直肠超声引导下经直肠与经会阴前列腺穿刺活检的临床价值比较

摘要

Objective To compare the clinical value of transperineal and transrectal prostate biopsy guided by transrectal ultrasonography in diagnosis of prostate cancer. Methods From July 2009 to December 2012, there were 78 and 83 patients underwent transrectal and transperineal prostate biopsy, respectively. Retrospective analysis their materials, and compared their pre-operation data, positive rate of prostate cancer and complication rate. Results There is no significant difference of serum PSA, prostatic volume and positive rate of nodules of these two groups. The complication rate of fever of patients underwent transrectal prostate biopsy were significant higher than patients underwent transperineal prostate biopsy, but the positive rate of prostate cancer, pain, hematuria, bloody stools urinary retention was similar. Conclusion Both of transperineal and transrectal prostate biopsy guided by transrectal ultrasonography are effective way for diagnosis prostate cancer. When choosing appropriate way for biopsying, the result of digital rectal examination, transrectal ultrasound and patients' condition should be considered.%　　目的比较直肠超声引导下经直肠与经会阴前列腺穿刺活检术在诊断前列腺癌的临床价值。方法回顾分析2009年7月-2012年12月间在本院行直肠超声引导下经直肠前列腺穿刺活检术的78例患者与行直肠超声引导下经会阴前列腺穿刺活检术的83例患者资料，比较两组患者的术前资料、前列腺癌阳性检出率及穿刺并发症。结果两组患者的术前血清PSA、前列腺体积及结节阳性率无明显差别，经直肠穿刺术后患者并发发热的比例明显高于经会阴穿刺的患者，而前列腺癌阳性检出率，术后疼痛、血尿、血便和尿潴留的发生率无明显差异。结论经直肠超声引导下的经直肠穿刺和经会阴穿刺前列腺活检术都是有效的活检方法。应根据患者直肠指检是否扪及肿块、经直肠超声是否发现占位来选择穿刺方法。