠出血的发生率前者显著高于后者(15.5%对3.4%,P<0.05和50.5%对3.4%,P >0.01),而会阴部肿胀的发生率前者明显低于后者(3.1%对13.6%,P <0.05)。

结论

经直肠和经会阴穿刺活检对前列腺癌诊断均有效。由于两者并发症不同,两种方法的选择取决于患者的具体情况。

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